Outcomes after treatment of acute aortic occlusion.

Science.gov (United States)

de Varona Frolov, Serguei R; Acosta Silva, Marcela P; Volo Pérez, Guido; Fiuza Pérez, Maria D

2015-11-01

Acute aortic occlusion (AAO) is a rare disease with high morbidity and mortality. The aim of this study was to describe the results of surgical treatment of acute aortic occlusion and risk factors for mortality. Retrospective review of the clinical history of 29 patients diagnosed and operated on for AAO during 28 years. The following variables were analysed: age, sex, tabaco use, diabetes, chronic renal insufficiency, chronic heart failure, atrial fibrillation, arterial hypertension, symptoms, diagnosis and treatment, 30-day mortality and long-term survival. A univariant analysis was performed of variables related to mortality. Twenty-nine patients were included (18 male) with a mean age of 66,2 years. The aetiology was: embolism (EM) in 11 cases and Thrombosis (TR) in 18 cases. The surgical procedures performed included bilateral transfemoral thrombectomy (14 cases), aorto-bifemoral by-pass (8 cases), axilo uni/bifemoral by-pass (5 cases) and aortoiliac and renal tromboendarterectomy (2 cases). Morbidity included: renal failure (14 cases), mesenteric ischemia (4 cases), cardiac complications (7 cases), respiratory complications (5 cases) and loss of extremity (2 cases). The in-hospital mortality was 21% (EM 0%, TR 21%). The estimated survival at 1.3 and 5 years was 60, 50 and 44% respectively. Age (p=0.032), arterial hypertension (p=0.039) and aetiology of the AAO (p=0.039) were related to mortality. Acute aortic occlusion is a medical emergency with high mortality rates. Acute renal failure is the most common postoperative complication. Copyright © 2012 AEC. Publicado por Elsevier España, S.L.U. All rights reserved.

Collateral Circulation in Chronic Total Occlusions - An Interventional Perspective

Science.gov (United States)

Choo, Gim-Hooi

2015-01-01

Human coronary collaterals are inter-coronary communications that are believed to be present from birth. In the presence of chronic total occlusions, recruitment of flow via these collateral anastomoses to the arterial segment distal to occlusion provide an alternative source of blood flow to the myocardial segment at risk. This mitigates the ischemic injury. Clinical outcome of coronary occlusion ie. severity of myocardial infarction/ischemia, impairment of cardiac function and possibly survival depends not only on the acuity of the occlusion, extent of jeopardized myocardium, duration of ischemia but also to the adequacy of collateral circulation. Adequacy of collateral circulation can be assessed by various methods. These coronary collateral channels have been used successfully as a retrograde access route for percutaneous recanalization of chronic total occlusions. Factors that promote angiogenesis and further collateral remodeling ie. arteriogenesis have been identified. Promotion of collateral growth as a therapeutic target in patients with no suitable revascularization option is an exciting proposal.

Collateral Circulation in Chronic Total Occlusions - an interventional perspective.

Science.gov (United States)

Choo, Gim-Hooi

2015-09-09

Human coronary collaterals are inter-coronary communications that are believed to be present from birth. In the presence of chronic total occlusions, recruitment of flow via these collateral anastomoses to the arterial segment distal to occlusion provide an alternative source of blood flow to the myocardial segment at risk. This mitigates the ischemic injury. Clinical outcome of coronary occlusion ie. severity of myocardial infarction/ischemia, impairment of cardiac function and possibly survival depends not only on the acuity of the occlusion, extent of jeopardized myocardium, duration of ischemia but also to the adequacy of collateral circulation. Adequacy of collateral circulation can be assessed by various methods. These coronary collateral channels have been used successfully as a retrograde access route for percutaneous recanalization of chronic total occlusions. Factors that promote angiogenesis and further collateral remodeling ie. arteriogenesis have been identified. Promotion of collateral growth as a therapeutic target in patients with no suitable revascularization option is an exciting proposal.

Aortoiliac reconstructive surgery based upon the results of duplex scanning

NARCIS (Netherlands)

van der Zaag, E. S.; Legemate, D. A.; Nguyen, T.; Balm, R.; Jacobs, M. J.

1998-01-01

OBJECTIVE: To evaluate whether duplex scanning can replace angiography in patients operated for aortoiliac obstructive disease. DESIGN: Retrospective. MATERIALS AND METHODS: Between January 1995 and October 1996, 44 patients underwent vascular surgery of the aortoiliac tract. The study population

Endovascular Treatment of an Aortoiliac Tuberculous Pseudoaneurysm

International Nuclear Information System (INIS)

Villegas, Miguel O.; Mereles, Alberto Pérez; Tamashiro, Gustavo A.; Dini, Andrés E.; Mollón, Ana P.; De Cándido, Laura V.; Zelaya, Denis A.; Soledispa-Suarez, Carlos I.; Denato, Sergio; Tamashiro, Alberto; Diaz, Jose A.

2013-01-01

We report a rare case of a tuberculous mycotic aortoiliac pseudoaneurysm treated with an endovascular procedure and follow-up of 36 months. The patient was a white 72-year-old man with pulmonary tuberculosis and a former smoker with hypertension, chronic renal failure, and dyslipidemia. A computed tomographic scan of the abdomen and pelvis revealed a left paravertebral cavity with fluid content and involvement of vertebrae L2–L4. After a surgical repair attempt, the patient was treated with the implant of a bifurcated endoprosthesis. Because it is unlikely that any center has extensive experience in the management of this rare manifestation of the disease, we reviewed the literature for similar cases.

Endovascular Treatment of an Aortoiliac Tuberculous Pseudoaneurysm

Energy Technology Data Exchange (ETDEWEB)

Villegas, Miguel O.; Mereles, Alberto Perez; Tamashiro, Gustavo A.; Dini, Andres E.; Mollon, Ana P.; De Candido, Laura V.; Zelaya, Denis A.; Soledispa-Suarez, Carlos I.; Denato, Sergio; Tamashiro, Alberto; Diaz, Jose A., E-mail: joseantoniodiaz@hotmail.com [Hospital Nacional Prof. Alejandro Posadas, Department of Cardiology, Section of Hemodinamia (Argentina)

2013-04-15

We report a rare case of a tuberculous mycotic aortoiliac pseudoaneurysm treated with an endovascular procedure and follow-up of 36 months. The patient was a white 72-year-old man with pulmonary tuberculosis and a former smoker with hypertension, chronic renal failure, and dyslipidemia. A computed tomographic scan of the abdomen and pelvis revealed a left paravertebral cavity with fluid content and involvement of vertebrae L2-L4. After a surgical repair attempt, the patient was treated with the implant of a bifurcated endoprosthesis. Because it is unlikely that any center has extensive experience in the management of this rare manifestation of the disease, we reviewed the literature for similar cases.

Aorto-iliac occlusive disease in the different population groups ...

African Journals Online (AJOL)

Background. It has previously been accepted that atherosclerotic disease is uncommon among blacks worldv.ride; however, recent studies have increasingly reported atherosclerotic disease in this group. Study design. Prospective study of hospital patients with aorta-iliac occlusive disease presenting to the vascUlar ...

Endovascular Treatment of Anastomotic Pseudoaneurysms after Aorto-iliac Surgical Reconstruction

International Nuclear Information System (INIS)

Lagana, Domenico; Carrafiello, Gianpaolo; Mangini, Monica; Recaldini, Chiara; Lumia, Domenico; Cuffari, Salvatore; Caronno, Roberto; Castelli, Patrizio; Fugazzola, Carlo

2007-01-01

Purpose. To assess the effectiveness of endovascular treatment of anastomotic pseudoaneurysms (APAs) following aorto-iliac surgical reconstruction. Materials. We retrospectively evaluated 21 men who, between July 2000 and March 2006, were observed with 30 APAs, 13 to the proximal anastomosis and 17 to the distal anastomosis. The patients had had previous aorto-iliac reconstructive surgery with a bypass due to aneurysm (15/21) or obstructive disease (6/21). The following devices were used: 12 bifurcated endoprostheses, 2 aorto-monoiliac, 4 aortic extenders, 1 stent-graft leg, and 2 covered stents. Follow-up was performed with CT angiography at 1, 3, and 6 months after the procedure and yearly thereafter. Results. Immediate technical success was 100%. No periprocedural complications occurred. Four patients died during follow-up from causes not related to APA, and 1 (treated for prosthetic-enteric fistula) from sepsis 3 months after the procedure. During a mean follow-up of 19.7 months (range 1-72 months), 2 of 21 occlusions of stent-graft legs occurred 3 and 24 months after the procedure (treated with thrombolysis and percutaneous transluminal angioplasty and femorofemoral bypass, respectively) and 1 type I endoleak. Primary clinical success rate was 81% and secondary clinical success was 91%. Conclusion. Endovascular treatment is a valid alternative to open surgery and can be proposed as the treatment of choice for APAs, especially in patients who are a high surgical risk. Further studies with larger series and longer follow-up are necessary to confirm the long-term effectiveness of this approach

Vena Cava Filter Retrieval with Aorto-Iliac Arterial Strut Penetration.

Science.gov (United States)

Holly, Brian P; Gaba, Ron C; Lessne, Mark L; Lewandowski, Robert J; Ryu, Robert K; Desai, Kush R; Sing, Ronald F

2018-05-03

To evaluate the safety and technical success of inferior vena cava (IVC) filter retrieval in the setting of aorto-iliac arterial strut penetration. IVC filter registries from six large United States IVC filter retrieval practices were retrospectively reviewed to identify patients who underwent IVC filter retrieval in the setting of filter strut penetration into the adjacent aorta or iliac artery. Patient demographics, implant duration, indication for placement, IVC filter type, retrieval technique and technical success, adverse events, and post procedural clinical outcomes were identified. Arterial penetration was determined based on pre-procedure CT imaging in all cases. The IVC filter retrieval technique used was at the discretion of the operating physician. Seventeen patients from six US centers who underwent retrieval of an IVC filter with at least one strut penetrating either the aorta or iliac artery were identified. Retrieval technical success rate was 100% (17/17), without any major adverse events. Post-retrieval follow-up ranging from 10 days to 2 years (mean 4.6 months) was available in 12/17 (71%) patients; no delayed adverse events were encountered. Findings from this series suggest that chronically indwelling IVC filters with aorto-iliac arterial strut penetration may be safely retrieved.

Cost-effectiveness of identifying aortoiliac and femoropopliteal arterial disease with angiography or duplex scanning

International Nuclear Information System (INIS)

Coffi, S.B.; Ubbink, D.Th.; Dijkgraaf, M.G.W.; Reekers, J.A.; Legemate, D.A.

2008-01-01

Objectives: Cost-effectiveness analysis of three diagnostic imaging strategies for the assessment of aortoiliac and femoropopliteal arteries in patients with peripheral arterial occlusive disease. The strategies were: angiography as the reference strategy, duplex scanning (DS) plus supplementary angiography (S1) and DS plus confirmative angiography (S2). Design, materials and methods: A decision model was built with sensitivity and specificity data from literature, supplemented with prospective hospital cost data in Euro ( Euro ). The probability of correctly identifying the status of a lesion was taken as the primary outcome. We compared strategies by assessing the extra costs per additional correctly identified case. Results: Assuming no false positive or false negative results, angiography is the most effective strategy if the prevalence of significant obstructive lesions in the aortoiliac and femoropopliteal tract exceeds 70%, or if the sensitivity of duplex scanning is lower than 83%. In case of lower prevalence, strategy S1 becomes equally or even more effective than angiography. At a prevalence of 75%, performing angiography costs Euro 8443 per extra correctly identified case compared with strategy S1. Conclusions: In most situations angiography is more effective than diagnostic strategy S1. However, if society is unwilling to pay more than Euro 8443 for knowing a patient's disease status, diagnostic strategy S1 is a cost-effective alternative to angiography, especially at lower prevalence values

Differentiation of chronic total occlusion and subtotal occlusion of the femoropopliteal artery-role of retrograde flow sign and collateral circulation on CT angiography images.

Science.gov (United States)

Zhang, Shujun; Su, Yanfei; Chen, Haisong

2017-08-01

To study the value of a retrograde flow sign and the collateral circulation on CT angiography (CTA) for the differential diagnosis of chronic total occlusion from subtotal occlusion of the femoropopliteal artery (FPA). 50 patients with obstruction of the FPA underwent CTA and digital subtraction angiography examinations of the lower limbs. The frequency of a retrograde flow sign and collateral circulation on CTA in chronic total and subtotal occlusion was noted and analyzed, with the results of digital subtraction angiography as a standard to judge total or subtotal occlusion. The decreasing CT value from the distal to proximal direction on CTA suggests the existence of retrograde flow. There were significant differences in the occurrence rates of a retrograde flow sign on CTA in the chronic total and subtotal obstruction groups (X 2 = 13.1, p collateral circulation sign (X 2 = 13.5, p collateral circulation sign to diagnose chronic total obstruction of the FPA had a sensitivity of 92.3% and specificity of 89.8%. The retrograde flow sign combined with a collateral circulation sign is of great clinical value for differentiation of chronic total stenosis from severe stenosis (subtotal occlusion) of the FPA. Advances in knowledge: A retrograde flow sign combined with a collateral circulation sign is of great clinical value to differentiate between chronic total stenosis and severe stenosis (subtotal occlusion) of the FPA.

Epidemiology of aortic disease - aneurysm, dissection, occlusion

International Nuclear Information System (INIS)

Steckmeier, B.

2001-01-01

The physiological infrarenal aortic diameter varies between 12.4 mm in women an 27.6 mm in men. As defined, an aneurysmatic dilatation begins with 29 mm. According to that, 9% of all people above the age of 65 are affected by an abdominal aortic aneurysm (AAA). Compared with the female sex, the male sex predominates at a rate of about 5:1. The disease is predominant in men of the white race. In black men, black and white women the incidence of AAA is identical. 38 to 50 percent of the AAA patients (patients) suffer from hypertension, 33 to 60% from coronary, 28% from cerebrovascular and 25% from peripheral occlusive disease. The AAA expansion rate varies between 0.2 and 0.8 cm per year and is exponential from a diameter of 5 cm on. In autopsy studies, the rupture rates with AAA diameters of 7 cm were below 5%, 39% and 65%, respecitvely. 70% of the AAA patients do not die of a rupture, but of a cardiac disease. Serum markers, such as metalloproteinases and procollagen peptides are significantly increased in AAA patients. Thoraco-abdominal aneurysms (TAA) make up only 2 to 5% of all degenerative aneurysms. 20 to 30% of the TAA patients are also affected by an AAA. 80% of the TAA are degenerative, 15 to 20% are a consequence of the chronic dissection - including 5% of Marfan patients -, 2% occur in case of infections and 1 to 2% in case of aortitis. The TAA incidence in 100,000 person-years is 5.9% during a monitoring period of 30 years. In case of TAA, an operation is indicated with a maximum diameter of 5.5 to 6 cm and more and, in case of a Marfan's syndrome (incidence of 1:10,000), with a maximum diameter of 5.5 cm and more. With regard to aorto-iliac occlusive diseases, there are defined 3 types of distribution. Type I refers to the region of the bifurcation itself. Type II defines the diffuse aortoiliac spread of the disease. Type III designates multiple-level occlusions also beyond the inguinal ligament. Type I patients in most cases are female and more

The reentry catheter: a second chance for endoluminal reentry at difficult lower extremity subintimal arterial recanalizations.

Science.gov (United States)

Etezadi, Vahid; Benenati, James F; Patel, Parag J; Patel, Rahul S; Powell, Alex; Katzen, Barry T

2010-05-01

From January 2005 to July 2008, a retrospective study was conducted at a single institution to investigate technical success of the use of a reentry device (Outback LTD reentry catheter) in aortoiliac and femoropopliteal artery recanalization in 34 patients (18 men; mean age +/- SD, 72 years +/- 11) in whom the conventional guide wires and catheters failed to reenter the true lumen. True lumen reentry was achieved in 87% (n = 23) and 91% (n = 11) of patients with femoropopliteal and aortoiliac occlusions, respectively. The overall technical success rate with the device was 88% (n = 34). The device success rate in Transatlantic Inter-Society Consensus II class D lesions was significantly lower than in lower lesion classes (71.4% vs 100%; P < .05). No procedure-related complications were encountered. In conclusion, the use of the reentry catheter enhances the likelihood of successful subintimal recanalization of chronic occlusions in femoropopliteal and aortoiliac arteries.

Percutaneous endovascular therapy for symptomatic chronic total occlusion of the left subclavian artery.

Science.gov (United States)

Akif Cakar, Mehmet; Tatli, Ersun; Tokatli, Alptug; Kilic, Harun; Gunduz, Huseyin; Akdemir, Ramazan

2018-03-16

Percutaneous endovascular therapy is an accepted and preferred procedure for symptomatic subclavian artery disease. However, the technical feasibility and effectiveness of treating chronic total occlusion of the subclavian artery with this approach is uncertain. We aimed to evaluate the initial and mid-term results of endovascular therapy for patients with symptomatic chronic total occlusion of the left subclavian artery. Consecutive patients who underwent balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery between January 2010 and February 2014 were included. Overall, 16 patients (10 male, 6 female; mean age 56 ± 13 years) underwent balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery - 6 (37.5%) had arm claudication, 8 (50.0%) had vertebrobasilar insufficiency and 2 (12.5%) had coronary steal. 18 balloon-expandable stents were implanted to 15 patients. The central luminal passage was not achieved in one patient because of the subintimal position of guidewire (procedural success rate 93.8%). There were no procedure-related complications. Mean preprocedural and postprocedural systolic blood pressure differences between the upper extremities were 37 ± 13 (range 25-60) mmHg and 11 ± 9 (range 5-38) mmHg, respectively; the improvement was statistically significant. Outpatient follow-up revealed one asymptomatic restenosis at two years. Patency rate at two years was 93.3%. Balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery is safe and effective, with good acute success rate and mid-term patency. Prospective randomised studies on larger patient populations would provide more precise results.

Carotid angioplasty with stenting for chronic internal carotid artery occlusion: technical note

Energy Technology Data Exchange (ETDEWEB)

Kobayashi, Nozomu; Tanasawa, Toshihiko; Okada, Takeshi; Endo, Otone; Yamamoto, Naohito [Kainan Hospital Aichi Prefectural Welfare Federation of Agricultural Cooperatives, Department of Neurosurgery, Aichi (Japan); Miyachi, Shigeru; Hattori, Kenichi [Nagoya University Graduate School of Medicine, Department of Neurosurgery, Nagoya (Japan)

2006-11-15

Carotid angioplasty with stenting (CAS) is becoming accepted as an effective and reliable treatment option for severe carotid artery stenosis. However, it is rarely applied for carotid occlusion, especially in its chronic stage. We report our experience of CAS for chronic internal carotid artery occlusion representing compromised cerebral blood flow using various protection methods. A 77-year-old woman, who was already diagnosed with severe left internal carotid artery stenosis, suddenly had right hemiparesis and aphasia. At that time, she was treated conservatively because her neurological status was quite good, in spite of left carotid artery occlusion. Her symptoms improved in the short term, except slight aphasia, but deteriorated again 18 days from the onset, and magnetic resonance imaging (MRI) showed new ischemic lesions. CAS was then performed for the occluded carotid artery on the 23rd day from the first onset. Using the proximal protection technique, the occluded lesion was crossed carefully with a microguidewire. Stents were also placed successfully with the distal protection technique. The occluded carotid artery was completely recanalized without any unfavorable events or neurological deterioration. In this patient, CAS was successfully to treat chronic carotid artery occlusion. These procedures and techniques are reviewed and discussed. (orig.)

Carotid angioplasty with stenting for chronic internal carotid artery occlusion: technical note

International Nuclear Information System (INIS)

Kobayashi, Nozomu; Tanasawa, Toshihiko; Okada, Takeshi; Endo, Otone; Yamamoto, Naohito; Miyachi, Shigeru; Hattori, Kenichi

2006-01-01

Carotid angioplasty with stenting (CAS) is becoming accepted as an effective and reliable treatment option for severe carotid artery stenosis. However, it is rarely applied for carotid occlusion, especially in its chronic stage. We report our experience of CAS for chronic internal carotid artery occlusion representing compromised cerebral blood flow using various protection methods. A 77-year-old woman, who was already diagnosed with severe left internal carotid artery stenosis, suddenly had right hemiparesis and aphasia. At that time, she was treated conservatively because her neurological status was quite good, in spite of left carotid artery occlusion. Her symptoms improved in the short term, except slight aphasia, but deteriorated again 18 days from the onset, and magnetic resonance imaging (MRI) showed new ischemic lesions. CAS was then performed for the occluded carotid artery on the 23rd day from the first onset. Using the proximal protection technique, the occluded lesion was crossed carefully with a microguidewire. Stents were also placed successfully with the distal protection technique. The occluded carotid artery was completely recanalized without any unfavorable events or neurological deterioration. In this patient, CAS was successfully to treat chronic carotid artery occlusion. These procedures and techniques are reviewed and discussed. (orig.)

Chronic total coronary occlusion: treatment results.

Science.gov (United States)

Kirk Christensen, Martin; Freeman, Phillip Fischer; Rasmussen, Jeppe Groendal; Villadsen, Anton Boel; Raungaard, Bent; Eggert Jensen, Svend; Thuesen, Leif

2017-08-01

To describe the clinical and procedural coronary chronic total occlusion (CTO) treatment results in a Nordic PCI centre during the implementation of a CTO treatment program. In a retrospective registry study, we assessed; (1) indication for the procedure, (2) Canadian Cardiovascular Society angina pectoris score (CCS)/New York Heart Association (NYHA) heart failure score, (3) lesion complexity and (4) adverse events during hospital stay and three months following the index procedure. The study cohort included 503 patients (594 lesions). From 2010 to 2013 96% of procedures were performed with antegrade wire-escalation technique and 4% performed using retrograde techniques, from 2013-2016 the corresponding numbers were 83% and 17.0%. The procedural success rate was 69%, increasing from 64% before to 72% (p = .06) after routinely using the retrograde approach. No individual patient characteristic, lesion variable or score was strongly associated with procedural success or failure. There were 4% serious procedure related complications. In patients with PCI of a CTO lesion only, 87% were in CCS or NYHA functional class ≥2 before the index procedure vs. 22% at follow-up. Routine use of retrograde techniques tended to increase the procedural success rate. Clinical results after three months were acceptable, but the complication rate was higher than for non-CTO PCI. Individual patient and lesion characteristics had a low predictability for procedural success. Therefore, clinical symptoms, objective signs of myocardial ischemia and procedural risk should be focus points in coronary chronic total occlusion treatment strategies.

The modified pulse-spray method using Urokinase in subacute and chronic thrombotic arterial occlusion

International Nuclear Information System (INIS)

Kim, Youn Kil; Hahn, Seong Tae; Baek, Jee Hee; Kim, Choon Yul; Shinn, Kyung Sub

1996-01-01

To evaluate the effectiveness and safety of the modified pulse-spray method using Urokinase(UK) in subacute and chronic thrombotic arterial occlusion. Modified pulse-spray methods using UK were performed in seven patients with subacute (1 week-1month) to chronic (1month-5years) occlusive symptoms such as limb pain, claudication and impotence. Angiographic examination revealed thrombotic occlusion of the aorta, common iliac arteries, brachial arterio-venous hemodialysis graft and femoro-popliteal bypass graft. The patients underwent thrombolysis using modified pulse-spray and additional constant infusion of UK. In the presence of underlying stenosis or organized clots, balloon angioplasty or stent placement was performed. Complete lysis was obtained in five of seven patients. For initial lysis, the mean dose of UK was 420,000 units, and the mean modified pulse-spray time was 50 minutes. Mean total dose of UK and mean total time for complete lysis were 800,000 units and 161 minutes, respectively. Thrombolysis of the femoro-popliteal bypass graft failed due to severe occlusion of the distal anastomosis. Partial lysis was achieved in one patient with aorto-illac occlusion, but further thrombolysis was stopped due to bleeding at the puncture site. The modified pulse-spray method using UK is effective in treating subacute and chronic arterial thrombotic occlusion. It augments the speed, safety and efficacy of thrombolysis. When underlying stenosis or organized clots remain after thrombolysis, ballon angioplasty or stent placement would be helpful

Mortality and complications after aortic bifurcated bypass procedures for chronic aortoiliac occlusive disease

DEFF Research Database (Denmark)

Bredahl, Kim; Jensen, Leif Panduro; Schroeder, Torben V

2015-01-01

skills, particularly because open surgery is increasingly used in those patients who are unsuitable for endovascular repair and hence technically more demanding. We assessed the early outcome after aortic bifurcated bypass procedures during two decades of growing endovascular activity and identified...... preoperative risk factors. METHODS: Data on patients with chronic limb ischemia were prospectively collected during a 20-year period (1993 to 2012). The data were obtained from the Danish Vascular Registry, assessed, and merged with data from The Danish Civil Registration System. RESULTS: We identified 3623...... aortobifemoral and 144 aortobiiliac bypass procedures. The annual caseload fell from 323 to 106 during the study period, but the 30-day mortality at 3.6% (95% confidence interval [CI], 3.0-4.1) and the 30-day major complication rate remained constant at 20% (95% CI, 18-21). Gangrene (odds ratio [OR], 3.3; 95% CI...

Neuroendoscopic treatment of idiopathic occlusion of unilateral foramen of Monro presenting as chronic headache

Directory of Open Access Journals (Sweden)

Dhaval Shukla

2016-01-01

Full Text Available Asymmetric ventriculomegly due to idiopathic occlusion of the foramen of Monro is rare. Such patients present with clinical features of raised intracranial pressure (ICP. Presentation as chronic headache has not been previously described. In the absence of raised ICP, pursuing surgical treatment raises a clinical dilemma as the headache may be a primary headache with no improvement after surgery. A 21-year-old woman presented with chronic headache. She was found to have asymmetric ventriculomegaly due to the occlusion of the foramen of Monro. She underwent endoscopic septostomy and widening of the foramen of Monro. Her headache subsided after surgery. At 15 months of follow-up, she was free from headache without medications. Unilateral occlusion of the foramen of Monro can present with asymmetric ventriculomegaly resulting in chronic headache. Though the symptoms of raised ICP may not be present, still endoscopic relief of ventriculomegaly leads to cure of headache.

Morphological characteristics of chronic total occlusion. Predictors of different strategies for long-segment femoral arterial occlusions

Energy Technology Data Exchange (ETDEWEB)

Wei, Li-Ming; Zhu, Yue-Qi; Zhang, Pei-Lei; Lu, Hai-Tao; Zhao, Jun-Gong [Shanghai Jiaotong University Affiliated Sixth People' s Hospital, Department of Diagnostic and Interventional Radiology, Shanghai (China); Liu, Fang [Shanghai Jiaotong University Affiliated Sixth People' s Hospital, Department of Endocrinology, Shanghai (China)

2018-03-15

To investigate morphological characteristics used to predict recanalisation strategies in long-segment (>10 cm) femoral chronic total occlusion (LSF-CTO) angioplasty. We retrospectively evaluated a range of morphological CTA and DSA features in patients who underwent recanalisation of LSF-CTO. The stage of CTO was classified into early (3-12 months) and late (>12 months) according to estimated duration. Characteristics including stump morphology, lesion length and calcification, proximal side branches, collaterals circulation, runoff vessels and concomitant arterial occlusion were used as predictors, and multivariate logistic regression analysis was performed to identify variables associated with late-stage CTO and retrograde technique. A total of 119 patients with 137 CTOs in 137 limbs were enrolled. Overall, successful recanalisation was achieved in 122 CTOs (89.1%). Flush occlusion [odds ratio (OR) 2.958; 95% confidence interval (CI) 1.172-7.465; p = 0.022], large collateral (OR 2.778; 95% CI 1.201-6.427; p = 0.017) and TransAtlantic Inter-Society Consensus II class D (TASC D) lesion (OR 1.743; 95% CI 1.019-2.981; p = 0.042) were predictors for late-stage CTO. Flush occlusion (OR 75.278; 95% CI 10.664-531.384; p < 0.001) and large collateral (OR 23.213; 95% CI 3.236-166.523; p = 0.002) were associated with high likelihood for retrograde approach. Flush occlusion and large collateral were associated with a CTO at late-stage which may require retrograde recanalisation. (orig.)

LONG-TERM SUCCESS OF AORTOILIAC OPERATION FOR ARTERIOSCLEROTIC OBSTRUCTIVE DISEASE

NARCIS (Netherlands)

VANDENAKKER, PJ; VANSCHILFGAARDE, R; BRAND, R; VANBOCKEL, JH; TERPSTRA, JL

The current retrospective study was performed on 747 patients with aortoiliac obstructive disease who under-went reconstructive operation. Unlike many other centers, the University Hospital Leiden has, throughout the years, maintained the strategy of avoiding the implantation of a prosthesis in

Occlusion of retinal capillaries caused by glial cell proliferation in chronic ocular inflammation.

Science.gov (United States)

Bianchi, E; Ripandelli, G; Feher, J; Plateroti, A M; Plateroti, R; Kovacs, I; Plateroti, P; Taurone, S; Artico, M

2015-01-01

The inner blood-retinal barrier is a gliovascular unit in which glial cells surround capillary endothelial cells and regulate retinal capillaries by paracrine interactions. During chronic ocular inflammation, microvascular complications can give rise to vascular proliferative lesions, which compromise visual acuity. This pathologic remodelling caused by proliferating Müller cells determines occlusion of retinal capillaries. The aim of the present study was to identify qualitative and quantitative alterations in the retinal capillaries in patients with post-traumatic chronic ocular inflammation or post-thrombotic vascular glaucoma. Moreover, we investigated the potential role of vascular endothelial growth factor (VEGF) and pro-inflammatory cytokines in retinal inflammation. Our electron microscopy findings demonstrated that during chronic ocular inflammation, thickening of the basement membrane, loss of pericytes and endothelial cells and proliferation of Müller cells occur with irreversible occlusion of retinal capillaries. Angiogenesis takes place as part of a regenerative reaction that results in fibrosis. We believe that VEGF and pro-inflammatory cytokines may be potential therapeutic targets in the treatment of this disease although further studies are required to confirm these findings.

Rendezvous technique for recanalization of long-segmental chronic total occlusion above the knee following unsuccessful standard angioplasty.

Science.gov (United States)

Cao, Jun; Lu, Hai-Tao; Wei, Li-Ming; Zhao, Jun-Gong; Zhu, Yue-Qi

2016-04-01

To assess the technical feasibility and efficacy of the rendezvous technique, a type of subintimal retrograde wiring, for the treatment of long-segmental chronic total occlusions above the knee following unsuccessful standard angioplasty. The rendezvous technique was attempted in eight limbs of eight patients with chronic total occlusions above the knee after standard angioplasty failed. The clinical symptoms and ankle-brachial index were compared before and after the procedure. At follow-up, pain relief, wound healing, limb salvage, and the presence of restenosis of the target vessels were evaluated. The rendezvous technique was performed successfully in seven patients (87.5%) and failed in one patient (12.5%). Foot pain improved in all seven patients who underwent successful treatment, with ankle-brachial indexes improving from 0.23 ± 0.13 before to 0.71 ± 0.09 after the procedure (P rendezvous technique is a feasible and effective treatment for chronic total occlusions above the knee when standard angioplasty fails. © The Author(s) 2015.

Endovascular crossing of Chronic Total Occlusions using an impulse : An explorative design study

NARCIS (Netherlands)

Sakes, A.; van der Wiel (student), Marleen; Dodou, D.; Breedveld, P.

2017-01-01

In this study we investigated whether exerting an impulse on a Chronic Total Occlusion (CTO) improves the success rate of CTO crossing as compared to the currently used method of statically pushing the guidewire against the CTO. A prototype (Ø2 mm) was developed that generates translational

Infrainguinal arterial reconstructions in patients with aortoiliac occlusive disease: the influence of iliac stenting.

Science.gov (United States)

Timaran, C H; Stevens, S L; Freeman, M B; Goldman, M H

2001-12-01

Iliac artery angioplasty (IAA) is an effective adjunct when combined with infrainguinal arterial reconstructions (IARs) in appropriate patients with multilevel occlusive disease. However, the effect of iliac artery stenting (IAS) on the outcome of patients undergoing distal bypass procedures is not defined. The purpose of this study was to estimate the influence of previous IAS for iliac occlusive disease on the outcome of IARs, compared with those after IAA alone or aortofemoral bypass grafting procedures (AFBs). During a 5-year period (1995-2000), 105 patients with previous intervention for iliac occlusive disease underwent 120 IARs. The criteria prepared by the Ad Hoc Committee on Reporting Standards (Society for Vascular Surgery/International Society for Cardiovascular Surgery) were followed to define the variables. The TransAtlantic Inter-Society Consensus classification was used to characterize the type of iliac lesions. Univariate (Kaplan-Meier) and multivariate analyses (Cox proportional hazards model) were used to determine the association between preoperative variables and cumulative primary patency. Forty-five IARs were performed in patients with an earlier IAS repair, 33 in patients with an earlier IAA repair, and 42 in patients with an earlier AFB repair. There were not significant differences between patients in the IAS and IAA groups, except for a more frequent use of polytetrafluoroethylene grafts for IARs in the IAS group (40% vs 15%; chi(2) test, P = .03). The 5-year primary patency rate for IARs was 68% in the IAS group, 46% in the IAA group, and 61% in the AFB group. Univariate analyses revealed that primary patency rates for IARs in patients with previous IAS were significantly higher than those in the IAA group (Kaplan-Meier, log-rank test, P = .02). Previous IAA repair was associated with a two-fold increased risk of IAR graft failure (relative risk, 2.2; 95% CI, 1.1-4.8; P = .04). IARs in patients with previous IAS have significantly

Percutaneous Intervention for Concurrent Chronic Total Occlusions in Patients With STEMI: The EXPLORE Trial

NARCIS (Netherlands)

Henriques, J.P.; Hoebers, L.P.; Ramunddal, T.; Laanmets, P.; Eriksen, E.; Bax, M.; Ioanes, D.; Suttorp, M.J.; Strauss, B.H.; Barbato, E.; Nijveldt, R.; Rossum, A.C. van; Marques, K.M.; Elias, J.; Dongen, I.M. van; Claessen, B.E.; Tijssen, J.G.; Schaaf, R.J. van der; Boer, M.J. de; et al.,

2016-01-01

BACKGROUND: In 10% to 15% of patients with ST-segment elevation myocardial infarction (STEMI), concurrent coronary chronic total occlusion (CTO) in a non-infarct-related artery is present and is associated with increased morbidity and mortality. OBJECTIVES: The EXPLORE (Evaluating Xience and Left

Is Internal Iliac Artery Embolization Essential Prior to Endovascular Repair of Aortoiliac Aneurysms?

International Nuclear Information System (INIS)

Bharwani, N.; Raja, J.; Choke, E.; Belli, A. M.; Thompson, M. M.; Morgan, R. A.; Munneke, G.

2008-01-01

Patients who undergo endovascular repair of aorto-iliac aneurysms (EVAR) require internal iliac artery (IIA) embolization (IIAE) to prevent type II endoleaks after extending the endografts into the external iliac artery. However, IIAE may not be possible in some patients due to technical factors or adverse anatomy. The aim of this study was to assess retrospectively whether patients with aorto-iliac aneurysms who fail IIAE have an increase in type II endoleak after EVAR compared with similar patients who undergo successful embolization. We retrospectively analyzed the records of 148 patients who underwent EVAR from December 1997 to June 2005. Sixty-one patients had aorto-iliac aneurysms which required IIAE before EVAR. Fifty patients had successful IIAE and 11 patients had unsuccessful IIAE prior to EVAR. The clinical and imaging follow-up was reviewed before and after EVAR. The endoleak rate of the embolized group was compared with that of the group in whom embolization failed. After a mean follow-up of 19.7 months in the study group and 25 months in the control group, there were no statistically significant differences in outcome measures between the two groups. Specifically, there were no type II endoleaks related to the IIA in patients where IIAE had failed. We conclude that failure to embolize the IIA prior to EVAR should not necessarily preclude patients from treatment. In patients where there is difficulty in achieving coil embolization, it is recommended that EVAR should proceed, as clinical sequelae are unlikely

Differentiation of acute total occlusion of coronary artery from chronic total occlusion in coronary computed tomography angiography

International Nuclear Information System (INIS)

Kwag, Hyon Joo

2012-01-01

To compare the features of coronary computed tomography angiography (CCTA) imaging of the patients with acute total occlusion (ATO) of coronary artery with those of chronic total occlusion (CTO). CCTA of 26 patients with complete interruption of the coronary artery in CCTA and occlusion in conventional coronary angiography, were retrospectively analyzed. Discrimination between the ATO group (n = 11, patients with non ST elevation myocardial infarction or unstable angina) and the CTO group (n = 15, patients with stable angina or nonspecific symptom) was arbitrarily determined by clinical diagnosis. Lesion length, remodeling index (RI), plaque density measured by Hounsfield units (HU), plaque composition, percentage attenuation drop across the lesion, and presence of myocardial thinning were evaluated. Comparisons between the ATO and CTO groups revealed significantly shorter lesion length in the ATO group (0.40 cm vs. 1.87 cm, respectively; p = 0.001), and significantly higher RI (1.56 vs. 1.10, respectively; p = 0.004). Plaque density of the ATO group was lower (37.0 HU vs. 104.7 HU, respectively; p < 0.001) and non calcified plaque was frequently seen in the ATO group (72.7% vs. 26.7%, respectively; p = 0.02). Percentage attenuation drop across the lesion was lower for the ATO group (10.92% vs. 25.44%, respectively; p = 0.005). Myocardial thinning was exclusively observed in the CTO group (seven of 15 patients, p = 0.01). CCTA shows various statistically significant differences between the ATO and CTO groups

Differentiation of acute total occlusion of coronary artery from chronic total occlusion in coronary computed tomography angiography

Energy Technology Data Exchange (ETDEWEB)

Kwag, Hyon Joo [Sungkyunkwan Univ. School of Medicine, Seoul (Korea, Republic of)

2012-08-15

To compare the features of coronary computed tomography angiography (CCTA) imaging of the patients with acute total occlusion (ATO) of coronary artery with those of chronic total occlusion (CTO). CCTA of 26 patients with complete interruption of the coronary artery in CCTA and occlusion in conventional coronary angiography, were retrospectively analyzed. Discrimination between the ATO group (n = 11, patients with non ST elevation myocardial infarction or unstable angina) and the CTO group (n = 15, patients with stable angina or nonspecific symptom) was arbitrarily determined by clinical diagnosis. Lesion length, remodeling index (RI), plaque density measured by Hounsfield units (HU), plaque composition, percentage attenuation drop across the lesion, and presence of myocardial thinning were evaluated. Comparisons between the ATO and CTO groups revealed significantly shorter lesion length in the ATO group (0.40 cm vs. 1.87 cm, respectively; p = 0.001), and significantly higher RI (1.56 vs. 1.10, respectively; p = 0.004). Plaque density of the ATO group was lower (37.0 HU vs. 104.7 HU, respectively; p < 0.001) and non calcified plaque was frequently seen in the ATO group (72.7% vs. 26.7%, respectively; p = 0.02). Percentage attenuation drop across the lesion was lower for the ATO group (10.92% vs. 25.44%, respectively; p = 0.005). Myocardial thinning was exclusively observed in the CTO group (seven of 15 patients, p = 0.01). CCTA shows various statistically significant differences between the ATO and CTO groups.

Impact of the Occlusion Duration on the Performance of J-CTO Score in Predicting Failure of Percutaneous Coronary Intervention for Chronic Total Occlusion.

Science.gov (United States)

de Castro-Filho, Antonio; Lamas, Edgar Stroppa; Meneguz-Moreno, Rafael A; Staico, Rodolfo; Siqueira, Dimytri; Costa, Ricardo A; Braga, Sergio N; Costa, J Ribamar; Chamié, Daniel; Abizaid, Alexandre

2017-06-01

The present study examined the association between Multicenter CTO Registry in Japan (J-CTO) score in predicting failure of percutaneous coronary intervention (PCI) correlating with the estimated duration of chronic total occlusion (CTO). The J-CTO score does not incorporate estimated duration of the occlusion. This was an observational retrospective study that involved all consecutive procedures performed at a single tertiary-care cardiology center between January 2009 and December 2014. A total of 174 patients, median age 59.5 years (interquartile range [IQR], 53-65 years), undergoing CTO-PCI were included. The median estimated occlusion duration was 7.5 months (IQR, 4.0-12.0 months). The lesions were classified as easy (score = 0), intermediate (score = 1), difficult (score = 2), and very difficult (score ≥3) in 51.1%, 33.9%, 9.2%, and 5.7% of the patients, respectively. Failure rate significantly increased with higher J-CTO score (7.9%, 20.3%, 50.0%, and 70.0% in groups with J-CTO scores of 0, 1, 2, and ≥3, respectively; PJ-CTO score predicted failure of CTO-PCI independently of the estimated occlusion duration (P=.24). Areas under receiver-operating characteristic curves were computed and it was observed that for each occlusion time period, the discriminatory capacity of the J-CTO score in predicting CTO-PCI failure was good, with a C-statistic >0.70. The estimated duration of occlusion had no influence on the J-CTO score performance in predicting failure of PCI in CTO lesions. The probability of failure was mainly determined by grade of lesion complexity.

Excimer laser coronary atherectomy in septal collaterals during retrograde recanalization of a chronic total occlusion

Directory of Open Access Journals (Sweden)

Bernward Lauer

2011-09-01

Full Text Available Management of chronic total occlusions has been refined through the development of a retrograde approach via collateral pathways. We describe the use of Excimer Laser Coronary Atherectomy in the septal collaterals. This appraoch was not yet described in the literature.

Gap in gender parity: gender disparities in incidence and clinical impact of chronic total occlusion in non-infarct artery in patients with non-ST-segment elevation myocardial infarction and multivessel coronary artery disease.

Science.gov (United States)

Tajstra, Mateusz; Hawranek, Michał; Desperak, Piotr; Ciślak, Aneta; Gąsior, Mariusz

2017-10-03

A chronic total occlusion in a non-infarct-related artery is an independent predictor of mortality in non-ST elevation myocardial infarction. There are no mortality data about the impact of a chronic total occlusion in patients with non-ST elevation myocardial infarction according to gender. The purpose of this study was to evaluate the prevalence of the chronic total occlusion in in men and women and examine its impact on clinical outcomes. Data from consecutive patients with multivessel coronary artery disease treated in a high-volume center between 2006 and 2012 were included in a prospective registry and divided according to gender and the presence of chronic total occlusion. All of the analyzed patients were followed up for at least 24 months, with all-cause mortality defined as the primary endpoint. Among the 515 patients who fulfilled the inclusion criteria, 32.8% were female. In the female arm, the 24-month mortality for the groups with and without chronic total occlusion was similar (18.9% and 14.7%, respectively; p = 0.47). In contrast, in the male arm, the occurrence of chronic total occlusion was associated with higher 24-month mortality (24.3% vs. 13.4%; p = 0.009). Multivariate analysis of the male arm revealed a trend toward a positive association between the occurrence of chronic total occlusion and 24-month mortality (HR 1.62; 95% CI 0.93-2.83; p = 0.087). The presence of chronic total occlusion in men is associated with an adverse long-term prognosis, whereas in women this effect was not observed.

Optical coherence tomography findings after chronic total occlusion interventions: Insights from the “AngiographiC evaluation of the everolimus-eluting stent in chronic Total occlusions” (ACE-CTO) study (NCT01012869)

Energy Technology Data Exchange (ETDEWEB)

Sherbet, Daniel P.; Christopoulos, Georgios; Karatasakis, Aris; Danek, Barbara Anna; Kotsia, Anna; Navara, Rachita; Michael, Tesfaldet T.; Roesle, Michele; Rangan, Bavana V.; Haagen, Donald [VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, TX (United States); Garcia, Santiago [Minneapolis VA Healthcare System and University of Minnesota, Minneapolis, MN (United States); Maniu, Calin [Bon Secours Health System, Suffolk, VA (United States); Pershad, Ashish [Banner Good Samaritan Medical Center, Phoenix, AZ (United States); Abdullah, Shuaib M.; Hastings, Jeffrey L.; Kumbhani, Dharam J.; Luna, Michael; Addo, Tayo; Banerjee, Subhash [VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, TX (United States); Brilakis, Emmanouil S., E-mail: esbrilakis@gmail.com [VA North Texas Healthcare System and University of Texas Southwestern Medical Center, Dallas, TX (United States)

2016-10-15

Background: There is limited information on optical coherence tomography (OCT) findings after percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs). OCT allows high resolution imaging that can enhance understanding of the vascular response after stenting of chronically occluded vessels. Methods: The Angiographic Evaluation of the Everolimus-Eluting Stent in Chronic Total Occlusions (ACE-CTO) study collected angiographic and clinical outcomes from 100 patients undergoing CTO PCI with the everolimus-eluting stent (EES). OCT was performed 8-months post stenting in 62 patients. Every third frame was analyzed throughout the course of the stented arterial segment. Lumen contours were semi-automatically traced and stent struts were manually delineated, with automatic measurement of the strut to lumen distance. Struts on the luminal side of the lumen contour were classified as malapposed if the distance to the lumen contour exceeded 0.108 mm. Results: A total of 44,450 struts in 6047 frames were analyzed, of which 4113 9.3%, 95% confidence intervals [CI] 9.0% to 9.5%) were malapposed and 1230 (2.8%, 95% CI 2.6% to 2.9%) were uncovered. Fifty-five of 62 patients (88.7%, 95% CI 78.5% to 98.4%) had at least one malapposed stent strut and 50 patients (80.7%, 95% CI 69.2% to 88.6%) had at least one uncovered stent strut. Mean strut-intimal thickness of the apposed and malapposed struts was 0.126 ± 0.140 mm and − 0.491 ± 0.440 mm, respectively. Conclusion: High rates of stent strut malapposition and incomplete stent strut coverage were observed after CTO PCI using EES, highlighting unique challenges associated with stent implantation in CTOs. - Highlights: • Percutaneous coronary intervention with drug-eluting stents for chronic total occlusion is associated with a 40% rate of binary in-stent restenosis at 8 months • Of patients who receive a drug eluting stent for a chronic total occlusion 88.7% will have stent strut malapposition and 80.7% will

Utility of adjunctive modalities in Coronary chronic total occlusion intervention

Directory of Open Access Journals (Sweden)

Hemal Bhatt

2017-05-01

Full Text Available Coronary chronic total occlusion (CTO intervention remains one of the most challenging domains in interventional cardiology. Due to the technical challenges involved and potential procedural complications, CTO percutaneous coronary intervention (PCI attempt and success rates remain less than standard PCI. However, the use of several adjunctive tools such as intravascular ultrasound, optical coherence tomography, rotational atherectomy, orbital atherectomy, excimer laser coronary atherectomy and percutaneous left ventricular assist device may contribute to improved CTO PCI success rates or provide better hemodynamic assessment of CTO lesion (i.e., using fractional flow reserve. In this review we present the current literature describing the utility and efficacy of these adjunctive modalities in CTO intervention.

Epulis and pyogenic granuloma with occlusal interference

Directory of Open Access Journals (Sweden)

Widowati Witjaksono

2005-06-01

Full Text Available In dental clinic of Hospital University Science Malaysia (HUSM, there were cases with Localized Gingival Enlargement (LGE in the oral cavity with occlusal interference. In this study, three cases were observed. They were a 13 - year- old female with fibrous lge around 31 and 32 with occlusal interference in protrusive movement due to X bite, a 15 - year – old female with pyogenic granuloma near 11 & 21 with occlusal interference due to deep bite; and a 24 – year – old female who was eight months in pregnancy with pyogenic granuloma on the 34-35 and severe generalized pregnancy gingivitis with occlusal interference in centric occlusion and lateral movement. Clinical and histopathological diagnosis of the first case showed fibrous epulis, whereas the second and third cases disclosed pyogenic granuloma. Chronic trauma of the gingiva due to occlusal interference was assumed to be the cause of those LGE in case 1 and 2, while in case 3 poor oral hygiene and chronic trauma were assumed to be the etiologic factors.

Impact of diabetes mellitus on acute outcomes of percutaneous coronary intervention in chronic total occlusions: insights from a US multicentre registry.

Science.gov (United States)

Martinez-Parachini, J R; Karatasakis, A; Karmpaliotis, D; Alaswad, K; Jaffer, F A; Yeh, R W; Patel, M; Bahadorani, J; Doing, A; Nguyen-Trong, P-K; Danek, B A; Karacsonyi, J; Alame, A; Rangan, B V; Thompson, C A; Banerjee, S; Brilakis, E S

2017-04-01

To examine the impact of diabetes mellitus on procedural outcomes of patients who underwent percutaneous coronary intervention for chronic total occlusion. We assessed the impact of diabetes mellitus on the outcomes of percutaneous coronary intervention for chronic total occlusion among 1308 people who underwent such procedures at 11 US centres between 2012 and 2015. The participants' mean ± sd age was 66 ± 10 years, 84% of the participants were men and 44.6% had diabetes. As compared with participants without diabetes, participants with diabetes were more likely to have undergone coronary artery bypass graft surgery (38 vs 31%; P = 0.006), and to have had previous heart failure (35 vs 22%; P = 0.0001) and peripheral arterial disease (19 vs 13%; P = 0.002). They also had a higher BMI (31 ± 6 kg/m 2 vs 29 ± 6 kg/m 2 ; P = 0.001), similar Japanese chronic total occlusion scores (2.6 ± 1.2 vs 2.5 ± 1.2; P = 0.82) and similar final successful crossing technique: antegrade wire escalation (46 vs 47%; P = 0.66), retrograde (30 vs 28%; P = 0.66) and antegrade dissection re-entry (24 vs 25%; P = 0.66). Technical (91 vs 90%; P = 0.80) and procedural (89 vs 89%; P = 0.93) success was similar in the two groups, as was the incidence of major adverse cardiac events (2.2 vs 2.5%; P = 0.61). In a contemporary cohort of people undergoing percutaneous coronary intervention for chronic total occlusion, nearly one in two (45%) had diabetes mellitus. Procedural success and complication rates were similar in people with and without diabetes. © 2016 Diabetes UK.

Subadventitial techniques for chronic total occlusion percutaneous coronary intervention: The concept of "vessel architecture".

Science.gov (United States)

Azzalini, Lorenzo; Carlino, Mauro; Brilakis, Emmanouil S; Vo, Minh; Rinfret, Stéphane; Uretsky, Barry F; Karmpaliotis, Dimitri; Colombo, Antonio

2018-03-01

Despite improvements in guidewire technologies, the traditional antegrade wire escalation approach to chronic total occlusion (CTO) recanalization is successful in only 60-80% of selected cases. In particular, long, calcified, and tortuous occlusions are less successfully approached with a true-to-true lumen approach. Frequently, the guidewire tracks into the subadventitial space, with no guarantee of distal re-entry into the true lumen. The ability to manage the subadventitial space has been a key step in the tremendous improvement in success rates of contemporary CTO percutaneous coronary intervention (PCI), whether operating antegradely or retrogradely. A modern approach to CTO PCI involves understanding the concept of "vessel architecture," which is based on the distinction between coronary structures (occlusive plaque, comprising the disrupted intima and media, and the outer adventitia) and extravascular space. The vessel architecture represents a safe work environment for guidewire and device manipulation. This review provides an anatomy-based description of the concept of vessel architecture, along with a historical perspective of subadventitial techniques for CTO PCI, and outcome data of CTO PCI utilizing the subadventitial space. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

Value of duplex scanning compared with angiography and pressure measurement in the assessment of aortoiliac arterial lesions

NARCIS (Netherlands)

Legemate, D. A.; Teeuwen, C.; Hoeneveld, H.; Eikelboom, B. C.

1991-01-01

To detect haemodynamically significant lesions in the aortoiliac arteries, invasive tests such as angiography and intra-arterial pressure measurement (IAPM) are considered valuable diagnostic tools. The value of duplex scanning as a direct non-invasive examination technique was prospectively

Outcomes after open repair for ruptured abdominal aortic aneurysms in patients with friendly versus hostile aortoiliac anatomy

NARCIS (Netherlands)

van Beek, S. C.; Reimerink, J. J.; Vahl, A. C.; Wisselink, W.; Reekers, J. A.; Legemate, D. A.; Balm, R.

2014-01-01

In patients with a ruptured abdominal aortic aneurysm (RAAA), anatomic suitability for endovascular aneurysm repair (EVAR) depends on aortic neck and iliac artery characteristics. If the aortoiliac anatomy is unsuitable for EVAR ("hostile anatomy"), open repair (OR) is the next option. We

Interventricular Septal Hematoma and Coronary-Ventricular Fistula: A Complication of Retrograde Chronic Total Occlusion Intervention

OpenAIRE

Abdul-rahman R. Abdel-karim; Minh Vo; Michael L. Main; J. Aaron Grantham

2016-01-01

Interventricular septal hematoma is a rare complication of retrograde chronic total occlusion (CTO) percutaneous coronary interventions (PCI) with a typically benign course. Here we report two cases of interventricular septal hematoma and coronary-cameral fistula development after right coronary artery (RCA) CTO-PCI using a retrograde approach. Both were complicated by development of ST-segment elevation and chest pain. One case was managed actively and the other conservatively, both with a f...

Effect of aorto-iliac bifurcation and iliac stenosis on flow dynamics in an abdominal aortic aneurysm

Science.gov (United States)

Patel, Shivam; Usmani, Abdullah Y.; Muralidhar, K.

2017-06-01

Physiological flows in rigid diseased arterial flow phantoms emulating an abdominal aortic aneurysm (AAA) under rest conditions with aorto-iliac bifurcation and iliac stenosis are examined in vitro through 2D PIV measurements. Flow characteristics are first established in the model resembling a symmetric AAA with a straight outlet tube. The influence of aorto-iliac bifurcation and iliac stenosis on AAA flow dynamics is then explored through a comparison of the nature of flow patterns, vorticity evolution, vortex core trajectory and hemodynamic factors against the reference configuration. Specifically, wall shear stress and oscillatory shear index in the bulge portion of the models are of interest. The results of this investigation indicate overall phenomenological similarity in AAA flow patterns across the models. The pattern is characterized by a central jet and wall-bounded vortices whose strength increases during the deceleration phase as it moves forward. The central jet impacts the wall of AAA at its distal end. In the presence of an aorto-iliac bifurcation as well as iliac stenosis, the flow patterns show diminished strength, expanse and speed of propagation of the primary vortices. The positions of the instantaneous vortex cores, determined using the Q-function, correlate with flow separation in the bulge, flow resistance due to a bifurcation, and the break in symmetry introduced by a stenosis in one of the legs of the model. Time-averaged WSS in a healthy aorta is around 0.70 N m-2 and is lowered to the range ±0.2 N m-2 in the presence of the downstream bifurcation with a stenosed common iliac artery. The consequence of changes in the flow pattern within the aneurysm on disease progression is discussed.

Effect of aorto-iliac bifurcation and iliac stenosis on flow dynamics in an abdominal aortic aneurysm

International Nuclear Information System (INIS)

Patel, Shivam; Usmani, Abdullah Y; Muralidhar, K

2017-01-01

Physiological flows in rigid diseased arterial flow phantoms emulating an abdominal aortic aneurysm (AAA) under rest conditions with aorto-iliac bifurcation and iliac stenosis are examined in vitro through 2D PIV measurements. Flow characteristics are first established in the model resembling a symmetric AAA with a straight outlet tube. The influence of aorto-iliac bifurcation and iliac stenosis on AAA flow dynamics is then explored through a comparison of the nature of flow patterns, vorticity evolution, vortex core trajectory and hemodynamic factors against the reference configuration. Specifically, wall shear stress and oscillatory shear index in the bulge portion of the models are of interest. The results of this investigation indicate overall phenomenological similarity in AAA flow patterns across the models. The pattern is characterized by a central jet and wall-bounded vortices whose strength increases during the deceleration phase as it moves forward. The central jet impacts the wall of AAA at its distal end. In the presence of an aorto-iliac bifurcation as well as iliac stenosis, the flow patterns show diminished strength, expanse and speed of propagation of the primary vortices. The positions of the instantaneous vortex cores, determined using the Q -function, correlate with flow separation in the bulge, flow resistance due to a bifurcation, and the break in symmetry introduced by a stenosis in one of the legs of the model. Time-averaged WSS in a healthy aorta is around 0.70 N m −2 and is lowered to the range ±0.2 N m −2 in the presence of the downstream bifurcation with a stenosed common iliac artery. The consequence of changes in the flow pattern within the aneurysm on disease progression is discussed. (paper)

Effect of aorto-iliac bifurcation and iliac stenosis on flow dynamics in an abdominal aortic aneurysm

Energy Technology Data Exchange (ETDEWEB)

Patel, Shivam; Usmani, Abdullah Y; Muralidhar, K, E-mail: kmurli@iitk.ac.in [Department of Mechanical Engineering, Indian Institute of Technology Kanpur, Kanpur 208016 (India)

2017-06-15

Physiological flows in rigid diseased arterial flow phantoms emulating an abdominal aortic aneurysm (AAA) under rest conditions with aorto-iliac bifurcation and iliac stenosis are examined in vitro through 2D PIV measurements. Flow characteristics are first established in the model resembling a symmetric AAA with a straight outlet tube. The influence of aorto-iliac bifurcation and iliac stenosis on AAA flow dynamics is then explored through a comparison of the nature of flow patterns, vorticity evolution, vortex core trajectory and hemodynamic factors against the reference configuration. Specifically, wall shear stress and oscillatory shear index in the bulge portion of the models are of interest. The results of this investigation indicate overall phenomenological similarity in AAA flow patterns across the models. The pattern is characterized by a central jet and wall-bounded vortices whose strength increases during the deceleration phase as it moves forward. The central jet impacts the wall of AAA at its distal end. In the presence of an aorto-iliac bifurcation as well as iliac stenosis, the flow patterns show diminished strength, expanse and speed of propagation of the primary vortices. The positions of the instantaneous vortex cores, determined using the Q -function, correlate with flow separation in the bulge, flow resistance due to a bifurcation, and the break in symmetry introduced by a stenosis in one of the legs of the model. Time-averaged WSS in a healthy aorta is around 0.70 N m{sup −2} and is lowered to the range ±0.2 N m{sup −2} in the presence of the downstream bifurcation with a stenosed common iliac artery. The consequence of changes in the flow pattern within the aneurysm on disease progression is discussed. (paper)

Transluminal recanalization of chronic total occlusion of radial artery using rendezvous technique: a case report and literature review.

Science.gov (United States)

Arabi, Mohammad; Ahmed, Ishtiaq; Qattan, Nabeel

2014-01-01

Although endovascular management of lower extremity peripheral arterial disease (PAD) is well studied, little information exists regarding endovascular treatment of critical upper limb ischemia. We report a case of transluminal recanalization of right radial artery chronic total occlusion (CTO) using rendezvous technique in a patient with critical hand ischemia and dry gangrene of the right index finger.

Conservative Management of an Epicardial Collateral Perforation During Retrograde Chronic Total Occlusion Percutaneous Coronary Intervention.

Science.gov (United States)

Ngo, Christian; Christopoulos, George; Brilakis, Emmanouil S

2016-01-01

Coronary artery perforation is a highly feared complication of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) and can lead to pericardial effusion, tamponade, and, rarely, emergent cardiac surgery. Perforation of epicardial collaterals during retrograde CTO-PCI may be particularly challenging to treat, as embolization from both sides of the perforation may be required to control the bleeding. However, conservative measures can occasionally be effective. We present a case of epicardial collateral vessel perforation that was managed conservatively with anticoagulation reversal.

Endovascular diagnostics and treatment of stenosis, acute thrombosis and chronic occlusion of arteries and upper limbs

International Nuclear Information System (INIS)

Tonev, I.; Zechirov, B.; Stanoev, D.; Velikov, C.; Smilkova, D.

2015-01-01

Full text: Diseases of the upper limb arteries are significantly rarer than those of the lower limbs but they are not causes and due to the lack of diagnostic algorithms are often missed. the symptoms are not typical except for those in acute thrombosis. The complaints in acute thrombosis is strong, sudden pain in the limb or part of it, bruising or paleness of the ischemic area and a lack of pulsation. Diagnosis is fairly easy – clinical events, difference in blood pressure or a lack of blood pressure in the affected limb, a total lack of blood pressure or a difference in the pressure in the left and right arm. Then complaints in stenosis and chronic occlusions is significantly less pronounced and is expressed as weakness in the affected limb, heaviness, bluish or paleness. If the proximal segments are affected Still’s syndrome is often observed. The complaints is not decisive for diagnosis. A difference in blood pressure of more than 20 mm Hg and an echodoppler examination of the arteries are the main criteria for directing the patients for angiography. Contrast CT and MRT are not used often. treatment is vascular surgery and endovascular. In acute thrombosis priority takes vascular surgery through extraction of the thrombi with Fogerty catheters, and in chronical stenosis and occlusions – dilation and stenting. Clinical cases: Case 1 – Revascularization of artery brachialis, radialis and ulnaris after acute occlusion L.Y., 77 years old. Complains of sharp pain and bruising of right forearm since two hours before hospitalization. A lack of blood flow was identified using palpation and echodoppler. After a diagnostic angiography , thrombaspiration was undertaken, through a leading catheter, recovering blood flow in both arteries and stenting of the proximal segment of artery radialis. Case 2: Revascularization of Trunkus brachiocefalicus K.P., 65 years old. Suffering from bradypsychia for several months. Bradypsychia becomes worse after manual labor

Bioresorbable vascular scaffold (BVS) for in-stent chronic total occlusion: Antegrade recanalization and IVUS-guided BVS implantation by radial access

Energy Technology Data Exchange (ETDEWEB)

Medda, Massimo [Interventional Cardiology Unit, Istituto Clinico Sant' Ambrogio, Milano (Italy); Casilli, Francesco, E-mail: frcasill@tin.it [Interventional Cardiology Unit, Istituto Clinico Sant' Ambrogio, Milano (Italy); Bande, Marta [Interventional Cardiology Unit, Istituto Clinico Sant' Ambrogio, Milano (Italy); Latini, Maria Giulia [Cardiologia Interventistica, IRCCS Policlinico San Donato, San Donato Milanese, Milano (Italy); Ghommidh, Mehdi [Interventional Cardiology Unit, Istituto Clinico Sant' Ambrogio, Milano (Italy); Del Furia, Francesca [Unità Operativa di Cardiologia, Azienda Ospedaliera di Melegnano, Milano (Italy); Inglese, Luigi [Interventistica Cardiovascolare, Gruppo Sanitario Policlinico di Monza, Milano (Italy)

2016-01-15

The completely absorbable stents represent one of the latest innovations in the field of interventional cardiology, prospecting the possibility of “vascular repair”. In the published trials (ABSORB Cohort A and B, ABSORB EXTEND, and ABSORB II, III and IV) chronic total occlusions (CTOs) were considered an exclusion criteria. More recently the CTO-ABSORB pilot study demonstrated the safety and feasibility of bioresorbable vascular scaffold (BVS) use in case of CTO recanalization. We present the first case, to our knowledge, of in-stent occlusion successfully treated with an everolimus-eluting BVS and discuss its potential advantages in such kind of lesions.

Bioresorbable vascular scaffold (BVS) for in-stent chronic total occlusion: Antegrade recanalization and IVUS-guided BVS implantation by radial access

International Nuclear Information System (INIS)

Medda, Massimo; Casilli, Francesco; Bande, Marta; Latini, Maria Giulia; Ghommidh, Mehdi; Del Furia, Francesca; Inglese, Luigi

2016-01-01

The completely absorbable stents represent one of the latest innovations in the field of interventional cardiology, prospecting the possibility of “vascular repair”. In the published trials (ABSORB Cohort A and B, ABSORB EXTEND, and ABSORB II, III and IV) chronic total occlusions (CTOs) were considered an exclusion criteria. More recently the CTO-ABSORB pilot study demonstrated the safety and feasibility of bioresorbable vascular scaffold (BVS) use in case of CTO recanalization. We present the first case, to our knowledge, of in-stent occlusion successfully treated with an everolimus-eluting BVS and discuss its potential advantages in such kind of lesions.

Occlusal Therapy in the Management of Chronic Orofacial Pain

OpenAIRE

Bush, Francis M.

1984-01-01

Review of the literature indicates that most routine orofacial dysfunctions are characterized by deep pain. Various disorders of the masticatory systems, particularly musculoskeletal conditions, are thought to be triggered by occlusal disharmonies. The pain component develops following a pattern of bruxism, muscle hyperactivity, fatigue and spasm. Treatment for most disorders has been to modify the occlusion, although the rational for doing so appears questionable.

Transluminal Recanalization of Chronic Total Occlusion of Radial Artery Using Rendezvous Technique: A Case Report and Literature Review

Directory of Open Access Journals (Sweden)

Mohammad Arabi

2014-01-01

Full Text Available Although endovascular management of lower extremity peripheral arterial disease (PAD is well studied, little information exists regarding endovascular treatment of critical upper limb ischemia. We report a case of transluminal recanalization of right radial artery chronic total occlusion (CTO using rendezvous technique in a patient with critical hand ischemia and dry gangrene of the right index finger.

The Use of a Re-Entry Catheter in Recanalization of Chronic Inflow Occlusions of the Common Iliac Artery

International Nuclear Information System (INIS)

Ramjas, Greg; Thurley, Peter; Habib, Said

2008-01-01

Endovascular treatment of iliac artery occlusions can be unsuccessful due to a failure to break back into the true lumen, and lesions without a proximal stump can be particularly problematic. True lumen re-entry catheters have not been previously used for this type of lesion. The authors report eight patients, five males and three females, with lifestyle-limiting intermittent claudication referred for endovascular treatment. Imaging demonstrated unilateral chronic total occlusion of the common iliac artery in six patients and two patients with short patent stumps at the origin of the occluded common iliac artery. Endovascular therapy was initially unsuccessful due to an inability to re-enter the true lumen after crossing the occlusion in the subintimal plane. With the assistance of the Outback LTD catheter it was possible to achieve continuity of the dissecting tract with the true lumen, thus facilitating successful primary stenting in all eight patients. To our knowledge this is the first report of the use of the Outback LTD catheter in this type of lesion

Immediate endovascular treatment of an aortoiliac aneurysm ruptured into the inferior vena cava.

Science.gov (United States)

Kopp, Reinhard; Weidenhagen, Rolf; Hoffmann, Ralf; Waggershauser, Tobias; Meimarakis, Georgios; Andrassy, Joachim; Clevert, Dirk; Czerner, Stephan; Jauch, Karl-Walter

2006-07-01

An aortocaval fistula is a severe complication of an aortoiliac aneurysm, usually associated with high perioperative morbidity and mortality during open operative repair. We describe the successful endovascular treatment of a symptomatic infrarenal aortic aneurysm ruptured into the inferior vena cava with secondary interventional coiling of a persistent type II endoleak because of retrograde perfusion of the inferior mesenteric artery. Endovascular exclusion of ruptured abdominal aneurysms seems to be a valuable treatment option for selected patients even with complicated vascular conditions like an aortocaval fistula.

Endovascular repair of an aorto-iliac aneurysm succeeded by kidney transplantation Tratamento endovascular de aneurisma aorto-ilíaco sucedido por transplante renal

Directory of Open Access Journals (Sweden)

Marcelo Bellini Dalio

2010-09-01

Full Text Available We present the case of aorto-iliac aneurysm in a patient with chronic renal failure requiring dialysis who were treated with an endovascular stent graft and, later on, submitted to kidney transplantation. A 53-year-old male with renal failure requiring dialysis presented with an asymptomatic abdominal aorto-iliac aneurysm measuring 5.0cm of diameter. He was treated with endovascular repair technique, being used an endoprosthesis Excluder®. After four months, he was successfully submitted to kidney transplantation (dead donor, with anastomosis of the graft renal artery in the external iliac artery distal to the endoprosthesis. The magnetic resonance imaging, carried out 30 days after the procedure, showed a good positioning of the endoprosthesis and adequate perfusion of the renal graft. In the follow-up, the patient presented improvement of nitrogenous waste, good positioning of the endoprosthesis without migration or endoleak. The endovascular repair of aorto-iliac aneurysm in a patient with end-stage renal failure under hemodialysis treatment showed to be feasible, safe and efficient, as it did not prevent the success of the posterior kidney transplantation.Apresentamos o caso de aneurisma aortoilíaco em um paciente com insuficiência renal crônica dialítica tratado com uma endoprótese vascular, sendo, após, submetido a transplante renal. Um homem de 53 anos com insuficiência renal dialítica apresentava um aneurisma abdominal aortoilíaco assintomático com 5,0cm de diâmetro. Foi tratado com técnica endovascular com uma endoprótese Excluderâ. Após quatro meses, foi submetido a transplante renal (doador cadáver com sucesso, com anastomose da artéria renal do enxerto na artéria ilíaca externa distal à endoprótese. A ressonância magnética 30 dias após o procedimento mostrou a endoprótese bem posicionada e o enxerto renal bem perfundido. No seguimento, o paciente evoluiu com melhora das escórias nitrogenadas, bom

Combined Radial-Pedal Access Strategy and Radial-Pedal Rendezvous in the Revascularization of Complex Total Occlusions of the Superficial Femoral Artery (the "No Femoral Access" Strategy).

Science.gov (United States)

Hanna, Elias B; Prout, Davey L

2016-04-01

To describe the combined use of radial-pedal access for recanalization of complex superficial femoral artery (SFA) occlusions unsuitable for transfemoral recanalization. Patients are selected for this strategy if they have a long (≥ 10 cm) SFA occlusion with unfavorable aortoiliac anatomy, an absent ostial stump, or severely diseased and calcified distal reconstitution. Left radial artery and distal anterior or posterior tibial artery are accessed with 6-F and 4-F sheaths, respectively. The SFA lesion is crossed retrogradely with a 0.035-inch wire system. If retrograde crossing is not immediately successful, transradial subintimal tracking and radial-pedal subintimal rendezvous are used to allow retrograde reentry. Fifteen patients (mean age 62 ± 5 years; 11 men) have been treated in this fashion, and frequently stented, through the tibiopedal access. Seven patients required radial-pedal rendezvous to facilitate retrograde reentry. Two patients underwent transradial iliac stenting during the same session, and 1 patient underwent transradial kissing angioplasty of the profunda. No major complication occurred in any patient. After the procedure, the pulse across the accessed tibial artery was palpable in all patients. In patients with long and complex SFA occlusion unsuitable for transfemoral recanalization, a radial-pedal strategy can overcome revascularization obstacles. © The Author(s) 2016.

Collateral Function in Patients with Coronary Occlusion Evaluated by 201Thallium Scintigraphy

Directory of Open Access Journals (Sweden)

Aida Hasanović

2008-11-01

Full Text Available The present study evaluated the impact of the angiographically documented collaterals on regional myocardial perfusion measured by 201thallium scintigraphy in patients with a chronic total occlusion.The study included 60 patients with chronic total occlusion who underwent rest-stress myocardial perfusion scintigraphy and coronary angiography. All patients had angiographic evidence of coronary collaterals. Patients were divided into two groups: group one had well-developed coronary collateral vessels (n=35 and group II had poor coronary collateral development (n=25.Patients with chronic total occlusion had severe and extensive stress-induced myocardial perfusion defects regardless of the grade of angiographic coronary collaterals. The perfusion defects in the group with good collaterals were predominantly reversible, suggesting that coronary collaterals preserved myocardial viability in the regions subtended by a total coronary occlusion. A significant correlation between good collaterals with complete protection and poor collaterals with no protection was noted.Our results demonstrate a protective effect of collaterals on myocardial perfusion during coronary occlusion. The effective angiographic collaterals may prevent resting regional wall motion abnormalities but do not appear to protect against stress-induced perfusion defect.

Percutaneous recanalization of chronic total occlusions: wherein lies the body of proof?

Science.gov (United States)

Tamburino, Corrado; Capranzano, Piera; Capodanno, Davide; Dangas, George; Zimarino, Marco; Bass, Theodore A; Mehran, Roxana; Antoniucci, David; Colombo, Antonio; La Manna, Alessio; Di Salvo, Maria E; Stone, Gregg W

2013-02-01

Although interventional technology and skills have markedly advanced, percutaneous coronary intervention (PCI) for coronary chronic total occlusion (CTO) lesions remains challenging. Indeed, CTO PCI is technically complex, carries the potential for a relatively high likelihood of failure and acute complications, and requires specifically skilled operators and a demanding use of resources. In addition, controversy persists surrounding appropriate indications for attempting CTO revascularization. Finally, there is a wide uncertainty on the actual benefits achieved with successful CTO recanalization. A growing number of studies have reported procedural results and/or assessed functional effects and long-term clinical outcomes of CTO PCI. We therefore sought to review and critically appraise the evidence base for procedural outcomes and potential clinical benefits of CTO PCI. Copyright © 2013 Mosby, Inc. All rights reserved.

Endovascular recanalization of native chronic total occlusions in patients with failed lower-extremity bypass grafts.

Science.gov (United States)

Wrigley, Clinton W; Vance, Ansar; Niesen, Timothy; Grilli, Christopher; Velez, J Daniel; Agriantonis, Demetrios J; Kimbiris, George; Garcia, Mark J; Leung, Daniel A

2014-09-01

To investigate the feasibility, safety, and outcome of endovascular recanalization of native chronic total occlusions (CTOs) in patients with failed lower-extremity bypass grafts. Retrospective review of 19 limbs in 18 patients with failed lower-extremity bypass grafts that underwent recanalization of native arterial occlusions between February 2009 and April 2013 was performed. Nine of the limbs presented with acute ischemia and 10 presented with chronic ischemia, including eight with critical limb ischemia and two with disabling claudication. The mean patency of the failed bypass grafts (63% venous) was 27 months. All limbs had Transatlantic Inter-Society Consensus class D lesions involving the native circulation. Technical success of the endovascular recanalization procedure was achieved in all but one limb (95%). The mean ankle brachial indices before and after treatment were 0.34 and 0.73, respectively. There were no major complications or emergency amputations. Mean patient follow-up was 64 weeks, and two patients were lost to follow-up. Primary patency rates at 3, 6, and 12 months were 87%, 48%, and 16%, respectively. Successful secondary procedures were performed in seven patients, with secondary patency rates at 3, 6, and 12 months of 88%, 73%, and 44%, respectively. Limb salvage rates at 12 and 24 months were 94% and 65%, and amputation-free survival rates at 12 and 24 months were 87% and 60%, respectively. Endovascular recanalization of native CTOs in patients with failed lower-extremity bypass grafts is technically feasible and safe and results in acceptable limb salvage. Copyright © 2014 SIR. Published by Elsevier Inc. All rights reserved.

The GuideLiner catheter: A supportive tool in percutaneous coronary intervention of chronic total occlusion

Directory of Open Access Journals (Sweden)

Jan-Erik Guelker

2018-04-01

Full Text Available Background: Failure of delivering a stent or a balloon across the target lesion during percutaneous coronary intervention (PCI of chronic total occlusion (CTO, especially in arteries with calcified tortuous anatomy, is often due to insufficient backup support from the guiding catheter. The purpose of this study was to assess the feasibility of the GuideLiner (GL catheter use. Methods: We examined 18 patients and used the GL catheter to overcome poor support and excessive friction in standardized antegrade and retrograde CTO procedures. The GL is a coaxial, monorail guiding catheter extension delivered through a standard guiding catheter and is available in different sizes. Results: Almost all lesions were classified as severely calcified (94.4 ± 0.24%. The Japanese CTO score reflecting lesion complexity was 3.56 ± 0.78. All procedures were performed femorally; the retrograde approach was used in 27.8 ± 0.46% of cases. The overall success rate was 88.9 ± 0.32%; there were no relevant complications. Conclusions: The GL catheter is an adjunctive interventional device which enhances and amplifies CTO-PCI. Its use is indicated in cases in which back-up force needs to be strengthened to pass a CTO despite advanced calcification. It can be recommended as an important additional tool in advanced interventional cardiology such as antegrade and retrograde CTO-PCI if other techniques like anchor balloon or anchor wire are not possible. Keywords: Chronic total occlusion, GuideLiner catheter, Percutaneous coronary intervention, Severe calcification

Direct measured systolic pressure gradients across the aorto-iliac segment in multiple-level-obstruction arteriosclerosis

DEFF Research Database (Denmark)

Noer, Ivan; Praestholm, J; Tønnesen, K H

1981-01-01

Patients with severe ischemia due to multi-level obstructions in the leg arteries both above and below the region were assessed preoperatively by intraarterial brachial and femoral artery pressure measurements. The systolic pressure drop along aorto-iliac obstructions was compared to the angiogra....... Due to large variations, however, the angiographic information was found to be useless in the individual patient. No difference in the pressure drop was found between cases in which rich and poor collateral networks were visualized....

Peripheral Stent Thrombosis Leading to Acute Limb Ischemia and Major Amputation: Incidence and Risk Factors in the Aortoiliac and Femoropopliteal Arteries

International Nuclear Information System (INIS)

Katsanos, Konstantinos; Al-Lamki, Said A. M.; Parthipun, Aneeta; Spiliopoulos, Stavros; Patel, Sanjay Dhanji; Paraskevopoulos, Ioannis; Zayed, Hany; Diamantopoulos, Athanasios

2017-01-01

PurposeTo report the real-world incidence and risk factors of stent thrombosis in the aortoiliac and femoropopliteal arteries in case of bare nitinol stent (BNS) or covered nitinol stent (CNS) placement from a single-centre retrospective audit.Materials and MethodsMedical records of consecutive patients treated with peripheral stent placement for claudication or critical limb ischemia were audited for definite stent thrombosis defined as imaging confirmed stent thrombosis that presented as acute limb-threatening ischemia. Cases were stratified between aortoiliac and femoropopliteal anatomy. Cox regression analysis was employed to adjust for baseline clinical and procedural confounders and identify predictors of stent thrombosis and major limb loss.Results256 patients (n = 277 limbs) were analysed over a 5-year period (2009–2014) including 117 aortoiliac stents (34 CNS; 12.8 ± 5.0 cm and 83 BNS; 7.8 ± 4.0 cm) and 160 femoropopliteal ones (60 CNS; 21.1 ± 11.0 cm and 100 BNS; 17.5 ± 11.9 cm). Median follow-up was 1 year. Overall stent thrombosis rate was 6.1% (17/277) after a median of 43 days (range 2–192 days) and affected almost exclusively the femoropopliteal segment (12/60 in the CNS cohort vs. 4/100 in the BNS; p = 0.001). Annualized stent thrombosis rates (per 100 person-years) were 12.5% in case of CNS and 1.4% in case of BNS (HR 6.3, 95% CI 2.4–17.9; p = 0.0002). Corresponding major amputations rates were 8.7 and 2.5%, respectively (HR 4.5, 95% CI 2.7–27.9; p = 0.0006). On multivariable analysis, critical leg ischemia and CNS placement were the only predictors of stent thrombosis. Diabetes, critical leg ischemia, femoropopliteal anatomy, long stents and CNS were independent predictors of major amputations.ConclusionsPlacement of long femoropopliteal covered nitinol stents is associated with an increased incidence of acute stent thrombosis and ensuing major amputation. Risks are significantly lower in the aortoiliac vessels

Peripheral Stent Thrombosis Leading to Acute Limb Ischemia and Major Amputation: Incidence and Risk Factors in the Aortoiliac and Femoropopliteal Arteries

Energy Technology Data Exchange (ETDEWEB)

Katsanos, Konstantinos, E-mail: katsanos@med.upatras.gr [King’s Health Partners, Department of Interventional Radiology, Imaging Sciences Division, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Al-Lamki, Said A. M. [The Royal Hospital, Department of Radiology (Oman); Parthipun, Aneeta [King’s Health Partners, Department of Interventional Radiology, Imaging Sciences Division, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Spiliopoulos, Stavros [ATTIKO Athens University Hospital, 2nd Department of Radiology, Interventional Radiology Unit (Greece); Patel, Sanjay Dhanji [King’s Health Partners, Academic Department of Surgery, Cardiovascular Division, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Paraskevopoulos, Ioannis [King’s Health Partners, Department of Interventional Radiology, Imaging Sciences Division, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Zayed, Hany [King’s Health Partners, Academic Department of Surgery, Cardiovascular Division, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom); Diamantopoulos, Athanasios [King’s Health Partners, Department of Interventional Radiology, Imaging Sciences Division, Guy’s and St. Thomas’ Hospitals, NHS Foundation Trust (United Kingdom)

2017-03-15

PurposeTo report the real-world incidence and risk factors of stent thrombosis in the aortoiliac and femoropopliteal arteries in case of bare nitinol stent (BNS) or covered nitinol stent (CNS) placement from a single-centre retrospective audit.Materials and MethodsMedical records of consecutive patients treated with peripheral stent placement for claudication or critical limb ischemia were audited for definite stent thrombosis defined as imaging confirmed stent thrombosis that presented as acute limb-threatening ischemia. Cases were stratified between aortoiliac and femoropopliteal anatomy. Cox regression analysis was employed to adjust for baseline clinical and procedural confounders and identify predictors of stent thrombosis and major limb loss.Results256 patients (n = 277 limbs) were analysed over a 5-year period (2009–2014) including 117 aortoiliac stents (34 CNS; 12.8 ± 5.0 cm and 83 BNS; 7.8 ± 4.0 cm) and 160 femoropopliteal ones (60 CNS; 21.1 ± 11.0 cm and 100 BNS; 17.5 ± 11.9 cm). Median follow-up was 1 year. Overall stent thrombosis rate was 6.1% (17/277) after a median of 43 days (range 2–192 days) and affected almost exclusively the femoropopliteal segment (12/60 in the CNS cohort vs. 4/100 in the BNS; p = 0.001). Annualized stent thrombosis rates (per 100 person-years) were 12.5% in case of CNS and 1.4% in case of BNS (HR 6.3, 95% CI 2.4–17.9; p = 0.0002). Corresponding major amputations rates were 8.7 and 2.5%, respectively (HR 4.5, 95% CI 2.7–27.9; p = 0.0006). On multivariable analysis, critical leg ischemia and CNS placement were the only predictors of stent thrombosis. Diabetes, critical leg ischemia, femoropopliteal anatomy, long stents and CNS were independent predictors of major amputations.ConclusionsPlacement of long femoropopliteal covered nitinol stents is associated with an increased incidence of acute stent thrombosis and ensuing major amputation. Risks are significantly lower in the aortoiliac vessels

Effect of Graft Material on Red Blood Cell Loss Following Aortic Surgery

National Research Council Canada - National Science Library

Fisher, Jay

1990-01-01

... (Meadox Woven Double Velour) and PTFE (Gore-Tex) grafts. A total of 25 patients (13 Dacron, 12 PTFE) were studied including 21 with abdominal aortic aneurysms, and 4 with aorto-iliac occlusive disease...

The prevalence of carotid artery stenosis in patients undergoing aortic reconstruction.

Science.gov (United States)

Cahan, M A; Killewich, L A; Kolodner, L; Powell, C C; Metz, M; Sawyer, R; Lilly, M P; Benjamin, M E; Flinn, W R

1999-09-01

Coronary artery disease occurs frequently in patients undergoing aortic reconstruction, and it has been presumed that internal carotid artery occlusive disease is also common. This has led to the practice of screening for and repairing significant carotid lesions in asymptomatic patients prior to aortic reconstruction. The purpose of this study was to determine the true prevalence of internal carotid artery disease in these patients. The records of 240 patients who underwent duplex ultrasound screening for carotid artery disease prior to aortic reconstruction were reviewed. Surgery was performed for aortic aneurysm (AA) or aorto-iliac occlusive disease (AO). The prevalence of hyperlipidemia and coronary artery disease was similar between the two groups, but tobacco use, hypertension, and diabetes mellitus differed. Internal carotid artery stenosis > or = 50% occurred in 26.7% of the total group (64 of 240 cases). Stenosis > or = 50% was more common in the AO group (40 of 101 cases, 39.6%) than the AA group (24 of 139 cases, 17.3%, P = 0.0001). Severe disease (70% to 99%) was also more common in the AO group than the AA group (9.9% versus 3.6%, P = 0.0464). Internal carotid artery disease occurs commonly in patients undergoing aortic reconstruction, and screening is worthwhile. Significant disease is more common in patients with aorto-iliac occlusive disease than in those with aortic aneurysm, although atherosclerotic risk factors occur with varying frequency in the two groups. These findings suggest that additional factors may contribute to the higher prevalence of internal carotid artery stenosis in aorto-iliac occlusive disease.

Autofluorescence and high-definition optical coherence tomography of retinal artery occlusions

Directory of Open Access Journals (Sweden)

Raeba Mathew

2010-10-01

Full Text Available Raeba Mathew, Evangelia Papavasileiou, Sobha SivaprasadLaser and Retinal Research Unit, Department of Ophthalmology, King’s College Hospital, Denmark Hill, London, UKBackground: The purpose of this study is to illustrate the fundus autofluorescence and high-definition optical coherence tomography (HD-OCT features of acute and long-standing retinal artery occlusions.Design: Retrospective case series.Participants: Patients with acute and chronic retinal and cilioretinal artery occlusions are included in this series.Methods: A detailed clinical examination, color fundus photographs, autofluorescence, and HD-OCT of the subjects were performed.Results: HD-OCT demonstrates the localized and well-demarcated thickening of the inner retina in the acute phase of arterial occlusions that correlates with the areas of blocked autofluorescence caused by the cloudy swelling of the retina. The areas of blocked autofluorescence disappear with chronicity of the disease and this corresponds to the thinning of the inner retinal layers on HD-OCT.Conclusion: Heidelberg OCT and autofluorescence are useful tools to assess retinal arterial occlusions especially in subjects with unexplained visual field loss.Keywords: autofluorescence, high definition OCT, retinal artery occlusion

Deep venous thrombophlebitis following aortoiliac reconstructive surgery

International Nuclear Information System (INIS)

Reilly, M.K.; McCabe, C.J.; Abbott, W.M.; Brewster, D.C.; Moncure, A.C.; Reidy, N.C.; Darling, R.C.

1982-01-01

One hundred patients undergoing elective aortic surgery were scanned prospectively for development of deep venous thrombosis (DVT). The incidence of DVT in this population was 13%. Eleven patients showed only calf vein thrombosis on venography, whereas two had occlusive iliofemoral thrombus. The correlation between venous Doppler ultrasound and venography was 80%. More importantly, Doppler examination correctly identified both patients with occlusive thrombus. Fibrinogen scanning was associated with a false-positive rate of 31%. Only one patient suffered a nonfatal pulmonary embolus. Fibrinogen scanning has an unacceptably high false-positive rate; however, Doppler ultrasound will identify significant occlusive thrombus without a high false-positive rate. The low incidence of pulmonary emboli does not warrant such definitive measures as prophylactic vena caval interruption

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)

Zhang Fuxian; Zhang Changming; Hu Lu; Feng Yaping; Liang Gangzhu; Zhang Huan

2010-01-01

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

Cerebral perfusion MR imaging using FAIR-HASTE in chronic carotid occlusive disease. Comparison with dynamic susceptibility contrast-perfusion MR imaging

International Nuclear Information System (INIS)

Ida, Kentaro; Akaki, Shiro; Sei, Tetsuro; Kanazawa, Susumu; Tsunoda, Masatoshi

2006-01-01

To determine the efficacy of flow-sensitive alternating inversion recovery using half-Fourier single-shot turbo spin-echo (FAIR-HASTE) in detecting cerebral hypoperfusion in chronic carotid occlusive disease, we subjected 12 patients with various degrees of cervical internal carotid artery stenoses and/or occlusion (Stenosis group) and 24 volunteers (Normal group) to FAIR-HASTE. In addition, 10 out of 12 patients in the Stenosis group underwent dynamic susceptibility contrast-perfusion magnetic resonance imaging (DSC-pMRI) before and after revascularization in the dominantly affected side. The absolute asymmetry indexes (AIs) of both cerebral hemispheres in the Normal and Stenosis groups were compared in FAIR-HASTE. In addition, the AIs were compared with those in the Stenosis group before and after revascularization in both FAIR-HASTE and regional cerebral blood flow (rCBF), calculated with DSC-pMRI. A statistically significant difference was recognized between the AIs in the Normal and Stenosis groups (AI=2.25±1.92, 8.09±4.60, respectively; p<0.0001). Furthermore, in the Stenosis group the AIs on both FAIR-HASTE (8.88±4.93, 2.22±1.79, respectively; p=0.0003) and rCBF (7.13±3.57, 1.25±1.33, respectively; p=0.0003) significantly decreased after revascularization. In the Stenosis group, before revascularization, signal intensity on both FAIR-HASTE and rCBF had a tendency to be lower in the dominantly affected side. FAIR-HASTE imaging was useful in the detection and evaluation of cerebral hypoperfusion in chronic occlusive carotid disease. (author)

Dual-energy CT angiography in peripheral arterial occlusive disease - accuracy of maximum intensity projections in clinical routine and subgroup analysis

International Nuclear Information System (INIS)

Kau, Thomas; Eicher, Wolfgang; Reiterer, Christian; Niedermayer, Martin; Rabitsch, Egon; Hausegger, Klaus A.; Senft, Birgit

2011-01-01

To evaluate the accuracy of dual-energy CT angiography (DE-CTA) maximum intensity projections (MIPs) in symptomatic peripheral arterial occlusive disease (PAOD). In 58 patients, DE-CTA of the lower extremities was performed on dual-source CT. In a maximum of 35 arterial segments, severity of the most stenotic lesion was graded (<10%, 10-49% and 50-99% luminal narrowing or occlusion) independently by two radiologists, with DSA serving as the reference standard. In DSA, 52.3% of segments were significantly stenosed or occluded. Agreement of DE-CTA MIPs with DSA was good in the aorto-iliac and femoro-popliteal regions (κ = 0.72; κ = 0.66), moderate in the crural region (κ = 0.55), slight in pedal arteries (κ = 0.10) and very good in bypass segments (κ = 0.81). Accuracy was 88%, 78%, 74%, 55% and 82% for the respective territories and moderate (75%) overall, with good sensitivity (84%) and moderate specificity (67%). Sensitivity and specificity was 82% and 76% in claudicants and 84% and 61% in patients with critical limb ischaemia. While correlating well with DSA above the knee, accuracy of DE-CTA MIPs appeared to be moderate in the calf and largely insufficient in calcified pedal arteries, especially in patients with critical limb ischaemia. (orig.)

Knowledge of chronic total occlusion among Polish interventional cardiologists.

Science.gov (United States)

Bryniarski, Krzysztof L; Zabojszcz, Michał; Dębski, Grzegorz; Marchewka, Jakub; Legutko, Jacek; Surowiec, Sławomir; Siudak, Zbigniew; Żmudka, Krzysztof; Dudek, Dariusz; Bryniarski, Leszek

2015-01-01

Chronic total occlusion (CTO) recanalization is indicated in patients with symptoms and evidence of ischemia, but in most cases those types of lesions are still treated medically. In the last few years CTO angioplasty technique has changed dramatically due to considerable advances in techniques and dedicated equipment. An attempt to assess the state of knowledge of technical aspects of CTO angioplasty of coronary arteries among Polish interventional cardiologists. Questionnaire survey performed during two major Polish invasive cardiology workshops. In the study there participated 113 physicians with an average length of work experience of 13 years, most of them cardiologists certified as independent primary operators. The majority of respondents recognized the need of prevention of thrombotic complications through control of activated coagulation time during the CTO procedures. Prevention of renal complications and X-ray protection are also recognized as a significant part of the procedures. The benefits from the use of over-the-wire microcatheters and balloons, the proper choice of dedicated guidewires, contralateral injections and retrograde technique are underestimated. Despite satisfactory knowledge about indications and qualification for the CTO procedure, the awareness of procedural aspects (particularly the retrograde technique) as well as the dedicated CTO equipment among Polish interventional cardiologists is still insufficient.

Coronary collateral circulation in patients with chronic coronary total occlusion; its relationship with cardiac risk markers and SYNTAX score.

Science.gov (United States)

Börekçi, A; Gür, M; Şeker, T; Baykan, A O; Özaltun, B; Karakoyun, S; Karakurt, A; Türkoğlu, C; Makça, I; Çaylı, M

2015-09-01

Compared to patients without a collateral supply, long-term cardiac mortality is reduced in patients with well-developed coronary collateral circulation (CCC). Cardiovascular risk markers, such as N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitive C-reactive protein (hs-CRP) and high-sensitive cardiac troponin T (hs-cTnT) are independent predictors for cardiovascular mortality. The main goal of this study was to examine the relationship between CCC and cardiovascular risk markers. We prospectively enrolled 427 stable coronary artery disease patients with chronic total occlusion (mean age: 57.5±11.1 years). The patients were divided into two groups, according to their Rentrop scores: (a) poorly developed CCC group (Rentrop 0 and 1) and (b) well-developed CCC group (Rentrop 2 and 3). NT-proBNP, hs-CRP, hs-cTnT, uric acid and other biochemical markers were also measured. The SYNTAX score was calculated for all patients. The patients in the poorly developed CCC group had higher frequencies of diabetes and hypertension (prisk markers, such as NT-proBNP, hs-cTnT and hs-CRP are independently associated with CCC in stable coronary artery disease with chronic total occlusion. © The Author(s) 2014.

Combined stent placement and high dose PGE1 drip infusion for chronic occlusion of the superficial femoral artery as a modality to salvage chronic critical limb ischemia

Energy Technology Data Exchange (ETDEWEB)

Ikushima, Ichiro [Department of Radiology, Miyakonojo Medical Association Hospital, 5822-3 Oiwadacho, Miyakonojo 885-0062 (Japan)], E-mail: iku-i@fk.enjoy.ne.jp; Hirai, Toshinori [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University (Japan); Ishii, Akihiko [Department of Radiology, Miyakonojo Medical Association Hospital, 5822-3 Oiwadacho, Miyakonojo 885-0062 (Japan); Yamashita, Yasuyuki [Department of Diagnostic Radiology, Graduate School of Medical Sciences, Kumamoto University (Japan)

2008-04-15

Purpose: To assess the initial effect, short-term patency, and limb salvage rates of combined stent placement and high-dose prostaglandin E-1 (PGE1) drip infusion for chronic occlusion of the superficial femoral artery (SFA). Materials and methods: A total of 15 arteriosclerotic occlusive lesions of the SFA were treated in 11 consecutive patients (mean age: 78.4 years old). All cases were of category 4 or 5, based on the criteria of the Society of Vascular Surgery and Intermittent Society for Cardiovascular Surgery (SVC/ISCVS). In all cases a self-expandable stainless steel stent was implanted. PGE1 treatment was started 3-5 days before stent placement and continued for 7-10 days after the intervention. The technical success, limb salvage outcomes, patency rates, and complications were examined. Results: In all cases, the technical success rate of the procedure was 100%. After stent implantation, the clinical status of all cases was improved by at least +2, and major amputation was not required in any cases. The 12-month primary, secondary patency rates, and limb salvage rate were 57%, 100%, and 100%, respectively. Conclusion: Combined stent placement and high-dose PGE1 drip infusion is a treatment of choice for salvaging the lower limb of a patient with chronic critical ischemia.

Long-term outcomes after percutaneous coronary intervention for chronic total occlusion (from the CREDO-Kyoto registry cohort-2).

OpenAIRE

Yamamoto, Erika; Natsuaki, Masahiro; Morimoto, Takeshi; Furukawa, Yutaka; Nakagawa, Yoshihisa; Ono, Koh; Mitsudo, Kazuaki; Nobuyoshi, Masakiyo; Doi, Osamu; Tamura, Takashi; Tanaka, Masaru; Kimura, Takeshi

2013-01-01

Despite improving success rate of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) lesions, the clinical benefit of recanalization of CTO is still a matter of debate. Of 13, 087 patients who underwent PCI in the CREDO-Kyoto registry cohort-2, 1, 524 patients received PCI for CTO (CTO-PCI). Clinical outcomes were compared between 1, 192 patients with successful CTO-PCI and 332 patients with failed CTO-PCI. In-hospital death tended to occur less frequently in the succe...

Association between duration of coronary occlusion and high-intensity signal on T1-weighted magnetic resonance imaging among patients with angiographic total occlusion

Energy Technology Data Exchange (ETDEWEB)

Matsumoto, Kenji; Ehara, Shoichi; Hasegawa, Takao; Sakaguchi, Mikumo; Shimada, Kenei [Osaka City University Graduate School of Medicine, Department of Cardiovascular Medicine, Abeno-ku, Osaka (Japan)

2017-09-15

To evaluate the association between duration of the coronary occlusion and high-intensity signal (HIS) on noncontrast T1-weighted imaging using a 1.5-T magnetic resonance imager among patients with angiographic coronary total occlusion. The signal intensity of the coronary target area divided by the signal intensity of the left ventricular muscle near the target area at each site (TMR) was measured. Areas with a TMR >1.0 were defined as HIS. Thirty five lesions from 33 patients were divided into the following three groups: subacute occlusion (up to 3 months; n = 7), short-duration chronic total occlusion (SD-CTO: 3-6 months; n = 9) and long-duration CTO (LD-CTO: ≥6 months; n = 19). All subacute occlusion lesions showed a HIS within the occlusion site. Among patients with CTO, the frequency of a HIS within the occlusion site was significantly higher in SD-CTO than in LD-CTO lesions (p = 0.013). In multivariate analyses, only an occlusion duration of less than 6 months was an independent factor associated with the presence of HIS (odds ratio 7.6, 95% CI 1.1-54.5; p = 0.044). The presence of a HIS in the occlusion site was associated more with SD-CTO than with LD-CTO among patients with CTO. (orig.)

Association between duration of coronary occlusion and high-intensity signal on T1-weighted magnetic resonance imaging among patients with angiographic total occlusion

International Nuclear Information System (INIS)

Matsumoto, Kenji; Ehara, Shoichi; Hasegawa, Takao; Sakaguchi, Mikumo; Shimada, Kenei

2017-01-01

To evaluate the association between duration of the coronary occlusion and high-intensity signal (HIS) on noncontrast T1-weighted imaging using a 1.5-T magnetic resonance imager among patients with angiographic coronary total occlusion. The signal intensity of the coronary target area divided by the signal intensity of the left ventricular muscle near the target area at each site (TMR) was measured. Areas with a TMR >1.0 were defined as HIS. Thirty five lesions from 33 patients were divided into the following three groups: subacute occlusion (up to 3 months; n = 7), short-duration chronic total occlusion (SD-CTO: 3-6 months; n = 9) and long-duration CTO (LD-CTO: ≥6 months; n = 19). All subacute occlusion lesions showed a HIS within the occlusion site. Among patients with CTO, the frequency of a HIS within the occlusion site was significantly higher in SD-CTO than in LD-CTO lesions (p = 0.013). In multivariate analyses, only an occlusion duration of less than 6 months was an independent factor associated with the presence of HIS (odds ratio 7.6, 95% CI 1.1-54.5; p = 0.044). The presence of a HIS in the occlusion site was associated more with SD-CTO than with LD-CTO among patients with CTO. (orig.)

Early Introduction of Everolimus Immunosuppressive Regimen in Liver Transplantation with Extra-Anatomic Aortoiliac-Hepatic Arterial Graft Anastomosis

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Emanuele Felli

2014-01-01

Full Text Available Liver transplantation is the treatment of choice for patients with acute and chronic end-stage liver disease, when no other medical treatment is possible. Despite high rates of 1- to 5-year survival, long-term adverse effects of immunosuppressant agents remain of major concern. Current research and clinical efforts are made to develop immunosuppressant agents that minimize adverse effects along with a low rate of graft rejection. Tailoring immunosuppressive therapy to individual patients by the use of proliferation signal inhibitors seems to be the best way to minimize toxicity and increase efficacy. Recently everolimus has been introduced in clinical practice; among its adverse effects an increased incidence of arterial graft thrombosis in renal transplants, vascular anastomosis leakage, impaired wound healing, and thrombotic microangiopathy have been reported. We present the case of a 54-year-old patient submitted to liver transplantation for end-stage liver disease treated by an extra-anatomic aortoiliac-hepatic arterial graft anastomosis and early postoperative introduction of everolimus for acute renal failure. Postoperative period was characterized by two abdominal collections and reactivation of cytomegalovirus infection that were treated by percutaneous drainage and antiviral therapy, respectively; the patient is well after 8-month followup with patency of the arterial conduit and no leakage.

Influence of Iliac Stenotic Lesions on Blood Flow Patterns Near a Covered Endovascular Reconstruction of the Aortic Bifurcation (CERAB) Stent Configuration

NARCIS (Netherlands)

Jebbink, Erik Groot; Engelhard, Stefan; Lajoinie, Guillaume; de Vries, Jean-Paul P.M.; Versluis, Michel; Reijnen, Michel M.P.J.

2017-01-01

Purpose: To investigate the effect of distal stenotic lesions on flow patterns near a covered endovascular reconstruction of the aortic bifurcation (CERAB) configuration used in the treatment of aortoiliac occlusive disease. Method: Laser particle image velocimetry measurements were performed using

Acute pancreatitis during sickle cell vaso-occlusive painful crisis.

Science.gov (United States)

Ahmed, Shahid; Siddiqui, Anita K; Siddiqui, Rina K; Kimpo, Miriam; Russo, Linda; Mattana, Joseph

2003-07-01

Sickle cell disease is characterized by chronic hemolytic anemia and vaso-occlusive painful crisis. The vascular occlusion in sickle cell disease is a complex process and accounts for the majority of the clinical manifestations of the disease. Abdominal pain is an important component of vaso-occlusive painful crisis and may mimic diseases such as acute appendicitis and cholecystitis. Acute pancreatitis is rarely included as a cause of abdominal pain in patients with sickle cell disease. When it occurs it may result form biliary obstruction, but in other instances it might be a consequence of microvessel occlusion causing ischemia. In this series we describe four cases of acute pancreatitis in patients with sickle cell disease apparently due to microvascular occlusion and ischemic injury to the pancreas. All patients responded to conservative management. Acute pancreatitis should be considered in the differential diagnosis of abdominal pain in patients with sickle cell disease. Copyright 2003 Wiley-Liss, Inc.

Impact of the Intracoronary Rendezvous technique on coronary angioplasty for chronic total occlusion.

Science.gov (United States)

Nihei, Taro; Yamamoto, Yoshito; Kudo, Shun; Hanawa, Kenichiro; Hasebe, Yuhi; Takagi, Yusuke; Minatoya, Yutaka; Sugi, Masafumi; Shimokawa, Hiroaki

2017-10-01

The Rendezvous technique, which requires bidirectional wiring, is one of the useful methods for improving the success rate of recanalization for chronic total occlusion (CTO) in the field of peripheral intervention. Recently, advanced new devices for percutaneous coronary intervention have enabled us to perform the Rendezvous technique for peripheral as well as for coronary CTO lesions. We used the Intracoronary Rendezvous technique to perform angioplasty for coronary CTO. "Intracoronary Rendezvous" means that Rendezvous was achieved within the CTO lesion. From March 2009 to November 2015, 189 patients underwent CTO angioplasty at our institute, and we treated 10 patients with the Intracoronary Rendezvous technique. This technique involves crossing the Gaia series guidewire to the contralateral Corsair microcatheter located inside the plaque of CTO lesions. The majority of the CTO sites examined were in the proximal RCA (60 %). Lesion length of the occlusion was relatively long (64.4 ± 12.2 mm). Using the biplane imaging system, we were able to control the Gaia guidewires in a specific direction. Furthermore, if the antegrade and retrograde wires can be advanced into contiguous space inside the CTO lesion, we intentionally entered either wire into the contralateral Corsair microcatheter, followed by successful CTO crossing. CTO recanalization was completed for all patients without controlled antegrade retrograde subintimal tracking (CART) or reverse CART. No major complications occurred during hospitalization. These results indicate that the Rendezvous technique, assisted by new devices and a biplane imaging system, represents one of the primary options to achieve successful coronary CTO recanalization.

Initial and Long-Term Results of Endovascular Therapy for Chronic Total Occlusion of the Subclavian Artery

International Nuclear Information System (INIS)

Babic, Srdjan; Sagic, Dragan; Radak, Djordje; Antonic, Zelimir; Otasevic, Petar; Kovacevic, Vladimir; Tanaskovic, Slobodan; Ruzicic, Dusan; Aleksic, Nikola; Vucurevic, Goran

2012-01-01

Purpose: To study the initial and long-term results of angioplasty and primary stenting for the treatment of chronic total occlusion (CTO) of the subclavian artery (SA). Materials and Methods: From January 1999 to February 2010, 56 patients (25 men with a mean age of 58 ± 8 years) underwent endovascular treatment for CTO of the SA. Duplex scans and arteriograms confirmed occlusion in all cases. Indications for recanalization were subclavian steal syndrome in 33 patients (58.1%), arm claudication in 13 patients (23.2%), and coronary ischemia in 7 patients (12.5%) who had a history of previous coronary artery bypass grafting that included left internal thoracic artery graft. Three patients (5.4%) were treated before the scheduled coronary artery bypass surgery, which included left internal thoracic artery graft. After successful recanalization, all arteries were stented, and all of the patients were followed-up at 1, 3, 6, and 12 months after surgery and annually thereafter. Results: Successful recanalization of the SA was achieved in 46 patients (82.1%), and the complication rate was 7.1%. During follow-up (mean 40 ± 26 months; range 2 to 125), the primary patency rates after 1 and 3 years were 97.9% and 82.7%, respectively. At the end of follow-up, 76% of the arteries showed no evidence of restenosis. Univariate analysis failed to identify any variable predictive of long-term patency of successfully recanalized SA. Conclusion: Percutaneous transluminal angioplasty with stenting of the complete total occlusion of the SA is a safe and effective procedure associated with low risks and good long-term results.

Subintimal angioplasty for below-the-ankle arterial occlusion in diabetic patients with chronic critical limb ischemia

International Nuclear Information System (INIS)

Xu Ying; Zhu Yueqi; Zhao Jungong; Wang Jianbo; Tan Huaqiao; Cheng Yingsheng; Li Minghua; Wang Jue; Cheng Yongde

2011-01-01

Objective: To assess the feasibility and efficacy of subintimal angioplasty (SA) for the treatment of below-the-arterial occlusion in diabetic patients with chronic critical limb ischemia (CLI). Methods: SA was adopted for 57 diseased lower limbs in 37 diabetic patients with chronic CLI and occlusive disease of the dorsalis pedis artery (DPA) and/or planter artery (PA), who were not suitable candidates for intraluminal angioplasty or bypass surgery. Of the total 57 diseased lower limbs, tissue loss was seen in 31 (54.4%) and pain was reported in 51 (89.5%). SA was carried out to create continuous arterial flow to the foot for limb salvage. Both before and after the procedure the clinical symptoms, DPA or PA pulse volume scores and ankle-brachial indexes (ABI) were determined in all patients, the results were compared and statistically analysed. During the follow-up period, the healing of the wound, the salvage of the diseased limb and the re-stenosis occurrence of the target vessels were evaluated. Kaplan-Meier curves were constructed to evaluate limb salvage, survival rate and freedom from amputation. Results: A total of 66 below-the-ankle arterial lesions were detected in 57 affected limbs. Of the 66 lesions, SA was successfully performed in 55 (83.3%). Before SA the median pulse volume scores and ABIs were 0.33±0.54 and 0.31±0.19 respectively, which became 2.04±1.05 and 0.80±0.14 respectively after SA, the differences in both median pulse volume scores and ABI were statistically significant (P<0.01 for both). One patient (2.7%) died within 30 days after the procedure. Mild complications, such as bleeding, thrombosis or angiospasm etc. occurred in five patents (13.5%). Twelve months after SA. Kaplan-Meier analysis showed that the limb salvage rate was 94.6%, the freedom from amputation was 89.2% and the survival rate was 97.3%. Conclusion: SA of the dorsalis pedis artery and/or planter artery is an effective technique for lower limb salvage in diabetic

Autofluorescence and high-definition optical coherence tomography of retinal artery occlusions

OpenAIRE

Mathew, Raeba; Papavasileiou, Evangelia; Sivaprasad, Sobha

2010-01-01

Raeba Mathew, Evangelia Papavasileiou, Sobha SivaprasadLaser and Retinal Research Unit, Department of Ophthalmology, King’s College Hospital, Denmark Hill, London, UKBackground: The purpose of this study is to illustrate the fundus autofluorescence and high-definition optical coherence tomography (HD-OCT) features of acute and long-standing retinal artery occlusions.Design: Retrospective case series.Participants: Patients with acute and chronic retinal and cilioretinal artery occlus...

South African Medical Journal - Vol 89, No 12 (1999)

African Journals Online (AJOL)

Aorto-iliac occlusive disease in the different population groups - clinical pattern, risk profile and results of reconstruction · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. T E Madiba, M Mars, J V Robbs, 1288-1292 ...

Comparison of gadofosveset-enhanced three-dimensional magnetic resonance angiography with digital subtraction angiography for lower-extremity peripheral arterial occlusive disease

International Nuclear Information System (INIS)

Grijalba, Fermin Urtasun; Esandi, Mercedes Ciriza

2010-01-01

Background: Minimally invasive imaging techniques are increasingly used for clinical decision making in patients with peripheral arterial occlusive disease (PAOD). Purpose: To assess whether gadofosveset-enhanced three-dimensional (3D) magnetic resonance (MR) angiography could replace digital subtraction angiography (DSA) for the evaluation of lower-extremity PAOD. Material and Methods: Thirty patients with symptomatic PAOD underwent prospectively both MR angiography and DSA. Gadofosveset-enhanced 3D MR angiography was performed on a 1.5T system equipped with a peripheral angio matrix coil. Four blinded observers independently analyzed MR angiograms and DSA images. The lower arterial vascular system was divided into three anatomic segments (aortoiliac, femoropopliteal, infrapopliteal) for review. The status of each segment was graded as normal, stenosis less than 50%, stenosis greater than 50%, or occluded and/or aneurismatic. Principal and secondary lesions were reported. Results: Although interobserver agreement for both was excellent, it was higher for DSA (?=0.92) than for MR angiography (?=0.86) for reporting the principal and secondary lesions in all segments. For different anatomic locations, the interobserver agreement of MR angiography and DSA was as follows: aortoiliac (?=0.93, k=0.95), femoropopliteal (?=0.86, k=0.90), and infrapopliteal (?=0.78, k=0.85). The lowest agreement was found for MR angiography on infrapopliteal segments (?=0.78). In four (13.3%) cases, MR angiography showed lesions that were not found by DSA. Five (16.6%) aneurysm cases, not observed by DSA, were shown by MR angiography. Conclusion: Gadofosveset-enhanced 3D MR angiography can be proposed for first-line imaging in the management of lower-limb PAOD patients and permits the selective use of DSA as a second-line examination when MR angiography fails or in an endovascular approach

Experimental occlusal interference induces long-term masticatory muscle hyperalgesia in rats.

Science.gov (United States)

Cao, Ye; Xie, Qiu-Fei; Li, Kai; Light, Alan R; Fu, Kai-Yuan

2009-08-01

Temporomandibular joint or related masticatory muscle pain represents the most common chronic orofacial pain condition. Patients frequently report this kind of pain after dental alterations in occlusion. However, lack of understanding of the mechanisms of occlusion-related temporomandibular joint and muscle pain prevents treating this problem successfully. To explore the relationship between improper occlusion (occlusal interference) and masticatory muscle pain, we created an occlusal interference animal model by directly bonding a crown to a maxillary molar to raise the masticating surface of the tooth in rats. We raised the occlusal surface to three different heights (0.2, 0.4, and 0.6mm), and for one month we quantitatively measured mechanical nociceptive thresholds of the temporal and masseter muscles on both sides. Results showed a stimulus-response relationship between the height of occlusal interference and muscle hyperalgesia. Removal of the crown 6 days after occlusal interference showed that the removal at this time could not terminate the 1 month duration of mechanical hyperalgesia in the masticatory muscles. Lastly, we systemically administered NMDA antagonist MK801 (0.2, 0.1, and 0.05 mg/kg) to the treated rats and found that MK801 dose dependently attenuated the occlusal interference-induced hyperalgesia. These findings suggest that occlusal interference is directly related to masticatory muscle pain, and that central sensitization mechanisms are involved in the maintenance of the occlusal interference-induced mechanical hyperalgesia.

Outcomes of the Endovascular Treatment of Stenotic Lesions versus Chronic Total Occlusions in the Iliac Sector.

Science.gov (United States)

Revuelta Suero, Sergio; Martínez López, Isaac; Hernández Mateo, Manuela; Marqués de Marino, Pablo; Cernuda Artero, Iñaki; Cabrero Fernández, Maday; Serrano Hernando, Francisco Javier

2016-07-01

This study compares outcomes of the endovascular treatment (EVT) of iliac artery occlusive disease according to whether the treated lesion is a stenosis or a chronic total occlusion (CTO). Patients undergoing EVT from 2003 to 2013 for iliac artery occlusive disease were identified and the lesions treated stratified into stenotic (Group 1, n = 375) or CTO (Group 2, n = 87). Patients were followed clinically and hemodynamically (thigh-brachial index, TBI). Comorbidities, procedural factors, and outcomes were compared between the 2 groups using Kaplan-Meier, Breslow, and Cox models. Four hundred sixty-two iliac endovascular procedures in 378 patients were included in a retrospective study. The 2 groups only differed in preprocedural TBI [0.77 (Group 1) vs. 0.67 (Group 2), P P2) patency rates [P1 93.0% and 85.8% vs. 83.1% and 74.7%, hazard ratio (HR) 1.90 (1.15-3.14), P = 0.018; P2 97.8% and 96.8% vs. 93.0% and 87.4%, HR 2.86 (1.39-5.90), P = 0.007] and freedom from reintervention (FFR) rates [91.6% and 83.5% vs. 84.1% and 78.9%, HR 1.51 (0.90-2.53), P = 0.132]. In a multivariate analysis, CTO showed a worse P2 than stenotic lesions [HR 2.81 (1.17-6.76), P = 0.021], yet no differences emerged in P1 [HR 1.41 (0.76-2.63), P = 0.277] or FFR [HR 1.43 (0.79-2.57), P = 0.237]. A lower preprocedural TBI was correlated with a greater risk of EVT failure in terms of patency and FFR (P 40 mm were related to a worse stent patency. Copyright © 2016 Elsevier Inc. All rights reserved.

[Complete denture occlusion considered from occlusal contacts during mastication].

Science.gov (United States)

Suzuki, Tetsuya

2004-12-01

Few reports describe the functional superiority of full balanced occlusion to that of lingualized occlusion. Recently, a bilateral balanced scheme has been much more generally applied than a unilateral balanced scheme in lingualized occlusion as well as in full balanced occlusion. Occlusal contacts on the non-chewing side occur earlier than on the chewing side;in the order of second molar, first molar, and then premolars. The contact on the balancing side contributes to the prevention of denture dislocation and guidance from eccentric positions to the centric occlusal position during mastication. Therefore, bilateral balanced occlusion was shown to be effective for denture stability during mastication with complete dentures. Today's typical edentulous patients have greater mean age than in the past, and thus are seen with severe alveolar bone resorption, thin mucosa and sometimes abnormalities of the maxillomandibular relation. Their occlusal positions are often unstable and changeable after insertion of complete dentures. Because lingualized occlusion allows for easier accommodation and correction, lingualized occlusion is more suitable for such cases than full balanced occlusion, which requires a strict occlusal relationship. In light of the standard Japanese diet, there is some doubt about why lingualized occlusion might be suitable for Japanese edentulous patients in terms of the sense of mastication. A method of evaluating the sense of mastication needs to be established.

Assessment of Occlusal Function in a Patient with an Angle Class I Spaced Dental Arch with Periodontal Disease Using a Brux Checker

Directory of Open Access Journals (Sweden)

Ayako Taira

2018-01-01

Full Text Available Comprehensive and appropriate occlusion reconstruction therapy is necessary for orthodontic treatment of adult patients with malocclusion with periodontal disease associated with occlusal trauma. We report the case of a patient with extensive moderate chronic periodontitis associated with occlusal trauma. The patient was diagnosed with extensive moderate chronic periodontitis associated with occlusal trauma and underwent thorough treatment for periodontal disease, oral management, and 20 months of orthodontic therapy. Moreover, reconstructed occlusion was performed to evaluate occlusal trauma for visualization using Brux Checker (BC analysis before and after active orthodontic treatment. The patient acquired stable anterior guidance and a functional occlusal relationship. BC findings revealed weakening of the functional contact between the lateral occlusal force of the dentition and the front teeth and alveolar bone regeneration. The laminar dura became clearer, and the periodontal tissue improved. Our results suggest that assessment of occlusion function using BC analysis and periodontal examination was effective in enabling occlusal treatment goal clarification through orthodontic treatment in case of periodontal disease associated with occlusal trauma.

[Relationship between Occlusal Discomfort Syndrome and Occlusal Threshold].

Science.gov (United States)

Munakata, Motohiro; Ono, Yumie; Hayama, Rika; Kataoka, Kanako; Ikuta, Ryuhei; Tamaki, Katsushi

2016-03-01

Occlusal dysesthesia has been defined as persistent uncomfortable feelings of intercuspal position continuing for more than 6 months without evidence of physical occlusal discrepancy. The problem often occurs after occlusal intervention by dental care. Although various dental treatments (e. g. occlusal adjustment, orthodontic treatment and prosthetic reconstruction) are attempted to solve occlusal dysesthesia, they rarely reach a satisfactory result, neither for patients nor dentists. In Japan, these symptoms are defined by the term "Occlusal discomfort syndrome" (ODS). The aim of this study was to investigate the characteristics of ODS with the simple occlusal sensory perceptive and discriminative test. Twenty-one female dental patients with ODS (mean age 55.8 ± 19.2 years) and 21 age- and gender-matched dental patients without ODS (mean age 53.1 ± 16.8 years) participated in the study. Upon grinding occlusal registration foils that were stacked to different thicknesses, participants reported the thicknesses at which they recognized the foils (recognition threshold) and felt discomfort (discomfort threshold). Although there was no significant difference in occlusal recognition thresholds between the two patient groups, the discomfort threshold was significantly smaller in the patients with ODS than in those without ODS. Moreover, the recognition threshold showed an age-dependent increase in patients without ODS, whereas it remained comparable between the younger (patient subgroups with ODS. These results suggest that occlusal discomfort threshold rather than recognition threshold is an issue in ODS. The foil grinding procedure is a simple and useful method to evaluate occlusal perceptive and discriminative abilities in patients with ODS.

Femoral artery pressure measurement to predict the outcome of arterial surgery in patients with multilevel disease

DEFF Research Database (Denmark)

Faris, I; Tønnesen, K H; Agerskov, K

1982-01-01

Direct measurement of the femoral artery pressure before operation has been used to predict the postoperative change in ankle and toe pressure in 102 limbs (83 patients) that underwent aortoiliac surgery for the treatment of atherosclerotic occlusion or stenosis affecting both the aortoiliac...... and femoral artery segments. Rest pain or gangrene was present in 74 limbs. In 26 other limbs simultaneous aortoiliac and femoral artery reconstructions were performed. The changes in both toe and ankle pressures could be confidently predicted from the preoperative data. A predicted toe pressure of lower than...... 25 mm Hg was associated with a high probability that amputation would be required. The chances of an amputation were less than 3% if a toe pressure higher than 40 mm Hg was predicted. If the predicted ankle pressure index was lower than 0.56, there was a 90% chance that intermittent claudication...

Endovascular repair of para-anastomotic aortoiliac aneurysms.

LENUS (Irish Health Repository)

Tsang, Julian S

2009-11-01

The purpose of this study is to evaluate the use of endovascular stent grafts in the treatment of para-anastomotic aneurysms (PAAs) as an alternative to high-risk open surgical repair. We identified all patients with previous open aortic aneurysm repair who underwent infrarenal endovascular aneurysm repair (EVAR) at our institution from June 1998 to April 2007. Patient demographics, previous surgery, and operative complications were recorded. One hundred forty-eight patients underwent EVAR during the study period and 11 patients had previous aortic surgery. Of these 11 redo patients, the mean age was 62 years at initial surgery and 71 years at EVAR. All patients were male. Initial open repair was for rupture in five (45%) patients. The average time between initial and subsequent reintervention was 9 years. All patients were ASA Grade III or IV. Fifty-five percent of the PAAs involved the iliac arteries, 36% the abdominal aorta, and 9% were aortoiliac. Ten patients had endovascular stent-grafts inserted electively, and one patient presented with a contained leak. Aorto-uni-iliac stent-grafts were deployed in seven patients, and bifurcated stent-grafts in four patients. A 100% successful deployment rate was achieved. Perioperative mortality was not seen and one patient needed surgical reintervention to correct an endoleak. Endovascular repair of PAAs is safe and feasible. It is a suitable alternative and has probably now become the treatment of choice in the management of PAAs.

Endovascular Sharp Recanalization for Calcified Femoropopliteal Artery Occlusion

Directory of Open Access Journals (Sweden)

Hsuan-Li Huang

2012-01-01

Full Text Available Endovascular intervention of peripheral chronic total occlusion (CTO is technically challenging and time consuming. Various techniques and devices are used to facilitate lesion crossing and improve the success rate of the procedure. However, these new devices are quite expensive and not readily available. We report 2 cases of peripheral CTO wherein the occlusions were successfully crossed by using stiff end of Terumo glidewire. This sharp recanalization may be a useful technique for the recanalization of calcified peripheral CTOs when conventional techniques fail and new devices are not readily available, but it is accompanied by the risk of distal atheroembolism.

What do Polish interventional cardiologists know about indications and qualification for recanalisation of chronic total coronary artery occlusions?

Science.gov (United States)

Bryniarski, Krzysztof L; Zabojszcz, Michał; Dębski, Grzegorz; Marchewka, Jakub; Legutko, Jacek; Jankowski, Piotr; Siudak, Zbigniew; Żmudka, Krzysztof; Dudek, Dariusz; Bryniarski, Leszek

2015-01-01

Chronic total occlusions (CTO) are diagnosed in about 20% of patients with significant coronary artery disease. A disproportion between the high prevalence of CTOs and low rate of invasive treatment still exists. Technical difficulties, clinical uncertainties whether patients benefit from recanalisation, and a lack of knowledge of CTO may be responsible for this fact. To assess the knowledge of coronary arteries CTO among Polish interventional cardiologists. A self-designed questionnaire was used during two major Polish invasive cardiology workshops held in 2014. The study included 113 physicians, mostly cardiologists certified as independent operators. Average self-declared efficacy of CTO recanalisation was 63.5%. Most of the respondents agreed that the operator involved in the CTO recanalisation program should perform at least 30-50 procedures per year. Only 67% stated that before CTO revascularisation the evaluation of myocardial viability should be performed with dobutamine stress echocardiography as a preferred test. One third of the physicians agreed that CTO percutaneous coronary intervention (PCI) should not be performed directly after diagnostic angiography, and 51.5% believed that in patients with multi-vessel coronary artery disease PCI of CTO should be performed first. Multi-slice spiral computed tomography during the qualification and planning of the CTO revascularisation, in the opinion of 91% of the responders, should not be used before each procedure but could be useful in selected cases. Polish interventional cardiologists remains in compliance with current opinions about recanalisation of chronic coronary artery occlusions and the consensus of the EuroCTO Club, but there is still an unceasing need for further education and promotion of knowledge about CTOs.

Occlusal stability.

Science.gov (United States)

Wiens, Jonathan P; Priebe, Jennifer W

2014-01-01

Occlusion is the foundation for clinical success in fixed, removable, and implant prosthodontic treatment. Understanding those principles is critical when restoring a patient's occlusion. Many philosophies, devices, and theories of occlusion have evolved based on anecdotal clinical observations and applied geometric perceptions. The literature has reported these classic and contemporary occlusal concepts. As evidence-based dentistry emerged, it championed scrutiny of previously held beliefs, resulting in the abandonment of many pragmatic, yet beneficial occlusal procedures. The impetus toward scientific discovery, whereby factual information might be universally applied in dental education and clinical practice, has renewed interest in occlusal studies. Copyright © 2014 Elsevier Inc. All rights reserved.

Reliable porcine coronary model of chronic total occlusion using copper wire stents and bioabsorbable levo-polylactic acid polymer.

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Sim, Doo Sun; Jeong, Myung Ho; Cha, Kyoung Rae; Park, Suk Ho; Park, Jong Oh; Shin, Young Min; Shin, Heungsoo; Hong, Young Joon; Ahn, Youngkeun; Schwartz, Robert S; Kang, Jung Chaee

2012-12-01

Chronic total occlusion (CTO) remains a challenge in interventional cardiology. We investigated the feasibility and reliability of copper wire stents and levo-polylactic acid (l-PLA) as a means of CTO induction in a porcine model. In one group of 20 swine, copper stents were crimped on a 3.0mm angioplasty balloon and inserted into the mid-left anterior descending coronary artery (LAD). In the other group of 20 swine, l-PLA was wrapped on a guidewire and pushed into the distal LAD with a 3.0mm balloon catheter to induce embolization. Of 20 swine which underwent copper stent implantation, 13 died of stent thrombosis. In the remaining 7 swine, total or near total occlusion with collateral circulation was observed at 5 weeks. Of 20 swine which underwent l-PLA embolization, 4 died of ventricular fibrillation during or shortly after the procedure. Serial histopathologic studies showed complete absorption of the polymer with replacement by fibrotic tissue approximately 4 weeks following the polymer implantation. CTO could be reliably induced in porcine coronary arteries by copper stents and l-PLA. These models may support investigation of new percutaneous devices to facilitate CTO interventions. Copyright © 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

Patients with restored occlusions. Part III: The effect of occlusal splint therapy and occlusal adjustments on TMJ dysfunction.

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Lederman, K H; Clayton, J A

1983-07-01

An earlier study of 50 patients with occlusions restored by fixed partial dentures indicated a high percent (68%) of TMJ dysfunction. Occlusal interferences can play a significant role in causing TMJ dysfunction. To determine the significance of occlusal interferences, occlusal splints were placed in 10 of these restored patients who had moderate to severe dysfunction. The PRI was used to detect the presence or absence of TMJ dysfunction. The PRI TMJ dysfunction scores were reduced in all 10 patients after use of the occlusal splint. Five of the patients achieved reproducible tracings (no TMJ dysfunction) during the experiment time of 7 months. The occlusion of two patients was adjusted to eliminate the need for the occlusal splint. Patients who wore the splint 24 hours a day showed a significant (0.0004 level) reduction in TMJ dysfunction. Those patients who did not wear the splint regularly or had high levels of stress had PRI scores that varied. This finding indicates that the occlusal splint is not a treatment, as its removal permits reactivation of the occlusal interference. Resolution of dysfunction did not occur until occlusal interferences were removed. The changes in PRI scores to different dysfunction categories (none, slight, moderate, and severe) for the experimental group were significant at the 0.01 level. A control group of five patients had similar pantographic tracings but no other treatment. Their PRI scores varied, but there was no significant change in PRI scores or dysfunction categories. It was concluded that occlusal interferences were active causes of TMJ dysfunction in 10 of 36 patients in a population with restored occlusions.

Routine Use of Surgical Retrograde Transtibial Endovascular Approach for Failed Attempts at Antegrade Recanalization of Chronic Peripheral Artery Total Occlusions

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Liang, GangZhu; Zhang, FuXian, E-mail: gangzhuliang@126.com; Luo, XiaoYun; Zhang, ChangMing; Feng, YaPing; Niu, LuYuan; Zhang, Huan; Hu, Lu; Zhao, Hui; Cheng, Long; Zhang, MingYi [Capital Medical University, Department of Vascular Surgery, Beijing Shijitan Hospital (China)

2016-12-15

PurposeOur aim was to describe the technical aspects and clinical outcomes of an open surgical approach to retrograde transtibial endovascular therapy for recanalization of chronic total occlusions (CTOs) of peripheral arteries because of inability to acquire antegrade intravascular access across the occlusion.Materials and MethodsBetween January 2011 and May 2014, conventional antegrade revascularization failed in 15 limbs of 15 patients (11 males, 4 females) with complex CTOs. The mean age of the patients was 74 years (range 48–83 years). Five patients had severe claudication (Rutherford Category 3), and 10 patients had critical limb-threatening ischemia (Rutherford Categories 4–5). For each of these cases of antegrade failure, an open surgical exposure of the tibial or dorsalis pedis artery was used to allow a safe retrograde transtibial endovascular approach to recanalize the CTO.ResultsSurgical retrograde access from the tibial artery was achieved successfully in 14 of the 15 patients. In the 14 successful retrograde endovascular approaches, surgical retrograde transtibial access was achieved from the dorsalis pedis artery in 8 patients and from the posterior tibial artery in 6. The average time to obtain retrograde access was 5 min (range 2–11 min). No stenosis or occlusion occurred in the tibial or dorsalis pedis arteries used for the retrograde access sites during follow-up.ConclusionsRoutine surgical exposure can be a safe and an effective method for retrograde transtibial access to the more proximal occluded arterial segments in selected patients with CTO.

Routine Use of Surgical Retrograde Transtibial Endovascular Approach for Failed Attempts at Antegrade Recanalization of Chronic Peripheral Artery Total Occlusions

International Nuclear Information System (INIS)

Liang, GangZhu; Zhang, FuXian; Luo, XiaoYun; Zhang, ChangMing; Feng, YaPing; Niu, LuYuan; Zhang, Huan; Hu, Lu; Zhao, Hui; Cheng, Long; Zhang, MingYi

2016-01-01

PurposeOur aim was to describe the technical aspects and clinical outcomes of an open surgical approach to retrograde transtibial endovascular therapy for recanalization of chronic total occlusions (CTOs) of peripheral arteries because of inability to acquire antegrade intravascular access across the occlusion.Materials and MethodsBetween January 2011 and May 2014, conventional antegrade revascularization failed in 15 limbs of 15 patients (11 males, 4 females) with complex CTOs. The mean age of the patients was 74 years (range 48–83 years). Five patients had severe claudication (Rutherford Category 3), and 10 patients had critical limb-threatening ischemia (Rutherford Categories 4–5). For each of these cases of antegrade failure, an open surgical exposure of the tibial or dorsalis pedis artery was used to allow a safe retrograde transtibial endovascular approach to recanalize the CTO.ResultsSurgical retrograde access from the tibial artery was achieved successfully in 14 of the 15 patients. In the 14 successful retrograde endovascular approaches, surgical retrograde transtibial access was achieved from the dorsalis pedis artery in 8 patients and from the posterior tibial artery in 6. The average time to obtain retrograde access was 5 min (range 2–11 min). No stenosis or occlusion occurred in the tibial or dorsalis pedis arteries used for the retrograde access sites during follow-up.ConclusionsRoutine surgical exposure can be a safe and an effective method for retrograde transtibial access to the more proximal occluded arterial segments in selected patients with CTO.

Sixty-eight years of experimental occlusal interference studies: what have we learned?

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Clark, G T; Tsukiyama, Y; Baba, K; Watanabe, T

1999-12-01

Understanding is needed regarding the effect that occlusal interferences have on the teeth, periodontium, and especially on jaw function. This article summarizes research in which experimental occlusal interferences have been placed on the teeth of animals and human volunteers. Data from 18 human and 10 animals studies were reviewed. Experimental occlusal interferences were grouped into those that alter intercuspal position and those contacting on lateral jaw movement only. The outcome of these interferences were analyzed according to their local pulpal-periodontal, jaw function, or bruxism effects. Experimental occlusal interferences in maximum intercuspation had a deleterious effect on periodontal and pulpal tissues of the affected tooth; sometimes this produces a disruption of smooth jaw function and occasionally jaw muscle pain and clicking. Experimental occlusal interferences that contact only in a lateral jaw movement are infrequently harmful to jaw function. Furthermore, no reliable evidence demonstrates that occlusal interferences can cause nocturnal bruxism, or stop it. Transient local tooth pain, loosening of the tooth, a slight change in postural muscle tension levels, chewing stroke patterns, and sometimes a clicking joint can be induced by an experimental occlusal interference. Because such findings are present in relatively asymptomatic patients, these data do not prove that occlusal interferences are causally related to a chronic jaw muscle pain or temporomandibular joint dysfunction problems.

Epidemiology of aortic disease - aneurysm, dissection, occlusion; Epidemiologie der Aortenerkrankung: Aneurysma, Dissektion, Verschluss

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Steckmeier, B. [Klinikum der Universitaet Muenchen-Innenstadt, Muenchen (Germany). Chirurgische Klinik und Poliklinik, Gefaesschirurgie

2001-08-01

The physiological infrarenal aortic diameter varies between 12.4 mm in women an 27.6 mm in men. As defined, an aneurysmatic dilatation begins with 29 mm. According to that, 9% of all people above the age of 65 are affected by an abdominal aortic aneurysm (AAA). Compared with the female sex, the male sex predominates at a rate of about 5:1. The disease is predominant in men of the white race. In black men, black and white women the incidence of AAA is identical. 38 to 50 percent of the AAA patients (patients) suffer from hypertension, 33 to 60% from coronary, 28% from cerebrovascular and 25% from peripheral occlusive disease. The AAA expansion rate varies between 0.2 and 0.8 cm per year and is exponential from a diameter of 5 cm on. In autopsy studies, the rupture rates with AAA diameters of <5 cm, between 5.1 and 6.9 cm, and of >7 cm were below 5%, 39% and 65%, respecitvely. 70% of the AAA patients do not die of a rupture, but of a cardiac disease. Serum markers, such as metalloproteinases and procollagen peptides are significantly increased in AAA patients. Thoraco-abdominal aneurysms (TAA) make up only 2 to 5% of all degenerative aneurysms. 20 to 30% of the TAA patients are also affected by an AAA. 80% of the TAA are degenerative, 15 to 20% are a consequence of the chronic dissection - including 5% of Marfan patients -, 2% occur in case of infections and 1 to 2% in case of aortitis. The TAA incidence in 100,000 person-years is 5.9% during a monitoring period of 30 years. In case of TAA, an operation is indicated with a maximum diameter of 5.5 to 6 cm and more and, in case of a Marfan's syndrome (incidence of 1:10,000), with a maximum diameter of 5.5 cm and more. With regard to aorto-iliac occlusive diseases, there are defined 3 types of distribution. Type I refers to the region of the bifurcation itself. Type II defines the diffuse aortoiliac spread of the disease. Type III designates multiple-level occlusions also beyond the inguinal ligament. Type I

Osseous changes in the foot bones in patients with arterial occlusion and simultaneous polyneuropathy

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Langer, R.; Langer, M.

1981-01-01

The present article evaluates 26 cases with arterial occlusion and additional polyneuropathy in diabetes mellitus or chronic alcohol addiction. For comparison, a group of 30 patients with arterial occlusion without neutrologically detectable polyneuropathy were also evaluated. It is pointed out that the osseous changes in the foot bone region are due to the additionally existing polyneuropathy and cannot be explained alone by an avascular bone necrosis in arterial vascular occlusion. Changes in the sense of an arthropathy occur in our group of patients even in case of unilateral arterial occlusion, these changes occurring bilaterally in the foot bones; after reconstruction measures in the arterial vascular system, these arthropathic changes in the foot bones continue to advance in case of persisting polyneuropathy. (orig.) [de

Osseous changes in the foot bones in patients with arterial occlusion and simultaneous polyneuropathy

Energy Technology Data Exchange (ETDEWEB)

Langer, R; Langer, M

1981-09-01

The present article evaluates 26 cases with arterial occlusion and additional polyneuropathy in diabetes mellitus or chronic alcohol addiction. For comparison, a group of 30 patients with arterial occlusion without neutrologically detectable polyneuropathy were also evaluated. It is pointed out that the osseous changes in the foot bone region are due to the additionally existing polyneuropathy and cannot be explained alone by an avascular bone necrosis in arterial vascular occlusion. Changes in the sense of an arthropathy occur in our group of patients even in case of unilateral arterial occlusion, these changes occurring bilaterally in the foot bones; after reconstruction measures in the arterial vascular system, these arthropathic changes in the foot bones continue to advance in case of persisting polyneuropathy.

Laser Recanalization of Central Venous Occlusion to Salvage a Threatened Arteriovenous Fistula.

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Rambhia, Sagar; Janko, Matthew; Hacker, Robert I

2018-07-01

Central venous occlusion is conventionally managed with balloon angioplasty, stent extension, or sharp recanalization. Here, we describe recanalization of a chronically occluded innominate vein using excimer laser after conventional techniques were unsuccessful. Patient clinical improvement and fistula patency have been sustained 2 years postintervention. This technique may provide new hemodialysis access options for patients who would not otherwise be candidates for hemodialysis access on the ipsilateral side of a central venous occlusion. Copyright © 2018 Elsevier Inc. All rights reserved.

Is right coronary artery chronic total vessel occlusion impacting the surgical revascularization results of patients with multivessel disease? A retrospective study

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Janusz Konstanty-Kalandyk

2018-06-01

Full Text Available Introduction Chronic total occlusion (CTO is common in the presence of other significantly narrowed coronary arteries. The impact of total occlusion and its association with completeness of revascularization on patients with multivessel disease undergoing coronary artery bypass graft (CABG remains largely unknown. Aim The aim of our study was to compare CABG operation characteristics, as well as 30-day mortality, incidence of post-operative major adverse cardiac and cerebrovascular events (MACCE between patients with and without CTO in right coronary artery (RCA. Materials and Methods A total of 156 consecutive patients were included in the analysis. CTO of RCA or right posterior descending artery (RPD was diagnosed in 57 patients (CTO-RCA group. Coronary stenosis without CTO in RCA was diagnosed in 99 patients (nonCTO-RCA group. Baseline characteristics were comparable in both groups. Results The majority of patients had class II (49.1% vs. 46%, p = 0.86 or class III (42.1% vs. 43%, p = 1.0 Canadian Cardiovascular Society grading system symptoms. Patients in the CTO-RCA group had in average 2.2 grafts implanted, as opposed to 2.4 grafts in patients in the nonCTO-RCA group (p = 0.003. Graft to the RCA was performed in 40.3% patients in the CTO-RCA group and in 81% patients in the nonCTO-RCA group (p = 0.001. The 30-day mortality from any cause or cardiac cause did not differ between groups (7% vs. 2%, p = 0.14 and 3.5% vs. 2%, p = 0.57 respectively. In a multivariate analysis CTO in RCA or RPD and peripheral artery disease were independent predictors of post-operative MACCE (7.9 (1.434–43.045 p = 0.02; 18.8 (3.451–101.833 p < 0.01, respectively. Conclusions Chronic total occlusion of RCA was found to be associated with smaller number of grafts performed during the CABG procedure. Although mortality between patients in the CTO-RCA and nonCTO-RCA groups did not differ, patients in the CTO-RCA group had higher incidence of post-operative MACCE.

Osteochondroma of the mandibular condyle: surgical excision followed by occlusal stabilization.

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Yoo, Ji-Yeon; Choi, Byung-Joon; Kwon, Yong-Dae; Lee, Deok-Won; Ohe, Joo-Young; Suh, Joon-Ho

2012-03-01

Osteochondroma of the mandibular condyle in adults can be treated by surgical excision, condylectomy followed by costochondral graft or orthognathic surgery. Such complex treatment plan may not be appropriate for patients with old age, affected with chronic osteochondroma of the condyle. In this clinical report, we present a patient with osteochondroma of the condyle treated by surgical excision. The patient's postoperative occlusion was a contraindication for orthognathic surgery because of the severe abrasion of the teeth and the chronic compensation of the dentition to the deviated mandible. Surgical excision of the lesion was carried out under general anesthesia, and the remaining condylar head was salvaged as much as possible. No graft materials or posthodontic condyle reconstruction was carried out. Because there was no occlusal stop to secure the mandible in a centric relation position of the condyle, a stabilization splint was delivered to position the condyle in a relatively stable position. The stability of the condyle position was evaluated by follow-up cone beam computed tomographic scans of the pathologic and the contralateral condyle, along with clinical factors such as occlusal contact points and mandible movements assayed by ARCUSdigma (KaVo). After significant condylar position was achieved, full prosthodontic reconstruction was performed to both the patient's and the dentist's satisfaction.

Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention in Patients With Diabetes: Insights From the OPEN CTO Registry.

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Salisbury, Adam C; Sapontis, James; Grantham, J Aaron; Qintar, Mohammed; Gosch, Kensey L; Lombardi, William; Karmpaliotis, Dimitri; Moses, Jeffrey; Cohen, David J; Spertus, John A; Kosiborod, Mikhail

2017-11-13

Few studies have evaluated the relationship of diabetes with technical success and periprocedural complications, and no studies have compared patient-reported health status after chronic total occlusion (CTO) percutaneous coronary intervention (PCI) in patients with and without diabetes. CTOs are more common in patients with diabetes, yet CTO PCI is less often attempted in patients with diabetes than in patients without. The association between diabetes and health status after CTO PCI is unknown. In the 12-center OPEN-CTO PCI registry (Outcomes, Patient Health Status, and Efficiency in Chronic Total Occlusion Registry), patients with and without diabetes were assessed for technical success, periprocedural complications, and health status over 1 year following CTO PCI using the Seattle Angina Questionnaire and the Rose Dyspnea Scale. Hierarchical modified Poisson regression was used to examine the independent association between diabetes and technical success, and hierarchical multivariable linear regression was used to assess the association between diabetes and follow-up health status. Diabetes was common (41.2%) and associated with a lower crude rate of technical success (83.5% vs. 88.1%; p = 0.04). After adjustment, there was no significant difference between diabetic and nondiabetic patients (relative risk: 0.96, 95% confidence interval: 0.91 to 1.01). There were no significant differences in complication rates between patients with and without diabetes. Angina burden, quality of life, and overall health status scores were similar between diabetic and nondiabetic patients over 1 year. Although technical success was lower in patients with diabetes, this reflected lower success among patients with prior bypass surgery, without any significant difference in success rate after adjusting for prior bypass and disease complexity. CTO PCI complication rates are similar in diabetic and nondiabetic patients, and symptom improvement following CTO PCI is robust

Practical importance and modern methods of the evaluation of skin microcirculation during chronic lower limb ischemia in patients with peripheral arterial occlusive disease and/or diabetes.

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Kluz, J; Małecki, R; Adamiec, R

2013-02-01

Skin ischemia is one of the crucial phenomena during chronic lower limb ischemia in patients with peripheral arterial occlusive disease and/or diabetes. However, risk stratification for development of ischemic ulceration and/or skin necrosis in those patients is not easy, mostly due to the complex structure of the dermal vascular bed and limited possibilities for studying the skin capillaries in everyday practice. All definitions of critical limb ischemia thus far have considered mostly the clinical symptoms and the degree of macrocirculatory impairment. Despite the fact that the reduction of absolute dermal perfusion and improper distribution of perfusion in ischemic feet, primarily diminished perfusion or even a complete loss of blood flow in nutritional capillaries, rather than arterial occlusion per se, is the eventual reason for critical limb ischemia symptoms, the vessels of the microcirculation are not routinely assessed in clinical practice. Monitoring of microcirculatory parameters, as a part of integrated diagnostic approach, may have a considerable value in the evaluation of risk, progression of the disease and the effectiveness of therapeutic intervention in individual patients. Relative simplicity and availability of different non-invasive methods, including video capillaroscopy and laser Doppler fluxmetry, should constitute a premise to their wider application in clinical management of chronic limb ischemia.

Influence of chronic stress and oclusal interference on masseter muscle pain in rat.

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Simonić-Kocijan, Suncana; Uhac, Ivone; Braut, Vedrana; Kovac, Zoran; Pavicić, Daniela Kovacević; Fugosić, Vesna; Urek, Miranda Muhvić

2009-09-01

This study aimed to investigate the individual effects of chronic stress and occlusal interference, as well as their combined influence on masseter muscle pain. Experiments were performed on 28 male Wistar rats. Animals were submitted to chronic stress procedure, exposed to occlusal interference, or exposed to both mantioned procedures. At the end of the procedure animals were submitted to orofacial formalin test, and nociceptive behavioral response was evaluated. Statisticaly significant difference of nociceptive behavioral response in chronicaly stressed rats and in the animals with occlusal interference in comparation to the control group were not obtained (p > 0.05). In contrast, nociceptive behavioral response was significantly increased in rats submitted to both of experimental procedures (p occlusal interference and chronic stress influence masseter muscle pain.

Effects of carbonated mineral water treatment in Băile Tuşnad on chronic arterial occlusive disease – a case report

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Gabriela Dogaru

2017-05-01

Full Text Available Introduction. Băile Tușnad spa is recognized for its role in the prevention and rehabilitation treatment of cardiovascular diseases, including chronic arterial occlusive disease, due to the presence of natural therapeutic factors: carbonated mineral waters through their peripheral vasodilator effects, natural mofettes, stimulating bioclimate. Aim. The current study aimed to assess the clinical efficiency of natural therapeutic factors in Băile Tuşnad for the continuation of rehabilitation treatment in a patient with chronic arterial occlusive disease, in order to encourage walking, reduce cardiovascular risk and improve quality of life. Material and method. Patient N.M., aged 75, with multiple cardiovascular risk factors. In 2013, he was diagnosed with lower limb peripheral ischemia syndrome stage II B Fontaine, predominantly left claudication at about 100 m, for which balloon angioplasty was performed. He attended rehabilitation treatment for 3 years in Baile Tuşnad, consisting of carbonated mineral water baths for 15 minutes, aerotherapy for 30 minutes daily for the stimulation of walking, massotherapy, kinesiotherapy, performed daily for 16 days, and in 2016, at the Rehabilitation Hospital Cluj-Napoca. He was clinically evaluated before and at the end of treatment by the Visual Analogue Scale, the 10-m walking test, adverse reactions, Doppler ultrasound. Results. At the end of treatment, an increase in the walking distance and speed, a significant improvement in the quality of gait was found; claudication occurred after 250 m, pain in the lower limbs was improved. There were no side reactions. Conclusions. Rehabilitation treatment with natural therapeutic factors influenced the clinical and functional picture, determining a significant improvement in the quality of gait and quality of life.

Endovascular management of inferior vena cava filter thrombotic occlusion.

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Branco, Bernardino C; Montero-Baker, Miguel F; Espinoza, Eduardo; Gamero, Maria; Zea-Vera, Rodrigo; Labropoulos, Nicos; Leon, Luis R

2018-01-01

Objective Inferior vena cava occlusion is a potentially life-threatening complication related to caval filters. We present our experience with filter-induced inferior vena cava occlusion in order to assess the feasibility, safety, and effectiveness of endovascular management. Methods A retrospective review of all patients undergoing inferior vena cava filter placement over a 60-month study period was performed. From this cohort, a total of 10 cases of inferior vena cava occlusion after filter placement were identified. Demographics, clinical data, procedures, and outcomes were extracted. Patients were followed to the last clinic visit or until they died. Results One-hundred eighty filters were placed by our group practice during the study period. Of those, a total of 10 patients were identified. Overall, there were 7 males; the mean age was 57.1 years (25-78 years). The median time between inferior vena cava filter placement and filter occlusion was 105 days (range 5-4745 days). All patients were clinically symptomatic at the time of their presentation. Nine out of 10 patients were successfully managed endovascularly. Trellis™-8 thrombectomy was the most common endovascular strategy performed ( n = 9). Four patients had balloon angioplasty, two of those with stent placement for chronically occluded inferior vena cava/iliac veins. No thromboembolic complications developed during a median follow-up period of 233 days (range 4-1083 days). Conclusions Endovascular management of inferior vena cava occlusion is feasible, safe, and effective in decreasing thrombus burden in the presence of an inferior vena cava filter. Further studies evaluating long-term inferior vena cava patency and optimal surveillance regimen after endovascular management of filter-related inferior vena cava occlusion are warranted.

Occlusal risk factors associated with temporomandibular disorders in young adults with normal occlusions.

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Wang, Chen; Yin, Xinmin

2012-10-01

The aim of this study was to characterize occlusal stability in young adults with temporomandibular disorder (TMD). Thirty-one patients (aged 19-31 years) with complete natural dentition and Angle class I occlusion who exhibited TMD were compared with 31 age- and sex-matched healthy control subjects. The occlusal registrations were performed using the T-Scan II occlusal imaging and analysis system. Center of occlusal force, asymmetry index of occlusal force, maximal movement of COF, premature contacts, clusion time, and disclusion time were recorded. Compared with control subjects, TMD subjects had a significantly higher frequency of premature contacts (16/32, 50.0%) and greater bilateral asymmetry in the occlusal force. Furthermore, prolonged clusion time and disclusion time also were observed in TMD subjects. These results suggest that a significant association exists between occlusal stability and TMD in young adults. Copyright © 2012 Elsevier Inc. All rights reserved.

A common variant of endothelial nitric oxide synthase (Glu298Asp) is associated with collateral development in patients with chronic coronary occlusions

International Nuclear Information System (INIS)

Lamblin, Nicolas; Cuilleret, François J; Helbecque, Nicole; Dallongeville, Jean; Lablanche, Jean-Marc; Amouyel, Philippe; Bauters, Christophe; Van Belle, Eric

2005-01-01

Experimental studies support an important role for endothelial nitric oxide synthase (eNOS) in the regulation of angiogenesis. In humans, a common polymorphism exists in the eNOS gene that results in the conversion of glutamate to aspartate for codon 298. In vitro and in vivo studies have suggested a decreased NOS activity in patients with the Asp 298 variant. We hypothesized that a genetic-mediated decreased eNOS activity may limit collateral development in patients with chronic coronary occlusions. We selected 291 consecutive patients who underwent coronary angiography and who had at least one chronic (>15 days) total coronary occlusion. Collateral development was graded angiographically using two different methods: the collateral flow grade and the recipient filling grade. Genomic DNA was extracted from white blood cells and genotyping was performed using previously published techniques. Collateral development was lower in patients carrying the Asp 298 variant than in Glu-Glu homozygotes (collateral flow grade: 2.64 ± 0.08 and 2.89 ± 0.08, respectively, p = 0.04; recipient filling grade: 3.00 ± 0.08 and 3.24 ± 0.07, respectively, p = 0.04). By multivariable analysis, three variables were independently associated with the collateral flow grade: female gender, smoking, and the Asp 298 variant (p = 0.03) while the Asp 298 variant was the sole variable independently associated with the recipient filling grade (p = 0.03). Collateral development is lower in patients with the Asp 298 variant. This may be explained by the decreased NOS activity in patients with the Asp 298 variant. Further studies will have to determine whether increasing eNOS activity in humans is associated with coronary collateral development

Technique, Complication, and Long-Term Outcome for Endovascular Treatment of Iliac Artery Occlusion

International Nuclear Information System (INIS)

Ozkan, Ugur; Oguzkurt, Levent; Tercan, Fahri

2010-01-01

The aim of this study was to report technical details, procedure-related complications, and results of endovascular treatment in chronic iliac artery occlusion. Between 2001 and 2008, endovascular treatments of 127 chronic iliac artery occlusions in 118 patients (8 women and 110 men; mean age, 59 years) were retrospectively reviewed. The study was based on Ad Hoc Committee on Reporting Standards (Society for Vascular Surgery/International Society for Cardiovascular Surgery Standards). All occlusions were treated with stent placement with or without preliminary balloon angioplasty. Kaplan-Meier estimators were used to determine patency rates. Univariate and multivariate analyses were performed to determine variables affecting successful recanalization, major complications, early stent thrombosis (≤30 days), and primary and secondary patency rates. Initial technical success was achieved in 117 (92%) procedures. Successful recanalization was obtained by antegrade approach in 69 of 77 (90%) procedures and by retrograde approach in 52 of 105 (50%) procedures (p < 0.001). Complications were encountered in 28 (24%) patients [minor in 7 patients (6%) and major in 22 patients (19%)]. One death occurred in the operative period secondary to iliac artery rupture. Early stent thrombosis was seen in eight (7%) patients. Presence of critical limb ischemia (p = 0.03), subintimal recanalization (p = 0.03), and major complication (p = 0.02) were the independent predictors of early stent thrombosis on multivariate analysis. Primary and secondary patency rates at 5 years were 63 and 93%, respectively. Presence of critical limb ischemia, TASC type C iliac lesions, combined occlusions of both common and external iliac arteries, and major complications were associated with decreased patency rates on univariate analysis, whereas these factors were not independent predictors of stent patency on multivariate analysis. In conclusion, endovascular treatment of iliac artery occlusion has a

Optimization of the static occlusion by "occlusal surface settling" in the Cerec 3D software.

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Späth, C; Kordass, B

2006-04-01

The adjustment of the static occlusion can be automated in computer-based systems. The Cerec 3D software makes it possible to take preformed occlusal surfaces from a database and adapt them to the antagonist. In this adaptation (settling), the CAD occlusal surface "settles" as whole or each cusp individually into the occlusal surface of the antagonist until stable occlusion is reached. Two occlusal surface shapes were compared: Vita Physiodens and Lee Culp. An index was formed from the number, quality, and position of the occlusal contacts for 35 model cases (25 molars, 10 premolars). With regard to the settling of the total occlusal surfaces, there were no differences between the two occlusal surface shapes. In "cusp settling" of the molars, Vita Physiodens performed significantly better. In the comparison of the 1st with the 3rd settling process, significant improvements occurred the 3rd time in many cases when settling individual cusps, but in clearly fewer cases in the settling process of the total occlusal surface. The Lee Culp tooth occlusion improved especially after the 3rd settling process of individual cusps. It is therefore expedient to combine both settling versions with one another.

The feasibility of transradial laser atherectomy for chronic total occlusion using the 5 Fr sheath system

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Khaled Sherif

2016-05-01

Full Text Available Objective. We present a case of chronic total occlusion (CTO approached with LASER endovascular intervention by radial artery approach using a 5 French sheath. Case report. A 57-year-old man presented to our hospital having had retrosternal chest pain for two days. Physical examination was normal at the time of presentation. The laboratory tests were within normal limits, including cardiac enzymes except the lipid panel which showed hypertriglyceridemia. The patient underwent a myocardial perfusion scintigraphy stress test that revealed inferior wall ischemia, with normal left ventricular ejection fraction. A 5-French vascular sheath was placed in the right radial artery. Selective coronary artery angiography was performed, which showed right coronary artery (RCA CTO. A 5-French JR4 guide catheter successfully engaged the RCA and Laser angioplasty was performed across the CTO into the RCA. A marked improvement of flow was evident thereafter. Conclusion. To best of our knowledge this is the first case report showing the feasibility of laser atherectomy using the 5 French sheath system in a coronary arterial CTO.

The feasibility of transradial laser atherectomy for chronic total occlusion using the 5 Fr sheath system.

Science.gov (United States)

Sherif, Khaled; Yaqub, Yasir; Suarez, Jose A

2016-05-01

We present a case of chronic total occlusion (CTO) approached with LASER endovascular intervention by radial artery approach using a 5 French sheath. A 57-year-old man presented to our hospital having had retrosternal chest pain for two days. Physical examination was normal at the time of presentation. The laboratory tests were within normal limits, including cardiac enzymes except the lipid panel which showed hypertriglyceridemia. The patient underwent a myocardial perfusion scintigraphy stress test that revealed inferior wall ischemia, with normal left ventricular ejection fraction. A 5-French vascular sheath was placed in the right radial artery. Selective coronary artery angiography was performed, which showed right coronary artery (RCA) CTO. A 5-French JR4 guide catheter successfully engaged the RCA and Laser angioplasty was performed across the CTO into the RCA. A marked improvement of flow was evident thereafter. To best of our knowledge this is the first case report showing the feasibility of laser atherectomy using the 5 French sheath system in a coronary arterial CTO. Copyright © 2016 by Academy of Sciences and Arts of Bosnia and Herzegovina.

Endovascular Treatment of Chronic Mesenteric Ischemia: Report of Five Cases

International Nuclear Information System (INIS)

Nyman, Ulf; Ivancev, Krasnodar; Lindh, Mats; Uher, Petr

1998-01-01

Purpose: To evaluate the midterm results of percutaneous transluminal angioplasty (PTA) and stent placement in stenotic and occluded mesenteric arteries in five consecutive patients with chronic mesenteric ischemia. Methods: Five patients with 70%-100% obliterations of all mesenteric vessels resulting in chronic mesenteric ischemia (n= 4) and as a prophylactic measure prior to abdominal aortic aneurysm repair (n= 1) underwent PTA of celiac and/or superior mesenteric artery (SMA) stenoses (n= 2), primary stenting of ostial celiac occlusions (n= 2), and secondary stenting of a SMA occlusion (n= 1; recoil after initial PTA). All patients underwent duplex ultrasonography (US) (n= 3) and/or angiography (n= 5) during a median follow-up of 21 months (range 8-42 months). Results: Clinical success was obtained in all five patients. Asymptomatic significant late restenoses (n3) were successfully treated with repeat PTA (n= 2) and stenting of an SMA occlusion (n= 1; celiac stent restenosis). Recurrent pain in one patient was interpreted as secondary to postsurgical abdominal adhesions. Two puncture-site complications occurred requiring local surgical treatment. Conclusions: Endovascular techniques may be attempted prior to surgery in cases of stenotic or short occlusive lesions in patients with chronic mesenteric ischemia. Surgery may still be preferred in patients with long occlusions and a low operative risk

Tips and tricks for antegrade recanalization of chronic total occlusions using the CrossBoss catheter.

Science.gov (United States)

Kwan, Tak W; Diwan, Ravi; Ratcliffe, Justin A; Huang, Yili; Patri, Rahul; James, David; Liou, Michael; Fallahi, Arzhang; Young, Bruce; Nanjundappa, Aravinda; Daggubati, Ramesh

2015-02-01

To provide new strategies and techniques for the successful recanalization of chronic total occlusions (CTOs) with the sole use of the CrossBoss catheter. In addition, some common CTO scenarios are illustrated in detail. CTOs are one of the most challenging complex coronary lesion subsets to intervene upon. Even with the innovation of specialized catheters, the success rate of antegrade recanalization remains low. Between June and December 2013, a retrospective analysis of 50 consecutive patients who presented with a planned percutaneous intervention (PCI) of a CTO was performed. In all patients, the CrossBoss catheter was used. No additional reentry devices were necessary. Procedural success was defined as failure. The average fluoroscopy time was 45.9 minutes and the average amount of contrast use was 273.8 mL. No patient suffered a coronary perforation from the CrossBoss catheter. With increased experience using the CrossBoss catheter, the antegrade success rate of CTOs can be improved. Some tips include identifying the likely course of the artery with the aid of retrograde injection, proper guidewire selection and manipulation, and redirecting the CrossBoss catheter if there is substantial deviation from the original path.

Analysis of decrease in lung perfusion blood volume with occlusive and non-occlusive pulmonary embolisms

International Nuclear Information System (INIS)

Ikeda, Yohei; Yoshimura, Norihiko; Hori, Yoshiro; Horii, Yosuke; Ishikawa, Hiroyuki; Yamazaki, Motohiko; Noto, Yoshiyuki; Aoyama, Hidefumi

2014-01-01

Highlights: • The proportion of preserved PE lesions in the non-occlusive group was 76.7% (33/43). • HUs of the iodine map were significantly higher in the non-occlusive group than in the occlusive group. • There was no significant difference in HUs between the non-occlusive and corresponding normal group. - Abstract: Purpose: The aim of this study was to determine if lung perfusion blood volume (lung PBV) with non-occlusive pulmonary embolism (PE) differs quantitatively and visually from that with occlusive PE and to investigate if lung PBV with non-occlusive PE remains the same as that without PE. Materials and methods: Totally, 108 patients suspected of having acute PE underwent pulmonary dual-energy computed tomography angiography (DECTA) between April 2011 and January 2012. Presence of PE on DECTA was evaluated by one radiologist. Two radiologists visually evaluated the PE distribution (segmental or subsegmental) and its nature (occlusive or non-occlusive) on DECTA and classified perfusion in lung PBV as “decreased,” “slightly decreased,” and “preserved”. Two radiologists used a lung PBV application to set a region of interest (ROI) in the center of the lesion and measured HU values of an iodine map. In the same slice as the ROI of the lesion and close to the lesion, another ROI was set in the normal perfusion area without PE, and HUs were measured. The proportion of lesions was compared between the occlusive and non-occlusive groups. HUs were compared among the occlusive, non-occlusive, and corresponding normal groups. Results: Twenty-five patients had 80 segmental or subsegmental lesions. There were 37 and 43 lesions in the occlusive and non-occlusive groups, respectively. The proportion of decreased lesions was 73.0% (27/37) in the occlusive group, while that of preserved lesions in the non-occlusive group was 76.7% (33/43). There was a significant difference in the proportion of lesions (P < 0.001) between the two groups. HUs of the

Effect of occlusion amblyopia after prescribed full-time occlusion on long-term visual acuity outcomes.

Science.gov (United States)

Longmuir, Susannah; Pfeifer, Wanda; Scott, William; Olson, Richard

2013-01-01

To investigate the incidence and characteristics of occlusion amblyopia with prescribed full-time patching and determine its effect on long-term visual acuity outcomes. The records of patients younger than 10 years diagnosed as having amblyopia between 1970 and 2000 were retrospectively reviewed. Patients were prescribed full-time occlusion and observed until completion of therapy. Of 597 patients treated for amblyopia by full-time patching, 115 were diagnosed as having occlusion amblyopia (19.3%). Seventy-five percent (86 of 115) developed occlusion amblyopia during the first episode of full-time patching. Occlusion amblyopia occurred more frequently in children prescribed full-time patching at an earlier age (P = .0002), with an odds ratio of 8.56 (95% confidence interval: 2.73, 26.84) in children younger than 36 months and 2.66 (95% confidence interval: 0.96, 7.37) in children between 36 and 59 months old. Seven of the patients with occlusion amblyopia did not reverse fixation and continued to fixate with the initially amblyopic eye after treatment. Final visual acuity in these eyes with occlusion amblyopia was 20/30 or better. After cessation of treatment, the final interocular difference in visual acuity was less in patients with a history of occlusion amblyopia (P = .003). Occlusion amblyopia occurred at all ages, but the incidence decreased with increasing age. Patients who developed occlusion amblyopia with prescribed full-time occlusion had less interocular visual acuity difference than patients who did not, suggesting that development of occlusion amblyopia can indicate the potential for the development of better vision in the originally amblyopic eye. Copyright 2013, SLACK Incorporated.

The lingualized occlusion of complete denture

Institute of Scientific and Technical Information of China (English)

BEN Wei-hong; Eleni Roumanas

2008-01-01

This article reviews the literatures dealing with the lingualized occlusion of complete denture including the origin,development and research. Lingualized occlusion is a valuable concept because many advantages of anatomic and nonanatomic occlusions are retained,satisfactory occlusion is easily obtained,balanced occlusion can be accomplished.

The success of opening single chronic total occlusion lesions to improve myocardialviabilitytrial (SOS-COMEDY)

Science.gov (United States)

Huang, Rongchong; Song, Xiantao; Zhang, Haishan; Tian, Wen; Huang, Zheng; Zhang, Xingwei; Yang, Junqing; Zhang, Dongfeng; Wu, Jian; Zhong, Lei; Ting, Henry H.

2018-01-01

Abstract Aims: Success of opening single (SOS)-comedy is a prospective multicenter study to compare the improvement in the decrease of myocardial viability by percutaneous coronary intervention (PCI) with that by optimal medical therapy (OMT) alone in patients with chronic total occlusion (CTO) of a single coronary artery. Methods and results: The risks and the benefits of both options (PCI and OMT) were listed in a CTO decision aid (DA). Eligible participants detected by invasive coronary angiography (ICA) or coronary computed tomography angiography (CCTA) were divided into PCI or OMT groups according to patients’ choice after shared-decision making process with DA. Participants will undergo positron emission tomography/computed tomography (PET/CT), cardiac magnetic resonance (CMR) and transthoracic echocardiography (TTE), and proceed to ICA and revascularization if possible. Blinded core laboratory interpretation will be performed for ICA, CCTA, PET/CT, CMR, and TTE. All participants will be followed up for 12 months. The primary endpoint is the improvement to the decrease of myocardial viability from baseline assessed with the use of PET/CT after 12-month follow-up. Conclusions: All of the patients are appropriately consented before enrolling in this study, which has been approved by the Ethics Committee. Results of SOS-COMEDY will be helpful to develop a strategy for single CTO patients. PMID:29668609

Occlusal stability in shortened dental arches.

Science.gov (United States)

Witter, D J; Creugers, N H; Kreulen, C M; de Haan, A F

2001-02-01

Shortened dental arches consisting of anterior and premolar teeth have been shown to meet oral functional demands. However, the occlusal stability may be at risk as a result of tooth migration. The aim of this nine-year study was to investigate occlusal stability in shortened dental arches as a function over time. Occlusal stability indicators were: 'interdental spacing', 'occlusal contacts of anterior teeth in Intercuspal Position', 'overbite', 'occlusal tooth wear', and 'alveolar bone support'. Subjects with shortened dental arches (n = 74) were compared with subjects with complete dental arches (controls, n = 72). Repeated-measurement regression analyses were applied to assess age-dependent variables in the controls and to relate the occlusal changes to the period of time since the treatment that led to the shortened dental arches. Compared with complete dental arches, shortened dental arches had similar overbite and occlusal tooth wear. They showed more interdental spacing in the premolar regions, more anterior teeth in occlusal contact, and lower alveolar bone scores. Since the differences remained constant over time, we conclude that shortened dental arches can provide long-term occlusal stability. Occlusal changes were self-limiting, indicating a new occlusal equilibrium.

[Association between collateral circulation and myocardial viability evaluated by cardiac magnetic resonance imaging in patients with coronary artery chronic total occlusion].

Science.gov (United States)

Li, J N; Zhang, L J; He, Y; Chen, Y L; Huang, R C; Lyu, S Z; Song, X T

2017-07-24

Objective: Late gadolinium enhancement(LGE) cardiac magnetic resonance imaging(CMR) was used to evaluate the myocardial viability of chronic total occlusion(CTO) in patients with coronary heart disease and to observe the relationship between collateral circulation and myocardium viability in these patients. Methods: This retrospective study included 40 patients with CTO diagnosed by invasive coronary angiography (CAG) from September 2015 to June 2016 in our department, all patients performed CMR examination within one week after CAG.The collateral circulation of CTO was graded with Rentrop classification as follows: poor or no collateral circulation group, moderate collateral circulation group and good collateral circulation group.According to CMR images, the delayed enhancement transmural extent of myocardial segments were scored, the ventricular wall motion of the myocardial segment were graded, and the wall motion score index (WMSI) was calculated.Spearman correlation analysis was used to analyze the relationship between the delayed enhancement transmural extent of myocardial segments and WMSI. Results: In the no or poor collateral group of 6 myocardial regions, 1 myocardial region had viable myocardium and 3 myocardial regions had no viable myocardium; in the moderate collateral group of 16 myocardial regions, 11 myocardial regions had viable myocardium and 5 myocardial regions had no viable myocardium; in the good collateral group of 24 myocardial regions, 21 myocardial regions had viable myocardium and 3 myocardial regions had no viable myocardium, there was significant difference between the groups ( P =0.002). The WMSI of poor or no collateral circulation group, moderate collateral circulation group and good collateral circulation group were 1.54±0.50, 1.21±0.34 and 1.26±0.40, respectively, there was no significant difference between the groups ( P =0.063). Spearman correlation analysis showed that the extent of delayed enhancement transmural extent of

Monocytic microRNA profile associated with coronary collateral artery function in chronic total occlusion patients.

Science.gov (United States)

Hakimzadeh, Nazanin; Elias, Joëlle; Wijntjens, Gilbert W M; Theunissen, Ruud; van Weert, Angela; Smulders, Martijn W; van den Akker, Nynke; Moerland, Perry D; Verberne, Hein J; Hoebers, Loes P; Henriques, Jose P S; van der Laan, Anja M; Ilhan, Mustafa; Post, Mark; Bekkers, Sebastiaan C A M; Piek, Jan J

2017-05-08

An expansive collateral artery network is correlated with improved survival in case of adverse cardiac episodes. We aimed to identify cellular microRNAs (miRNA; miR) important for collateral artery growth. Chronic total occlusion (CTO) patients (n = 26) were dichotomized using pressure-derived collateral flow index (CFI p ) measurements; high collateral capacity (CFI p  > 0.39; n = 14) and low collateral (CFI p  collateral capacity patients. Validation by real-time polymerase chain reaction demonstrated significantly decreased expression of miR339-5p in all stimulated monocyte phenotypes of low collateral capacity patients. MiR339-5p showed significant correlation with CFI p values in stimulated monocytes. Ingenuity pathway analysis of predicted gene targets of miR339-5p and differential gene expression data from high versus low CFI p patients (n = 20), revealed significant association with STAT3 pathway, and also suggested a possible regulatory role for this signaling pathway. These results identify a novel association between miR339-5p and coronary collateral function. Future work examining modulation of miR339-5p and downstream effects on the STAT3 pathway and subsequent collateral vessel growth are warranted.

Real-time fusion of coronary CT angiography with X-ray fluoroscopy during chronic total occlusion PCI

Energy Technology Data Exchange (ETDEWEB)

Ghoshhajra, Brian B.; Takx, Richard A.P. [Harvard Medical School, Cardiac MR PET CT Program, Massachusetts General Hospital, Department of Radiology and Division of Cardiology, Boston, MA (United States); Stone, Luke L.; Yeh, Robert W.; Jaffer, Farouc A. [Harvard Medical School, Cardiac Cathetrization Laboratory, Cardiology Division, Massachusetts General Hospital, Boston, MA (United States); Girard, Erin E. [Siemens Healthcare, Princeton, NJ (United States); Brilakis, Emmanouil S. [Cardiology Division, Dallas VA Medical Center and UT Southwestern Medical Center, Dallas, TX (United States); Lombardi, William L. [University of Washington, Cardiology Division, Seattle, WA (United States)

2017-06-15

The purpose of this study was to demonstrate the feasibility of real-time fusion of coronary computed tomography angiography (CTA) centreline and arterial wall calcification with X-ray fluoroscopy during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Patients undergoing CTO PCI were prospectively enrolled. Pre-procedural CT scans were integrated with conventional coronary fluoroscopy using prototype software. We enrolled 24 patients who underwent CTO PCI using the prototype CT fusion software, and 24 consecutive CTO PCI patients without CT guidance served as a control group. Mean age was 66 ± 11 years, and 43/48 patients were men. Real-time CTA fusion during CTO PCI provided additional information regarding coronary arterial calcification and tortuosity that generated new insights into antegrade wiring, antegrade dissection/reentry, and retrograde wiring during CTO PCI. Overall CTO success rates and procedural outcomes remained similar between the two groups, despite a trend toward higher complexity in the fusion CTA group. This study demonstrates that real-time automated co-registration of coronary CTA centreline and calcification onto live fluoroscopic images is feasible and provides new insights into CTO PCI, and in particular, antegrade dissection reentry-based CTO PCI. (orig.)

Impact of lesion morphology on angiographic and clinical outcomes in patients with chronic total occlusion after recanalization with drug-eluting stents: a multislice computed tomography study

Energy Technology Data Exchange (ETDEWEB)

Ito, Tsuyoshi [Toyohashi Heart Center, Toyohashi (Japan); Nagoya City University Graduate School of Medical Sciences, Department of Cardio-Renal Medicine and Hypertension, Nagoya (Japan); Tsuchikane, Etsuo; Nasu, Kenya; Kimura, Masashi; Terashima, Mitsuyasu; Kinoshita, Yoshihisa; Habara, Maoto; Suzuki, Takahiko [Toyohashi Heart Center, Toyohashi (Japan); Suzuki, Yoriyasu; Ehara, Mariko [Nagoya Heart Center, Nagoya (Japan); Ohte, Nobuyuki [Nagoya City University Graduate School of Medical Sciences, Department of Cardio-Renal Medicine and Hypertension, Nagoya (Japan)

2015-10-15

The aim of this study was to investigate the multislice computed tomography (MSCT) parameters associated with adverse outcomes after chronic total occlusion percutaneous coronary intervention (CTO-PCI) with drug-eluting stents. A total of 285 patients who underwent MSCT before CTO-PCI were analyzed. Lesion morphology was assessed with MSCT. Angiographic restenosis, reocclusion, and MACE (a composite of cardiac death, myocardial infarction, stent thrombosis, and target lesion revascularization) were analyzed. MACE was observed in 36 patients (13.6 %). Occlusion length was greater (39.5 ± 19.9 mm vs. 22.3 ± 13.7 mm, p < 0.01), minimal vessel area smaller (11.2 ± 5.7 mm{sup 2} vs. 14.5 ± 5.6 mm{sup 2}, p < 0.01), and severe calcification more common (36 % vs. 12 %, p < 0.01) in the MACE group compared to the non-MACE group. We defined occluded length >25.4 mm, minimal vessel area <11.9 mm{sup 2}, which were identified by receiver operating characteristic analysis, and severe calcification as CT-derived risk factors. Angiographic restenosis (60 % vs. 12 % vs. 7 %, p < 0.01), reocclusion (29 % vs. 2 % vs. 2 %, p < 0.01), and MACE (43 % vs. 6 % vs. 3 %, p < 0.01) were more common in patients with 2 or more risk factors than in those with 1 or 0. MSCT characteristics associated with adverse outcomes after CTO-PCI were occlusion length, minimal vessel area, and severe calcification. (orig.)

Evaluation of bone loss due to primary occlusal trauma in two experimental models of occlusal overload

OpenAIRE

LOPES, Ana Cristina Távora de Albuquerque; TÉO, Mirela Anne Quartaroli; CORRÊA, Mônica Grazieli; ISHIKIRIAMA, Bella Luna Colombini; CAMPOS, Mirella Lindoso Gomes

2016-01-01

Abstract Introduction Primary occlusal trauma (OT) is an injury of the periodontium with normal height as a result of occlusal forces which exceed their adaptive capacity. Objective To evaluate, histometrically, the alveolar bone loss in the furcation region of rats experimentally submitted to 2 models of occlusal overload. Material and method 45 animals randomly divided into 3 groups: Occlusal Interference (OI, n = 15) - fixing an orthodontic wire segment on the occlusal surface of the fi...

Physiological interpretation of Doppler shift waveforms: the femorodistal segment in combined disease.

Science.gov (United States)

Campbell, W B; Baird, R N; Cole, S E; Evans, J M; Skidmore, R; Woodcock, J P

1983-01-01

A new method is presented for assessing the femorodistal segment in multisegmental arterial disease, using the Laplace transform technique of Doppler waveform analysis. Blood velocity/time waveforms were obtained at femoral and ankle levels in three groups of limbs--50 without arterial disease, 12 with isolated aortoiliac stenoses, and 32 with femoropopliteal occlusions, with and without proximal disease. The waveforms were analysed for Laplace transform and pulsatility index values. The omega 0 coefficients of the Laplace transform analysis at femoral and ankle levels were compared in each subject, as the omega 0 gradient (femoral/ankle omega 0): and pulsatility index damping factor (femoral/ankle P1) was also calculated. The omega 0 gradient was shown to detect femoropopliteal occlusion in the presence of multisegmental arterial disease and to give some indication of its haemodynamic significance. The diagnostic accuracy of the omega 0 gradient was superior to that of pulsatility index damping factor. When combined with its existing ability to detect aortoiliac stenosis, this new application of the Laplace transform method offers the possibility both of a system for complete localisation of significant arterial lesions, and potential for follow-up of vascular surgical procedures in the lower limb, from two simple Doppler recordings.

Vertebrobasilar Artery Occlusion

Directory of Open Access Journals (Sweden)

Schoen, Jessica

2011-05-01

Full Text Available The presentation of vertebrobasilar artery occlusion varies with the cause of occlusion and location of ischemia. This often results in delay in diagnosis. Areas of the brain supplied by the posterior circulation are difficult to visualize and usually require angiography or magnetic resonance imaging. Intravenous thrombolysis and local-intra arterial thrombolysis are the most common treatment approaches used. Recanalization of the occluded vessel significantly improves morbidity and mortality. Here we present a review of the literature and a case of a patient with altered mental status caused by vertebrobasilar artery occlusion. [West J Emerg Med. 2011;12(2:233-239.

Influence of Chronic Stress and Oclusal Interference on Masseter Muscle Pain in Rat

OpenAIRE

Simonić-Kocijan, Sunčana; Uhač, Ivone; Braut, Vedrana; Kovač, Zoran; Kovačević Pavičić, Daniela; Fugošić, Vesna; Muhvić Urek, Miranda

2009-01-01

This study aimed to investigate the individual effects of chronic stress and occlusal interference, as well as their combined influence on masseter muscle pain. Experiments were performed on 28 male Wistar rats. Animals were submitted to chronic stress procedure, exposed to occlusal interference, or exposed to both mantioned procedures. At the end of the procedure animals were submitted to orofacial formalin test, and nociceptive behavioral response was evaluated. Statisticaly significant dif...

Superior mesenteric arterial branch occlusion causing partial jejunal ischemia: a case report

Directory of Open Access Journals (Sweden)

Van De Winkel Nele

2012-02-01

Full Text Available Abstract Introduction Ischemic bowel disease comprises both mesenteric ischemia and colonic ischemia. Mesenteric ischemia can be divided into acute and chronic ischemia. These are two separate entities, each with their specific clinical presentation and diagnostic and therapeutic modalities. However, diagnosis may be difficult due to the vague symptomatology and subtle signs. Case presentation We report the case of a 68-year-old Caucasian woman who presented with abdominal discomfort, anorexia, melena and fever. A physical examination revealed left lower quadrant tenderness and an irregular pulse. Computed tomography of her abdomen as well as computed tomography enterography, enteroscopy, angiography and small bowel enteroclysis demonstrated an ischemic jejunal segment caused by occlusion of a branch of the superior mesenteric artery. The ischemic segment was resected and an end-to-end anastomosis was performed. The diagnosis of segmental small bowel ischemia was confirmed by histopathological study. Conclusion Mesenteric ischemia is a pathology well-known by surgeons, gastroenterologists and radiologists. Acute and chronic mesenteric ischemia are two separate entities with their own specific clinical presentation, radiological signs and therapeutic modalities. We present the case of a patient with symptoms and signs of chronic mesenteric ischemia despite an acute etiology. To the best of our knowledge, this is the first report presenting a case of acute mesenteric ischemia with segmental superior mesenteric artery occlusion.

A Novel Risk Score in Predicting Failure or Success for Antegrade Approach to Percutaneous Coronary Intervention of Chronic Total Occlusion: Antegrade CTO Score.

Science.gov (United States)

Namazi, Mohammad Hasan; Serati, Ali Reza; Vakili, Hosein; Safi, Morteza; Parsa, Saeed Ali Pour; Saadat, Habibollah; Taherkhani, Maryam; Emami, Sepideh; Pedari, Shamseddin; Vatanparast, Masoomeh; Movahed, Mohammad Reza

2017-06-01

Total occlusion of a coronary artery for more than 3 months is defined as chronic total occlusion (CTO). The goal of this study was to develop a risk score in predicting failure or success during attempted percutaneous coronary intervention (PCI) of CTO lesions using antegrade approach. This study was based on retrospective analyses of clinical and angiographic characteristics of CTO lesions that were assessed between February 2012 and February 2014. Success rate was defined as passing through occlusion with successful stent deployment using an antegrade approach. A total of 188 patients were studied. Mean ± SD age was 59 ± 9 years. Failure rate was 33%. In a stepwise multivariate regression analysis, bridging collaterals (OR = 6.7, CI = 1.97-23.17, score = 2), absence of stump (OR = 5.8, CI = 1.95-17.9, score = 2), presence of calcification (OR = 3.21, CI = 1.46-7.07, score = 1), presence of bending (OR = 2.8, CI = 1.28-6.10, score = 1), presence of near side branch (OR = 2.7, CI = 1.08-6.57, score = 1), and absence of retrograde filling (OR = 2.5, CI = 1.03-6.17, score = 1) were independent predictors of PCI failure. A score of 7 or more was associated with 100% failure rate whereas a score of 2 or less was associated with over 80% success rate. Most factors associated with failure of CTO-PCI are related to lesion characteristics. A new risk score (range 0-8) is developed to predict CTO-PCI success or failure rate during antegrade approach as a guide before attempting PCI of CTO lesions.

Chronic Total Occlusion Crossing Approach Based on Plaque Cap Morphology: The CTOP Classification.

Science.gov (United States)

Saab, Fadi; Jaff, Michael R; Diaz-Sandoval, Larry J; Engen, Gwennan D; McGoff, Theresa N; Adams, George; Al-Dadah, Ashraf; Goodney, Philip P; Khawaja, Farhan; Mustapha, Jihad A

2018-02-01

To present the chronic total occlusion (CTO) crossing approach based on plaque cap morphology (CTOP) classification system and assess its ability to predict successful lesion crossing. A retrospective analysis was conducted of imaging and procedure data from 114 consecutive symptomatic patients (mean age 69±11 years; 84 men) with claudication (Rutherford category 3) or critical limb ischemia (Rutherford category 4-6) who underwent endovascular interventions for 142 CTOs. CTO cap morphology was determined from a review pf angiography and duplex ultrasonography and classified into 4 types (I, II, III, or IV) based on the concave or convex shape of the proximal and distal caps. Statistically significant differences among groups were found in patients with rest pain, lesion length, and severe calcification. CTOP type II CTOs were most common and type III lesions the least common. Type I CTOs were most likely to be crossed antegrade and had a lower incidence of severe calcification. Type IV lesions were more likely to be crossed retrograde from a tibiopedal approach. CTOP type IV was least likely to be crossed in an antegrade fashion. Access conversion, or need for an alternate access, was commonly seen in types II, III, and IV lesions. Distinctive predictors of access conversion were CTO types II and III, lesion length, and severe calcification. CTOP type I lesions were easiest to cross in antegrade fashion and type IV the most difficult. Lesion length >10 cm, severe calcification, and CTO types II, III, and IV benefited from the addition of retrograde tibiopedal access.

Cerebral hematocrit decreases with hemodynamic compromise in carotid artery occlusion: a PET study.

Science.gov (United States)

Yamauchi, H; Fukuyama, H; Nagahama, Y; Katsumi, Y; Okazawa, H

1998-01-01

This study investigated whether in patients with internal carotid artery occlusion the regional cerebral hematocrit correlates with cerebral hemodynamics or metabolic state and, if so, how the regional cerebral hematocrit changes in the hemodynamically compromised region. We used positron emission tomography to study seven patients with unilateral internal carotid artery occlusion and no cortical infarction in the chronic stage. The distributions of red blood cell and plasma volumes were assessed using oxygen-15-labeled carbon monoxide and copper-62-labeled human serum albumin-dithiosemicarbazone tracers, respectively. The calculated hematocrit value was compared with the hemodynamic and metabolic parameters measured with the oxygen-15 steady-state technique. In the cerebral cortex, the value of the cerebral hematocrit varied but was correlated with the hemodynamic and metabolic status. Stepwise regression analysis revealed that the large vessel hematocrit, the cerebral metabolic rate of oxygen, and the cerebral blood flow or the oxygen extraction fraction accounted for a significant proportion of variance of the cerebral hematocrit. The oxygen extraction fraction and the cerebral metabolic rate of oxygen negatively correlated with the cerebral hematocrit, whereas the cerebral blood flow correlated positively: patients with reduced blood supply relative to metabolic demand (decreased blood flow with increased oxygen extraction fraction) showed low hematocrit values. In carotid artery occlusion in the chronic stage, regional cerebral hematocrit may vary according to cerebral hemodynamics and metabolic status. Regional cerebral hematocrit may decrease with hemodynamic compromise unless oxygen metabolism concomitantly decreases.

Inner neural retina loss in central retinal artery occlusion.

Science.gov (United States)

Ikeda, Fumiko; Kishi, Shoji

2010-09-01

To report morphologic retinal changes and visual outcomes in acute and chronic central retinal artery occlusion (CRAO). We reviewed ten eyes of ten patients with CRAO (age, 65.3 ± 10.2 years) and measured retinal thicknesses at the central fovea and the perifovea using optical coherence tomography (OCT) over 8 ± 4 months. During the acute phase (within 10 days), the mean inner retinal thicknesses were 148% and 139% of normal values at 1 mm nasal and temporal to the fovea. They decreased to 22% and 11% of normal inner retinal thickness during the chronic phase (3 months or later). The retinal thickness at the perifovea decreased linearly until 3 months but was stable during the chronic phase. In contrast, the foveal thickness increased slightly in the acute phase but was equivalent to the normal level during the chronic phase. As a result of inner retinal atrophy, the foveal pit was shallow during the chronic phase. The final visual acuity was correlated positively with retinal thickness at the perifovea during the chronic CRAO phase. OCT showed that inner retinal necrosis with early swelling and late atrophy occurred in CRAO. The fovea and outer retina appeared to be excluded from ischemic change. The residual inner retina at the perifovea determined the final visual outcomes.

Impact of Proximal Cap Ambiguity on Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Multicenter US Registry.

Science.gov (United States)

Karatasakis, Aris; Danek, Barbara A; Karmpaliotis, Dimitri; Alaswad, Khaldoon; Jaffer, Farouc A; Yeh, Robert W; Patel, Mitul P; Bahadorani, John N; Wyman, R Michael; Lombardi, William L; Grantham, J Aaron; Kandzari, David E; Lembo, Nicholas J; Doing, Anthony H; Moses, Jeffrey W; Kirtane, Ajay J; Garcia, Santiago; Parikh, Manish A; Ali, Ziad A; Karacsonyi, Judit; Kalra, Sanjog; Rangan, Bavana V; Kalsaria, Pratik; Thompson, Craig A; Banerjee, Subhash; Brilakis, Emmanouil S

2016-10-01

We sought to determine the impact of proximal cap ambiguity on procedural techniques and outcomes for coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We examined the clinical and angiographic characteristics and outcomes of 1021 CTO-PCIs performed between 2012 and 2015 at 11 United States centers. Proximal cap ambiguity was present in 31% of target lesions and was associated with increased clinical and angiographic complexity (prior coronary artery bypass graft surgery: 43% vs 33%; P=.01; moderate/severe calcification 66% vs 51%; Pambiguity (68% vs 33%; Pambiguity was associated with increased use of intravascular ultrasound (49% vs 36%; P=.01) and contrast (281 mL vs 250 mL; Pambiguity is present in one-third of CTO-PCI target lesions and is associated with lower success rates, higher utilization of the retrograde approach, and lower procedural efficiency, but no significant difference in the incidence of major adverse cardiac events.

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

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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.

Microvascular dysfunction in the immediate aftermath of chronic total coronary occlusion recanalization.

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Ladwiniec, Andrew; Cunnington, Michael S; Rossington, Jennifer; Thackray, Simon; Alamgir, Farquad; Hoye, Angela

2016-05-01

The aim of this study was to compare microvascular resistance under both baseline and hyperemic conditions immediately after percutaneous coronary intervention (PCI) of a chronic total occlusion (CTO) with an unobstructed reference vessel in the same patient Microvascular dysfunction has been reported to be prevalent immediately after CTO PCI. However, previous studies have not made comparison with a reference vessel. Patients with a CTO may have global microvascular and/or endothelial dysfunction, making comparison with established normal values misleading. After successful CTO PCI in 21 consecutive patients, coronary pressure and flow velocity were measured at baseline and hyperemia in distal segments of the CTO/target vessel and an unobstructed reference vessel. Hemodynamics including hyperemic microvascular resistance (HMR), basal microvascular resistance (BMR), and instantaneous minimal microvascular resistance at baseline and hyperemia were calculated and compared between reference and target/CTO vessels. After CTO PCI, BMR was reduced in the target/CTO vessel compared with the reference vessel: 3.58 mm Hg/cm/s vs 4.94 mm Hg/cm/s, difference -1.36 mm Hg/cm/s (-2.33 to -0.39, p = 0.008). We did not detect a difference in HMR: 1.82 mm Hg/cm/s vs 2.01 mm Hg/cm/s, difference -0.20 (-0.78 to 0.39, p = 0.49). Instantaneous minimal microvascular resistance correlated strongly with the length of stented segment at baseline (r = 0.63, p = 0.005) and hyperemia (r = 0.68, p = 0.002). BMR is reduced in a recanalized CTO in the immediate aftermath of PCI compared to an unobstructed reference vessel; however, HMR appears to be preserved. A longer stented segment is associated with increased microvascular resistance. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Maximizing mandibular prosthesis stability utilizing linear occlusion, occlusal plane selection, and centric recording.

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Williamson, Richard A; Williamson, Anne E; Bowley, John; Toothaker, Randy

2004-03-01

The stability of mandibular complete dentures may be improved by reducing the transverse forces on the denture base through linear (noninterceptive) occlusion, selecting an occlusal plane that reduces horizontal vectors of force at occlusal contact, and utilizing a central bearing intraoral gothic arch tracing to record jaw relations. This article is intended to acquaint the reader with one technique for providing stable complete denture prostheses using the aforementioned materials, devices, and procedures.

Contralateral Occlusion Test: The effect of external ear canal occlusion on hearing thresholds.

Science.gov (United States)

Reis, Luis Roque; Fernandes, Paulo; Escada, Pedro

Bedside testing with tuning forks may decrease turnaround time and improve decision making for a quick qualitative assessment of hearing loss. The purpose of this study was to quantify the effects of ear canal occlusion on hearing, in order to decide which tuning fork frequency is more appropriate to use for quantifying hearing loss with the Contralateral Occlusion Test. Twenty normal-hearing adults (forty ears) underwent sound field pure tone audiometry with and without ear canal occlusion. Each ear was tested with the standard frequencies. The contralateral ear was suppressed with by masking. Ear occlusion was performed by two examiners. Participants aged between 21 and 30 years (25.6±3.03 years) showed an increase in hearing thresholds with increasing frequencies from 19.94dB (250Hz) to 39.25dB (2000Hz). The threshold difference between occluded and unoccluded conditions was statistically significant and increased from 10.69dB (250Hz) to 32.12dB (2000Hz). There were no statistically significant differences according to gender or between the examiners. The occlusion effect increased the hearing thresholds and became more evident with higher frequencies. The occlusion method as performed demonstrated reproducibility. In the Contralateral Occlusion Test, 256Hz or 512Hz tuning forks should be used for diagnosis of mild hearing loss, and a 2048Hz tuning fork should be used for moderate hearing loss. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

Primary Infrarenal Aortic Stenting With or Without Iliac Stenting for Isolated and Aortoiliac Stenoses: Single-Centre Experience With Long-Term Follow-Up

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Tapping, C. R.; Ahmed, M.; Scott, P. M.; Lakshminarayan, R.; Robinson, G. J.; Ettles, D. F.; Shrivastava, V., E-mail: vivek.shrivastava@hey.nhs.uk [Hull Royal Infirmary, Hull and East Yorkshire Hospitals NHS Trust, Department of Radiology (United Kingdom)

2013-02-15

The purpose of this study was to evaluate the technical success, complications, long-term clinical outcome, and patency after primary infrarenal aortic stenting for aortic and aortoiliac stenosis. Between January 1999 and January 2006, 22 consecutive patients underwent endovascular treatment because of infrarenal aortic stenosis with and without common iliac stenosis (10 men; mean age 64 {+-} 14 years). Eleven (11 of 22) patients had an isolated aortic stenosis, whereas 11 of 22 had aortic stenosis that extended into the common iliac arteries (CIAs). Thirteen patients were Rutherford classification type 3, and 9 patients were type 4. Statistical analysis included paired Student t test and Kaplan-Meier life table analysis; p < 0.05 was considered significant. Technical and initial clinical success was achieved in all patients. There were three (14 %) procedure-related complications, which included two access-point pseudoaneurysms and one non-flow-limiting left external iliac dissection. Patients were followed-up for a mean period of 88 months (range 60-132). Mean preprocedure ankle brachial pressure indexes (ABPI) were 0.60 {+-} -0.15 (right) and 0.61 {+-} -0.16 (left). After the procedure they were 0.86 {+-} -0.07 (right) and 0.90 {+-} -0.09 (left). The increase in ABPI was significant (p < 0.05), and this continued throughout follow-up. Four (18 %) patients had recurrence of symptoms during follow-up. These occurred at 36, 48, 48, and 50 months after the original procedure. All four patients were successfully treated with repeat angioplasty procedures. There was a significant difference in primary patency between isolated aortic stenosis (100 %) and aortoiliac stenosis (60 %) (p = 0.031). Cumulative follow-up was 1920 months yielding a reintervention rate of 0.025/events/year. Primary stenting of infrarenal stenosis is safe and successful with a low reintervention rate. It should be considered as first-line treatment for patients with infrarenal aortic stenotic

Computerized occlusal analysis in bruxism

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Lazić Vojkan

2006-01-01

Full Text Available Introduction. Sleep bruxism as nocturnal parafunction, also known as tooth grinding, is the most common parasomnia (sleep disorder. Most tooth grinding occurs during rapid eye movement - REM sleep. Sleep bruxism is an oral habit characterized by rhythmic activity of the masticatory muscles (m. masseter that causes forced contact between dental surfaces during sleep. Sleep bruxism has been associated with craniomandibular disorders including temporomandibular joint discomfort, pulpalgia, premature loss of teeth due to excessive attrition and mobility, headache, muscle ache, sleep interruption of an individual and problems with removable and fixed denture. Basically, two groups of etiological factors can be distinguished, viz., peripheral (occlusal factors and central (pathophysiological and psychological factors. The role of occlusion (occlusal discrepancies as the causative factor is not enough mentioned in relation to bruxism. Objective. The main objective of this paper was to evaluate the connection between occlusal factors and nocturnal parafunctional activities (occlusal disharmonies and bruxism. Method. Two groups were formed- experimental of 15 persons with signs and symptoms of nocturnal parafunctional activity of mandible (mean age 26.6 years and control of 42 persons with no signs and symptoms of bruxism (mean age 26.3 yrs.. The computerized occlusal analyses were performed using the T-Scan II system (Tekscan, Boston, USA. 2D occlusograms were analyzed showing the occlusal force, the center of the occlusal force with the trajectory and the number of antagonistic tooth contacts. Results. Statistically significant difference of force distribution was found between the left and the right side of the arch (L%-R% (t=2.773; p<0.02 in the group with bruxism. The difference of the centre of occlusal force - COF trajectory between the experimental and control group was not significant, but the trajectory of COF was longer in the group of

The Use of Below-Knee Percutaneous Transluminal Angioplasty in Arterial Occlusive Disease Causing Chronic Critical Limb Ischemia

International Nuclear Information System (INIS)

Loefberg, Ann-Marie; Loerelius, Lars-Erik; Karacagil, Sadettin; Westman, Bo; Almgren, Bo; Berqgvist, David

1996-01-01

Purpose: To determine the efficacy, safety and long-term results of crural artery percutaneous transluminal angioplasty (PTA) in limbs with chronic critical limb ischemia (CLI). Methods: Patients undergoing crural artery PTA due to CLI were followed at regular clinic visits with ankle brachial pressure index (ABPI) measurements. PTA of the crural arteries was attempted either alone (n= 39) or in combination with PTA of the superficial and/or popliteal artery (n= 55) in 86 limbs (82 patients and 94 procedures) presenting with CLI. The ages of patients ranged from 37 to 94 years (mean 72 years). The indications for PTA were rest pain in 10 and ulcer/gangrene in 84 limbs.Results: A technically successful PTA with at least one crural level was achieved in 88% of cases (n= 83). Cumulative primary clinical success rates at 6, 12, 24, and 36 months were 55%, 51%, 36%, and 36%, respectively. Cumulative secondary clinical success and limb salvage rates at 36 months were 44% and 72%, respectively. Conclusion: PTA of the crural arteries might be considered the primary choice of treatment in patients with CLI and distal lesions with localized stenosis or segmental short occlusions

Contemporary Management of Acute Aortic Occlusion Has Evolved but Outcomes Have Not Significantly Improved.

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Robinson, William P; Patel, Rupal K; Columbo, Jesse A; Flahive, Julie; Aiello, Francesco A; Baril, Donald T; Schanzer, Andres; Messina, Louis M

2016-07-01

Most existing series of acute aortic occlusion (AAO) predate the changes in surgical and endovascular therapy of the last 2 decades. We examined the contemporary management and outcomes of AAO. We reviewed consecutive patients with AAO at a tertiary referral center from 2004 to 2012. Outcomes were stratified and compared according to etiology and procedure performed. AAO in 29 patients was due to in situ thrombosis in 21 (72%) and embolism in 8 (28%) patients. Vascular patients with embolism were on average older (77 ± 7 vs. 66 ± 12 years, P = 0.02) and had higher rates of atrial fibrillation (100% vs. 20%, P = 0.0002) and congestive heart failure (75% vs. 0%, P = 0.0001) in comparison with those with in situ thrombosis. Neurologic deficit was present in 16 (55%) patients. Six patients (21%) presented with bilateral paresis/paralysis secondary to spinal cord or lumbosacral plexus ischemia, and primary neurologic etiology was investigated before vascular consultation was obtained in 4 of these 6 patients. Of the 29 patients, 28 (97%) underwent revascularization including transfemoral embolectomy (n = 6), transperitoneal aortoiliac thrombectomy (n = 2), axillobifemoral bypass (n = 10), aortobifemoral bypass (n = 6), and endovascular therapy including thrombolysis, angioplasty ± stenting (n = 4). In-hospital mortality was 31% and did not vary significantly according to etiology (embolism 38% vs. in situ thrombosis 29%, P = 0.67). In-hospital mortality varied widely according to procedure (transfemoral embolectomy 50%, aortoiliac thrombectomy 100%, axillobifemoral bypass 30%, aortobifemoral bypass 0%, and endovascular therapy 25%, P = 0.08). Major morbidity (59%), length of stay (8.6 ± 8.0 days), and discharge to a rehabilitation facility (50%) did not vary by etiology or procedure. At a media follow-up of 361 ± 460 days (range 3-2014), overall survival was 42%. There were no amputations among 20 survivors of initial

Radiation exposure to patient's skin during percutaneous coronary intervention for various lesions, including chronic total occlusion

International Nuclear Information System (INIS)

Suzuki, Shigeru; Furui, Shigeru; Kohtake, Hiroshi; Yokoyama, Naoyuki; Kozuma, Ken; Yamamoto, Yoshito; Isshiki, Takaaki

2006-01-01

Radiation skin injuries have been reported as a result of various procedures, so in the present study the patients' entrance skin dose (ESD) during percutaneous coronary intervention (PCI) was evaluated. ESDs were assessed during 97 procedures (13 for chronic total occlusion (CTO), 14 for multivessel stenoses, 22 for single-vessel multiple stenoses, and 48 for single stenosis). The patients wore jackets that had 48 or 52 radiosensitive indicators placed on the back during the PCI procedures, with 8 other indicators placed on both upper arms. After the procedure, the color of the indicators was analyzed with a color measuring instrument, and the patients' ESDs were calculated from the color difference of the indicators. The average maximum ESDs of the patients were 4.5±2.8 Gy (median: 4.6 Gy) for CTO, 2.3±0.7 Gy (median: 2.4 Gy) for multi-vessel stenoses, 1.8±1.0 Gy (median: 1.5 Gy) for single-vessel multiple stenoses, and 1.4±0.9 Gy (median: 1.2 Gy) for single stenosis. Skin injury can occur during PCI, especially for CTO, so it is important to estimate each patient's ESD and attempt to reduce it. (author)

Ten-minute umbilical cord occlusion markedly reduces cerebral blood flow and heat production in fetal sheep.

NARCIS (Netherlands)

Lotgering, F.K.; Bishai, J.M.; Struijk, P.C.; Blood, A.B.; Hunter, C.J.; Power, G.G.; Longo, L.D.

2003-01-01

OBJECTIVE: The study was undertaken to determine to what extent a 10-minute total umbilical cord occlusion affects autoregulation of cerebral blood flow and cerebral heat production in the fetus. STUDY DESIGN: In seven chronically catheterized late-gestation fetal sheep (127-131 days' gestation), we

[Effect of 2 methods of occlusion adjustment on occlusal balance and muscles of mastication in patient with implant restoration].

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Wang, Rong; Xu, Xin

2015-12-01

To compare the effect of 2 methods of occlusion adjustment on occlusal balance and muscles of mastication in patients with dental implant restoration. Twenty patients, each with a single edentulous posterior dentition with no distal dentition were selected, and divided into 2 groups. Patients in group A underwent original occlusion adjustment method and patients in group B underwent occlusal plane reduction technique. Ankylos implants were implanted in the edentulous space in each patient and restored with fixed prosthodontics single unit crown. Occlusion was adjusted in each restoration accordingly. Electromyograms were conducted to determine the effect of adjustment methods on occlusion and muscles of mastication 3 months and 6 months after initial restoration and adjustment. Data was collected and measurements for balanced occlusal measuring standards were obtained, including central occlusion force (COF), asymmetry index of molar occlusal force(AMOF). Balanced muscles of mastication measuring standards were also obtained including measurements from electromyogram for the muscles of mastication and the anterior bundle of the temporalis muscle at the mandibular rest position, average electromyogram measurements of the anterior bundle of the temporalis muscle at the intercuspal position(ICP), Astot, masseter muscle asymmetry index, and anterior temporalis asymmetry index (ASTA). Statistical analysis was performed using Student 's t test with SPSS 18.0 software package. Three months after occlusion adjustment, parameters of the original occlusion adjustment method were significantly different between group A and group B in balanced occlusal measuring standards and balanced muscles of mastication measuring standards. Six months after occlusion adjustment, parameters of the original occlusion adjustment methods were significantly different between group A and group B in balanced muscles of mastication measuring standards, but was no significant difference in balanced

One-year clinical evaluation of nanohybrid resin composite in the restoration of occlusal and proximo-occlusal cavities in Nigeria

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Lillian Lami Enone

2017-01-01

Full Text Available Background: This study aimed to evaluate the clinical performance of nanocomposites in a Nigerian adult population. Resin composites are becoming the preferred direct restorative material in restoring occlusal and proximo-occlusal cavities due to their aesthetic properties and good clinical service. Materials and Methods: This was a clinical study evaluating the clinical performance of a nanohybrid resin composite in the restoration of occlusal and proximo-occlusal cavities in Nigerian adults. This study was done in the Conservative Dentistry Clinic of the Lagos State University Teaching Hospital, Ikeja, from April 2014 to September 2015. The restorations were evaluated immediately at baseline, 3, 6 and 12 months postoperatively for colour match, marginal discolouration, surface roughness, anatomical form, marginal adaptation, retention, post-operative sensitivity and secondary caries using the modified USPHS criteria. Statistical analysis was performed using Fisher's exact test and a 5% level of significance was considered statistically significant. Results: Males had more proximo-occlusal (26.7 than occlusal (6.7 cavities while the females (43.3 had more occlusal cavities. The nanohybrid occlusal restorations had 100% alpha scores at baseline for anatomical form which dropped to 93.3% at 12 months with 6.7% of the restorations scoring Bravo, whereas all nanohybrid proximo-occlusal restorations had 100% alpha scores from baseline to the 12-month review. All occlusal and proximo-occlusal restorations evaluated for surface texture and marginal adaptation had alpha scores at baseline which dropped to 93.3% at 12 months. Conversely, all nanohybrid occlusal and proximo-occlusal restorations scored 100% for colour match and retention, sensitivity and secondary caries from baseline to 12 months. Conclusion: The clinical performance of natural elegance nanohybrid resin composite (Henry Schein® was satisfactory in the restoration of occlusal and

Recurrence of amblyopia after occlusion therapy.

Science.gov (United States)

Bhola, Rahul; Keech, Ronald V; Kutschke, Pamela; Pfeifer, Wanda; Scott, William E

2006-11-01

To determine the stability of visual acuity (VA) after a standardized occlusion regimen in children with strabismic and/or anisometropic amblyopia. Retrospective, population-based, consecutive observational case series. Four hundred forty-nine patients younger than 10 years who underwent an occlusion trial for amblyopia and were observed until there was a recurrence of amblyopia or for a maximum of 1 year after decrease or cessation of occlusion therapy. We performed a retrospective chart review of all patients treated by occlusion therapy for strabismic and/or anisometropic amblyopia at our institution over a 34-year period. Of the 1621 patients identified in our database, 449 met the eligibility criteria and were included in this study. Patients having at least a 2 logarithm of the minimum angle of resolution (logMAR)-level improvement in VA by optotypes or a change from unmaintained to maintained fixation preference during the course of occlusion therapy were included. A recurrence of amblyopia was defined as > or =2 logMAR levels of VA reduction or reversal of fixation preference within 1 year after a decrease or cessation of occlusion therapy. Recurrence of amblyopia after a decrease or cessation of occlusion therapy and its relationship with patient age and VA of the amblyopic eye at the time of decrease or cessation of occlusion therapy. Of 653 occlusion trials, 179 (27%) resulted in recurrence of amblyopia. The recurrence was found to be inversely correlated with patient age. There was no statistically significant association between the recurrence of amblyopia and VA of the amblyopic eye at the end of maximal occlusion therapy. There is a clinically important risk of amblyopia recurrence when occlusion therapy is decreased before the age of 10 years. The risk of recurrence is inversely correlated with age (P<0.0001).

Efficacy and safety of novel multi-lumen catheter for chronic total occlusions: from preclinical study to first-in-man experience.

Science.gov (United States)

Mitsutake, Yoshiaki; Ebner, Adrian; Yeung, Alan C; Taber, Mark D; Davidson, Charles J; Ikeno, Fumiaki

2015-02-15

To report our initial animal and human experience with a new multi-lumen catheter called MultiCross™ (Roxwood Medical, Inc.) in a porcine coronary model and patients with a chronic total occlusion (CTO). Preclinical safety study was done in the coronary vasculature of a porcine model. In a clinical setting, patients with a CTO of a coronary artery (n = 5) were enrolled. After an initial unsuccessful attempt using a conventional guidewire, operators could use the MultiCross system. The primary efficacy endpoint was successful recanalization (technical success) and the primary safety endpoint was serious adverse events through 30 days post-procedure. The MultiCross catheter was used for all patients after failure of the initial attempt with a guidewire. Successful recanalization was achieved in all CTOs attempted (100%). No patients reported any adverse events at 30 days post-procedure. In this first-in-man experience, the MultiCross catheter has the potential to enhance crossing of CTOs. © 2014 Wiley Periodicals, Inc.

Evaluation of bone loss due to primary occlusal trauma in two experimental models of occlusal overload

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Ana Cristina Távora de Albuquerque LOPES

Full Text Available Abstract Introduction Primary occlusal trauma (OT is an injury of the periodontium with normal height as a result of occlusal forces which exceed their adaptive capacity. Objective To evaluate, histometrically, the alveolar bone loss in the furcation region of rats experimentally submitted to 2 models of occlusal overload. Material and method 45 animals randomly divided into 3 groups: Occlusal Interference (OI, n = 15 - fixing an orthodontic wire segment on the occlusal surface of the first lower molar; Occlusal Overload (OO, n = 15 - wearing of the cusps of the lower contralateral molars, the second and third molars next to the first molar that had its dimensions maintained; Negative Control (NC, n = 15 - evaluation of the initial dimensions of the periodontal ligament (PL. Five animals / group were sacrificed after 14, 21 and 28 days. Result Intergroup evaluation showed significant bone loss in OI (p0.05. The thickness of the PL remained stable in NC (p>0.05. Conclusion OI and OO were effective in the experimental reproduction of OT, and OI promoted greater alveolar bone loss compared to OO, showing that the impact of occlusal overload in OI increased the extent of the OT injury.

Occlusion effects, Part I

DEFF Research Database (Denmark)

Hansen, Mie Østergaard

annoyances and the objective measurements were analysed. Persons suffering from tinnitus behaved differently than person without tinnitus. The latter group showed significant relations between the measured occlusion effect, hearing loss and the personal of occlusion. The actual sensation level is also...

Acetazolamide-augmented dynamic BOLD (aczBOLD imaging for assessing cerebrovascular reactivity in chronic steno-occlusive disease of the anterior circulation: An initial experience

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Junjie Wu

2017-01-01

Full Text Available The purpose of this study was to measure cerebrovascular reactivity (CVR in chronic steno-occlusive disease using a novel approach that couples BOLD imaging with acetazolamide (ACZ vasoreactivity (aczBOLD, to evaluate dynamic effects of ACZ on BOLD and to establish the relationship between aczBOLD and dynamic susceptibility contrast (DSC perfusion MRI. Eighteen patients with unilateral chronic steno-occlusive disease of the anterior circulation underwent a 20-min aczBOLD imaging protocol, with ACZ infusion starting at 5 min of scan initiation. AczBOLD reactivity was calculated on a voxel-by-voxel basis to generate CVR maps for subsequent quantitative analyses. Reduced CVR was observed in the diseased vs. the normal hemisphere both by qualitative and quantitative assessment (gray matter (GM: 4.13% ± 1.16% vs. 4.90% ± 0.98%, P = 0.002; white matter (WM: 2.83% ± 1.23% vs. 3.50% ± 0.94%, P = 0.005. In all cases BOLD signal began increasing immediately following ACZ infusion, approaching a plateau at ~8.5 min after infusion, with the tissue volume of reduced augmentation increasing progressively with time, peaking at 2.60 min (time range above 95% of the maximum value: 0–4.43 min for the GM and 1.80 min (time range above 95% of the maximum value: 1.40–3.53 min for the WM. In the diseased hemisphere, aczBOLD CVR significantly correlated with baseline DSC time-to-maximum of the residue function (Tmax (P = 0.008 for the WM and normalized cerebral blood flow (P = 0.003 for the GM, and P = 0.001 for the WM. AczBOLD provides a novel, safe, easily implementable approach to CVR measurement in the routine clinical environments. Further studies can establish quantitative thresholds from aczBOLD towards identification of patients at heightened risk of recurrent ischemia and cognitive decline.

Radiofrequency Wire Recanalization of Chronically Thrombosed TIPS

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Majdalany, Bill S., E-mail: bmajdala@med.umich.edu [University of Michigan Health System, Division of Interventional Radiology, Department of Radiology (United States); Elliott, Eric D., E-mail: eric.elliott@osumc.edu [The Ohio State University Wexner Medical Center, Division of Interventional Radiology, Department of Radiology (United States); Michaels, Anthony J., E-mail: Anthony.michaels@osumc.edu; Hanje, A. James, E-mail: James.Hanje@osumc.edu [The Ohio State University Wexner Medical Center, Division of Gastroenterology and Hepatology, Department of Medicine (United States); Saad, Wael E. A., E-mail: wsaad@med.umich.edu [University of Michigan Health System, Division of Interventional Radiology, Department of Radiology (United States)

2016-07-15

Radiofrequency (RF) guide wires have been applied to cardiac interventions, recanalization of central venous thromboses, and to cross biliary occlusions. Herein, the use of a RF wire technique to revise chronically occluded transjugular intrahepatic portosystemic shunts (TIPS) is described. In both cases, conventional TIPS revision techniques failed to revise the chronically thrombosed TIPS. RF wire recanalization was successfully performed through each of the chronically thrombosed TIPS, demonstrating initial safety and feasibility in this application.

[Temporomandibular joint, occlusion and bruxism].

Science.gov (United States)

Orthlieb, J D; Ré, J P; Jeany, M; Giraudeau, A

2016-09-01

Temporomandibular joint and dental occlusion are joined for better and worse. TMJ has its own weaknesses, sometimes indicated by bad functional habits and occlusal disorders. Occlusal analysis needs to be addressed simply and clearly. The term "malocclusion" is not reliable to build epidemiological studies, etiologic mechanisms or therapeutic advice on this "diagnosis". Understanding the impact of pathogenic malocclusion is not just about occlusal relationships that are more or less defective, it requires to locate them within the skeletal framework, the articular and behavioural context of the patient, and above all to assess their impact on the functions of the masticatory system. The TMJ-occlusion couple is often symbiotic, developing together in relation to its environment, compensating for its own shortcomings. However, a third partner may alter this relationship, such as bruxism, or more generally oral parafunctions, trauma or an interventionist practitioner. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Placement of a Port Catheter Through Collateral Veins in a Patient with Central Venous Occlusion

International Nuclear Information System (INIS)

Teichgraeber, Ulf Karl-Martin; Streitparth, Florian; Gebauer, Bernhard; Benter, Thomas

2010-01-01

Long-term utilization of central venous catheters (CVCs) for parenteral nutrition has a high incidence of central venous complications including infections, occlusions, and stenosis. We report the case of a 31-year-old woman presenting with a malabsorption caused by short gut syndrome due to congenital aganglionic megacolon. The patient developed a chronic occlusion of all central neck and femoral veins due to long-term use of multiple CVCs over more than 20 years. In patients with central venous occlusion and venous transformation, the implantation of a totally implanted port system by accessing collateral veins is an option to continue long-term parenteral nutrition when required. A 0.014-in. Whisper guidewire (Terumo, Tokyo) with high flexibility and steerability was chosen to maneuver and pass through the collateral veins. We suggest this approach to avoid unfavorable translumbar or transhepatic central venous access and to conserve the anatomically limited number of percutaneous access sites.

Treatment of temporomandibular disorder using occlusal splint

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Agus Dahlan

2009-03-01

Full Text Available Background: Patient suffering from occlusal abnormality is usually detected months or even years when the acute patient visits a dentist, and generally the patient does not receive direct treatment upon his complaints since minimum information is available on this type of treatment. In general, the dentist provides medication only or conducts incorrect selective grinding where in fact, the patient does not feel better from the previous conditions. Purpose: The objective of this study is to discuss the treatment on the dysfunctional temporomandibular joint followed by orofacial pain caused by occlusal disorder using occlusal splint. Case: In this case, a forty three years old male having trouble with the joint on the left jaw followed by orofacial pain caused by occlusal disorder. Case Management: Initial treatment with occlusal splint makes the patient comfortable and recovers from his complaints since the patient could restructure the chewing muscles. This treatment will be more successful if the dentist has the knowledge to use and choose occlusal splint method properly. Occlusal Splint could be used as a supporting therapy and consideration as one of the therapies to avoid the unwanted side effects. The use of occlusal splint is meant as an alternative of the main therapy in overcoming the problem of occlusal splint. Conclusion: Finally, therapy with occlusal splint is very effective as an alternative treatment to handle the dysfunction of temporomandibular joint caused by occlusion.

Catheter Occlusion in Home Infusion: The Influence of Needleless Connector Design on Central Catheter Occlusion.

Science.gov (United States)

Williams, Ann

Thrombotic catheter occlusion is a common complication associated with central venous catheters (CVCs). A wide variety of needleless connectors that differ greatly in design and function are available for use with CVCs; however, there are a limited number of studies comparing the catheter occlusion rate associated with differently designed needleless connectors. This retrospective observational study compared occlusion rates associated with a split-septum neutral-displacement needleless connector versus those of a solid-surface neutral-reflux needleless connector in patients undergoing home infusion therapy. The neutral-reflux needleless connector was associated with a significant reduction in occlusion rate and thrombolytic use versus the neutral-displacement needleless connector.

Hydrogel based occlusion systems

NARCIS (Netherlands)

Stam, F.A.; Jackson, N.; Dubruel, P.; Adesanya, K.; Embrechts, A.; Mendes, E.; Neves, H.P.; Herijgers, P.; Verbrugghe, Y.; Shacham, Y.; Engel, L.; Krylov, V.

2013-01-01

A hydrogel based occlusion system, a method for occluding vessels, appendages or aneurysms, and a method for hydrogel synthesis are disclosed. The hydrogel based occlusion system includes a hydrogel having a shrunken and a swollen state and a delivery tool configured to deliver the hydrogel to a

Endovascular revascularization for aortoiliac atherosclerotic disease

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Aggarwal V

2016-03-01

Full Text Available Vikas Aggarwal,1 Stephen W Waldo,2,3 Ehrin J Armstrong2,3 1Prairie Heart Institute, St John's Hospital, Springfield, IL, 2Section of Cardiology, Denver Veterans Affairs Medical Center, 3Section of Cardiology, University of Colorado, Aurora, CO, USA Abstract: Atherosclerotic iliac artery disease is increasingly being treated with endovascular techniques. A number of new stent technologies can be utilized with high long-term patency, including self-expanding stents, balloon-expandable stents, and covered stents, but comparative data on these stent types and in more complex lesions are lacking. This article provides a review of currently available iliac stent technologies, as well as complex procedural aspects of iliac artery interventions, including approaches to the treatment of iliac bifurcation disease, long segment occlusions, choice of stent type, and treatment of iliac artery in-stent restenosis. Keywords: peripheral artery disease, iliac artery, balloon expandable stent, self expanding stent, covered stent, claudication, endovascular

Adaptation in properties of skeletal muscle to coronary artery occlusion/reperfusion in rats

International Nuclear Information System (INIS)

Ogoh, Shigehiko; Taguchi, Sadayoshi

2002-01-01

The present study was designed to determine if changes in function and metabolism of heart muscle induce alterations in characteristics of skeletal muscle. We investigated the histochemical and biochemical properties of soleus (SOL) and extensor digitorum longus (EDL) muscles in Wistar rats at the chronic phase after coronary artery occlusion/reperfusion. The size of myocardial infarct region was evaluated using a high resolution pinhole single photo emission computed tomography (SPECT) system. 4wk after left coronary artery occlusion/reperfusion, the SOL and EDL of hindlimb were dissected out and immersed in isopentane cooled with liquid nitrogen for subsequent histochemical and biochemical analysis. From SPECT imaging, the blood circulation was recovered, but the recovery of fatty acid metabolism was not observed in infarct region of heart. Citrate synthase (CS) and 3-hydroxyacyl-CoA dehydrogenase (HAD) activities in infarct region of heart were lower in the myocardial infarction (MI, n=6) group compared with that of age-matched sham-operated (Sham, n=6) group. In addition, heart muscle hypertrophy caused by the dysfunction in MI group was observed. In skeletal muscle, the atrophy and transition of fiber type distribution in MI group, reported in previous studies of heart failure, were not observed. However, the succinate dehydrogenase (SDH) activity in the slow twitch oxidative (SO) from SOL of MI group decreased by 9.8% and in the fast twitch oxidative glycolytic fibers (FOG), 8.0% as compared with sham group. Capillary density of the SO fibers from SOL of MI group also reduced by 18.5% and in the FOG fibers, 18.2% as compared with Sham group. Decreased capillary density in this study related significantly to decreased SDH activity of single muscle fibers in chronic phase of perfusion after surgical infarction. Our results make it clear that there is a difference in the reaction of skeletal muscle to coronary artery occlusion/reperfusion compared with chronic

Adaptation in properties of skeletal muscle to coronary artery occlusion/reperfusion in rats

Energy Technology Data Exchange (ETDEWEB)

Ogoh, Shigehiko [Univ. of North Texas, Fort Worth, TX (United States). Health Science Center; Hirai, Taku [Kyoto Univ. (Japan). Graduate School of Medicine; Nohara, Ryuuji [Kitano Hospital, Osaka (Japan); Taguchi, Sadayoshi [Kyoto Univ. (Japan). Graduate School of Human and Environmental Studies

2002-10-01

The present study was designed to determine if changes in function and metabolism of heart muscle induce alterations in characteristics of skeletal muscle. We investigated the histochemical and biochemical properties of soleus (SOL) and extensor digitorum longus (EDL) muscles in Wistar rats at the chronic phase after coronary artery occlusion/reperfusion. The size of myocardial infarct region was evaluated using a high resolution pinhole single photo emission computed tomography (SPECT) system. 4wk after left coronary artery occlusion/reperfusion, the SOL and EDL of hindlimb were dissected out and immersed in isopentane cooled with liquid nitrogen for subsequent histochemical and biochemical analysis. From SPECT imaging, the blood circulation was recovered, but the recovery of fatty acid metabolism was not observed in infarct region of heart. Citrate synthase (CS) and 3-hydroxyacyl-CoA dehydrogenase (HAD) activities in infarct region of heart were lower in the myocardial infarction (MI, n=6) group compared with that of age-matched sham-operated (Sham, n=6) group. In addition, heart muscle hypertrophy caused by the dysfunction in MI group was observed. In skeletal muscle, the atrophy and transition of fiber type distribution in MI group, reported in previous studies of heart failure, were not observed. However, the succinate dehydrogenase (SDH) activity in the slow twitch oxidative (SO) from SOL of MI group decreased by 9.8% and in the fast twitch oxidative glycolytic fibers (FOG), 8.0% as compared with sham group. Capillary density of the SO fibers from SOL of MI group also reduced by 18.5% and in the FOG fibers, 18.2% as compared with Sham group. Decreased capillary density in this study related significantly to decreased SDH activity of single muscle fibers in chronic phase of perfusion after surgical infarction. Our results make it clear that there is a difference in the reaction of skeletal muscle to coronary artery occlusion/reperfusion compared with chronic

Complex left profunda femoris vein to renal vein bypass for the management of progressive chronic iliofemoral occlusion.

Science.gov (United States)

Anaya-Ayala, Javier E; Adams, Matthew K; Telich-Tarriba, Jose E; Dresser, Kelly L; Ismail, Nyla; Peden, Eric K

2013-01-01

Chronic occlusions of the inferior vena cava (IVC) and iliofemoral veins are long-term sequelae of deep venous thrombosis (DVT) that can lead to postthrombotic syndrome (PTS). Patients may present with a wide spectrum of signs and symptoms, ranging from mild discomfort and swelling to severe venous hypertension and ulcerations. We report a 68-year-old man who had a history of left lower extremity DVT after a laminectomy and who developed PTS with nonhealing ulcers. The patient underwent a cross-pubic femorofemoral venous bypass that failed to improve his clinical status. After unsuccessful endovascular attempts for recanalization of the iliofemoral segment, a profunda femoris to IVC bypass was performed. The symptoms recurred 2 years later. Venography revealed restenosis at the caval anastomosis that did not resolve by endovascular means. A surgical revision was performed, and given the quality of the IVC, a jump bypass was created to the left renal vein. The swelling improved and the ulcers healed completely. Twenty-eight months after the complex reconstructions, he remains ulcer-free with mild edema controlled with stockings. Venous reconstructions remain a viable option for patients with symptomatic and recalcitrant nonmalignant obstruction of the large veins. Copyright © 2013 Annals of Vascular Surgery Inc. Published by Elsevier Inc. All rights reserved.

In vivo evidence for long-term vascular remodeling resulting from chronic cerebral hypoperfusion in mice

OpenAIRE

Struys, Tom; Govaerts, Kristof; Oosterlinck, Wouter; Casteels, Cindy; Bronckaers, Annelies; Koole, Michel; Van Laere, Koen; Herijgers, Paul; Lambrichts, Ivo; Himmelreich, Uwe; Dresselaers, Tom

2016-01-01

We have characterized both acute and long-term vascular and metabolic effects of unilateral common carotid artery occlusion in mice by in vivo magnetic resonance imaging and positron emission tomography. This common carotid artery occlusion model induces chronic cerebral hypoperfusion and is therefore relevant to both preclinical stroke studies, where it serves as a control condition for a commonly used mouse model of ischemic stroke, and neurodegeneration, as chronic hypoperfusion is causati...

Guidewire and microcatheter utilization patterns during antegrade wire escalation in chronic total occlusion percutaneous coronary intervention: Insights from a contemporary multicenter registry.

Science.gov (United States)

Karatasakis, Aris; Tarar, Muhammad Nauman J; Karmpaliotis, Dimitri; Alaswad, Khaldoon; Yeh, Robert W; Jaffer, Farouc A; Wyman, R Michael; Lombardi, William L; Grantham, J Aaron; Kandzari, David E; Lembo, Nicholas J; Moses, Jeffrey W; Kirtane, Ajay J; Parikh, Manish; Garcia, Santiago; Doing, Anthony; Pershad, Ashish; Shah, Alpesh; Patel, Mitul; Bahadorani, John; Shoultz, Charles A; Danek, Barbara A; Thompson, Craig A; Banerjee, Subhash; Brilakis, Emmanouil S

2017-03-01

We sought to describe contemporary guidewire and microcatheter utilization for antegrade wire escalation (AWE) during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Equipment utilization for AWE has been variable and evolving over time. We examined device utilization during 694 AWE attempts in 679 patients performed at 15 experienced US centers between May 2012 and April 2015. Mean age was 65.6 ± 9.7 years, and 85% of the patients were men. Successful wiring occurred in 436 AWE attempts (63%). Final technical and procedural success was 91% and 89%, respectively. The mean number of guidewire types used for AWE was 2.2 ± 1.4. The most frequently used guidewire types were the Pilot 200 (Abbott Vascular, 56% of AWE procedures), Fielder XT (Asahi Intecc, 45%), and the Confianza Pro 12 (Asahi Intecc, 28%). The same guidewires were the ones that most commonly crossed the occlusion: Pilot 200 (36% of successful AWE crossings), Fielder XT (20%), and Confianza Pro 12 (11%). A microcatheter or over-the-wire balloon was used for 81% of AWE attempts; the Corsair microcatheter (Asahi Intecc) was the most commonly used (44%). No significant association was found between guidewire type and incidence of major adverse cardiac events (MACE). Our contemporary, multicenter CTO PCI registry demonstrates that the most commonly used wires for AWE are polymer-jacketed guidewires. "Stiff" and polymer-jacketed guidewires appear to provide high crossing rates without an increase in MACE or perforation, and may thus be considered for upfront use. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Diagnostic value of color doppler ultrasonography in detecting stenosis and occlusion of central veins in patients with chronic kidney disease

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Masoud Pezeshki Rad

2015-01-01

Full Text Available Venography is an invasive diagnostic test that uses contrast material that provides a picture of the condition of the veins. But, complications, including adverse effects on the kidney, do occur. On the other hand, with the current technological development, application of ultrasound in the diagnosis of obstructive diseases of the veins is gaining popularity, being non-invasive, easy to perform and cost-effective. The aim of this study was to evaluate the diagnostic value of Doppler sonography in the diagnosis of central vein stenosis. In this descriptive-analytical study, 41 hemodialysis patients who had been referred for 50 upper limb venographies to the radiology department of Imam Reza (AS were included. Patients with chronic kidney disease with a history of catheterization of the vein, jugular or subclavian, and who had established fistulas or synthetic vascular grafts were targeted. Central venous ultrasound was performed on both sides to evaluate stenosis or occlusion. Venography was performed by the radiologist the next day or the day before hemodialysis. Data on demographic characteristics, findings of clinical examination and findings of ultrasound as well as venography were recorded by using the SPSS software, Chi-square test and Spearman correlation, and Kappa agreement was calculated for sensitivity, specificity and predictive values. Twenty-three (56% patients were male subjects and 18 patients (44% were female. Twenty-three (56% patients of the study population were aged 60 years. The overall sensitivity, specificity and positive predictive value and negative predictive value of Doppler sonography in the proximal veins in hemodialysis patients compared with venography were, respectively, 80.9%, 79.3%, 73.9% and 85.1%. Color Doppler sonography, as a non-invasive method, could be a good alternative for venography in the assessment of the upper limb with central vein stenosis and occlusion.

Diagnostic value of color doppler ultrasonography in detecting stenosis and occlusion of central veins in patients with chronic kidney disease.

Science.gov (United States)

Rad, Masoud Pezeshki; Kazemzadeh, Gholam Hosain; Ziaee, Masood; Azarkar, Ghodsieh

2015-03-01

Venography is an invasive diagnostic test that uses contrast material that provides a picture of the condition of the veins. But, complications, including adverse effects on the kidney, do occur. On the other hand, with the current technological development, application of ultrasound in the diagnosis of obstructive diseases of the veins is gaining popularity, being non-invasive, easy to perform and cost-effective. The aim of this study was to evaluate the diagnostic value of Doppler sonography in the diagnosis of central vein stenosis. In this descriptive-analytical study, 41 hemodialysis patients who had been referred for 50 upper limb venographies to the radiology department of Imam Reza (AS) were included. Patients with chronic kidney disease with a history of catheterization of the vein, jugular or subclavian, and who had established fistulas or synthetic vascular grafts were targeted. Central venous ultrasound was performed on both sides to evaluate stenosis or occlusion. Venography was performed by the radiologist the next day or the day before hemodialysis. Data on demographic characteristics, findings of clinical examination and findings of ultrasound as well as venography were recorded by using the SPSS software, Chi-square test and Spearman correlation, and Kappa agreement was calculated for sensitivity, specificity and predictive values. Twenty-three (56%) patients were male subjects and 18 patients (44%) were female. Twenty-three (56%) patients of the study population were aged 60 years. The overall sensitivity, specificity and positive predictive value and negative predictive value of Doppler sonography in the proximal veins in hemodialysis patients compared with venography were, respectively, 80.9%, 79.3%, 73.9% and 85.1%. Color Doppler sonography, as a non-invasive method, could be a good alternative for venography in the assessment of the upper limb with central vein stenosis and occlusion.

Postural stability and occlusal status among Japanese elderly.

Science.gov (United States)

Song-Yu, Xuan; Rodis, Omar M M; Ogata, Sagiri; Can-Hu, Jin; Nishimura, Michiko; Matsumura, Seishi

2012-06-01

There are still no data available on the relationship between postural stability and occlusal status among the elderly. To examine relationships between postural stability and occlusal status through a cohort study among elderly Japanese. Oral examination, occlusal status, postural stability and a questionnaire were conducted and given to 87 community-dwelling Japanese at enrolment. The average occlusal pressure of the female group was statistically higher than the male group while average occlusal pressure and postural stability length were lesser in the group with more remaining teeth. Postural stability area and number of remaining teeth showed statistically significant correlations. Postural stability length was lesser in the group with strong occlusal force. Furthermore, the number of decayed teeth was fewer in the good hygiene group. This study identified a close relationship between occlusal status and postural stability of Japanese older individuals. Occlusal hypofunction was observed more in those with occlusal problems, and a decrease in their occlusal functions resulted in postural instability. © 2011 The Gerodontology Society and John Wiley & Sons A/S.

Upper limb artery segmental occlusions due to chronic use of ergotamine combined with itraconazole, treated by thrombolysis

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Nodari Franco

2011-08-01

Full Text Available Abstract Background The ergotamine tartrate associated with certain categories of drugs can lead to critical ischemia of the extremities. Discontinuation of taking ergotamine is usually sufficient for the total regression of ischemia, but in some cases it could be necessary thrombolytic and anticoagulant therapy to avoid amputation. Case report A woman of 62 years presented with a severe pain left forearm appeared 10 days ago, with a worsening trend. The same symptoms appeared after 5 days also in the right forearm. Physical examination showed the right arm slightly hypothermic, with radial reduced pulse in presence of reduced sensitivity. The left arm was frankly hypothermic, pulse less on radial and with an ulnar humeral reduced pulse, associated to a decreased sensitivity and motility. Clinical history shows a chronic headache for which the patient took a daily basis for years Cafergot suppository (equivalent to 3.2 mg of ergotamine. From about ten days had begun therapy with itraconazole for vaginal candidiasis. The Color-Doppler ultrasound shown arterial thrombosis of the upper limbs (humeral and radial bilateral, with minimal residual flow to the right and no signal on the humeral and radial left artery. Results Angiography revealed progressive reduction in size of the axillary artery and right humeral artery stenosis with right segmental occlusions and multiple hypertrophic collateral circulations at the elbow joint. At the level of the right forearm was recognizable only the radial artery, decreased in size. Does not recognize the ulnar, interosseous artery was thin. To the left showed progressive reduction in size of the distal subclavian and humeral artery, determined by multiple segmental steno-occlusion with collateral vessels serving only a thin hypotrophic interosseous artery. Arteriographic findings were compatible with systemic drug-induced disease. The immediate implementation of thrombolysis, continued for 26 hours, with

Percutaneous sharp recanalization of a membranous IVC occlusion with an occlusion balloon as a needle target

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Michael D. Rivers-Bowerman, MD, MSc, FRCPC

2017-09-01

Full Text Available A 50-year-old male with right upper quadrant symptoms and hepatic dysfunction was found to have multiple dilated hepatic veins (HVs with intrahepatic collateralization and membranous occlusion of the intrahepatic inferior vena cava (IVC consistent with primary Budd–Chiari syndrome. Venacavograms depicted drainage of the intrahepatic collaterals through a left-sided HV entering the IVC above the level of the occlusion. Sharp recanalization of the membranous IVC occlusion was performed with an occlusion balloon as a needle target under echocardiographic monitoring followed by balloon angioplasty with restoration of IVC patency. Clinical, laboratory, and venographic procedural success has been demonstrated to 9 months with minimal residual stenosis.

A new method of evaluating posterior occlusion and its relation to posttreatment occlusal changes.

Science.gov (United States)

Parkinson, C E; Buschang, P H; Behrents, R G; Throckmorton, G S; English, J D

2001-11-01

The purpose of this study was to assess the relationship between posterior occlusion and posttreatment changes in other occlusal variables. Pretreatment (T1), posttreatment (T2), and postretention (T3) records were obtained for 49 Class I (n = 23) and Class II (n = 26) extraction cases. Overbite, overjet, mandibular incisor irregularity, right and left molar deviations, midline deviation, and mandibular arch length were measured, and occlusal registrations were made of each set of dental casts. The proximity of posterior occlusal surfaces was measured as the contact or near-contact areas at or below 300 microm thickness, based on the optical densities of scanned images of the posterior occlusal registrations. The treatment changes for overbite, overjet, right and left molar deviation, and arch length were significantly greater in the Class II group, and the reductions in incisor irregularity were greater in the Class I group. No other class differences were found. Overbite, overjet, and incisor irregularity increased after treatment, and arch length continued to decrease, with no significant class differences. Contact and near-contact areas at or below 300 microm constituted 7% of the functional occlusal table for both classes at the end of treatment, having decreased significantly in both groups (21% in Class I and 29% in Class II) during treatment. Because contact and near-contact areas increased in some patients and decreased in others, there were no significant posttreatment changes. Negative correlations were found between contact and near-contact areas at T2 and changes in overjet from T2 to T3, and between contact and near-contact areas at T3 and changes in overbite from T2 to T3. No relationships were found between posterior contact and near-contact area and incisor irregularity. We concluded that (1) the area of actual and near contacts at or below 300 microm decreased significantly with treatment, indicating that, despite excellent treatment results by

Influence of mandibular fixation method on stability of the maxillary occlusal plane after occlusal plane alteration.

Science.gov (United States)

Yosano, Akira; Katakura, Akira; Takaki, Takashi; Shibahara, Takahiko

2009-05-01

In this study, we investigated how method of mandibular fixation influenced longterm postoperative stability of the maxilla in Class III cases. In particular, we investigated change in the maxillary occlusal plane after Occlusal Plane Alteration. Therefore, we focused on change in the palatal plane to evaluate stability of the maxillary occlusal plane, as the position of the palatal plane affects the maxillary occlusal plane. This study included 16 patients diagnosed with mandibular protrusion. Alteration of the occlusal plane was achieved by clockwise rotation of the maxilla by Le Fort I osteotomy and mandibular setback was performed by bilateral sagittal split ramus osteotomy. We analyzed and examined lateral cephalometric radiographs taken at 1 month, 3 months, 6 months, and 1 year after surgery. Stability achieved by two methods of mandibular fixation was compared. In one group of patients (group S) titanium screws were used, and in the other group (group P) titanium-locking mini-plates were used. No significant displacement was recognized in group S, whereas an approximately 0.7mm upward vertical displacement was recognized in the anterior nasal spine in group P. As a result, not only the angle of the palatal plane and S-N plane, but also occlusal plane angle in group P showed a greater decrease than that in group S. The results suggest that fixing the mandible with screws yielded greater stability of the maxilla and maxillary occlusal plane than fixing the mandible with titanium plates.

Lower limb revascularisation preceding surgical wound coverage - an interdisciplinary algorithm for chronic wound closure.

Science.gov (United States)

Aust, M C; Spies, M; Guggenheim, M; Gohritz, A; Kall, S; Rosenthal, H; Pichlmaier, M; Oehlert, G; Vogt, P M

2008-08-01

Chronic wounds may occur or persist due to arterial insufficiency. Despite the high prevalence of arterial occlusive disease, a search of the literature has yielded a paucity of data on the benefit of interventions to recanalise lower extremity arteries prior to surgical closure of chronic wounds. To investigate the correlation of simple clinical examinations and apparative diagnostics for the detection of arterial occlusive disease of the lower extremity in patients with chronic wounds, and to evaluate the benefit of vascular procedures to optimise wound perfusion before surgical closure. During a 6-year period, 150 patients with chronic lower extremity wounds (no healing for more than 30 days) were included into this prospective study. All patients underwent palpation of foot pulses, Doppler sonography and measurement of occlusive pressures. Positive clinical findings were re-evaluated by angiography. All patients with peripheral extremity vessel occlusions underwent vascular interventions (percutaneous transluminal angioplasty with stenting, open thrombectomy or vascular bypass surgery) prior to surgical wound closure. In all 34 patients (21%) with missing foot pulses, suspicious Doppler signals or pathological occlusive pressure measurements, the clinical diagnosis of arterial occlusion was confirmed by angiography. An arterial pathology had previously been diagnosed in merely two of those patients. Nineteen patients underwent percutaneous transluminal angioplasty and 21 stents were implanted; in 10 cases, open thrombectomy or vascular bypasses were performed. In all 34 patients, sufficient peripheral recanalisation and improved wound perfusion were successfully achieved. For definitive wound closure, microsurgical tissue transplantation was performed in 15 patients. Angiography was performed prior to surgery. In 11 patients, regional or local flaps were used. Six patients received split skin grafting only; two wounds healed conservatively following vascular

Occlusion Handling in Videos Object Tracking: A Survey

International Nuclear Information System (INIS)

Lee, B Y; Liew, L H; Cheah, W S; Wang, Y C

2014-01-01

Object tracking in video has been an active research since for decades. This interest is motivated by numerous applications, such as surveillance, human-computer interaction, and sports event monitoring. Many challenges related to tracking objects still remain, this can arise due to abrupt object motion, changing appearance patterns of objects and the scene, non-rigid object structures and most significant are occlusion of tracked object be it object-to-object or object-to-scene occlusions. Generally, occlusion in object tracking occur under three situations: self-occlusion, inter-object occlusion by background scene structure. Self-occlusion occurs most frequently while tracking articulated objects when one part of the object occludes another. Inter-object occlusion occurs when two objects being tracked occlude each other whereas occlusion by the background occurs when a structure in the background occludes the tracked objects. Typically, tracking methods handle occlusion by modelling the object motion using linear and non-linear dynamic models. The derived models will be used to continuously predicting the object location when a tracked object is occluded until the object reappears. Example of these method are Kalman filtering and Particle filtering trackers. Researchers have also utilised other features to resolved occlusion, for example, silhouette projections, colour histogram and optical flow. We will present some result from a previously conducted experiment when tracking single object using Kalman filter, Particle filter and Mean Shift trackers under various occlusion situation in this paper. We will also review various other occlusion handling methods that involved using multiple cameras. In a nutshell, the goal of this paper is to discuss in detail the problem of occlusion in object tracking and review the state of the art occlusion handling methods, classify them into different categories, and identify new trends. Moreover, we discuss the important

Occlusion Handling in Videos Object Tracking: A Survey

Science.gov (United States)

Lee, B. Y.; Liew, L. H.; Cheah, W. S.; Wang, Y. C.

2014-02-01

Object tracking in video has been an active research since for decades. This interest is motivated by numerous applications, such as surveillance, human-computer interaction, and sports event monitoring. Many challenges related to tracking objects still remain, this can arise due to abrupt object motion, changing appearance patterns of objects and the scene, non-rigid object structures and most significant are occlusion of tracked object be it object-to-object or object-to-scene occlusions. Generally, occlusion in object tracking occur under three situations: self-occlusion, inter-object occlusion by background scene structure. Self-occlusion occurs most frequently while tracking articulated objects when one part of the object occludes another. Inter-object occlusion occurs when two objects being tracked occlude each other whereas occlusion by the background occurs when a structure in the background occludes the tracked objects. Typically, tracking methods handle occlusion by modelling the object motion using linear and non-linear dynamic models. The derived models will be used to continuously predicting the object location when a tracked object is occluded until the object reappears. Example of these method are Kalman filtering and Particle filtering trackers. Researchers have also utilised other features to resolved occlusion, for example, silhouette projections, colour histogram and optical flow. We will present some result from a previously conducted experiment when tracking single object using Kalman filter, Particle filter and Mean Shift trackers under various occlusion situation in this paper. We will also review various other occlusion handling methods that involved using multiple cameras. In a nutshell, the goal of this paper is to discuss in detail the problem of occlusion in object tracking and review the state of the art occlusion handling methods, classify them into different categories, and identify new trends. Moreover, we discuss the important

Incidence of Central Vein Stenosis and Occlusion Following Upper Extremity PICC and Port Placement

International Nuclear Information System (INIS)

Gonsalves, Carin F.; Eschelman, David J.; Sullivan, Kevin L.; DuBois, Nancy; Bonn, Joseph

2003-01-01

The purpose of this study was to determine the incidence of central vein stenosis and occlusion following upper extremity placement of peripherally inserted central venous catheters(PICCs) and venous ports. One hundred fifty-four patients who underwent venography of the ipsilateral central veins prior to initial and subsequent venous access device insertion were retrospectively identified. All follow-up venograms were interpreted at the time of catheter placement by one interventional radiologist over a 5-year period and compared to the findings on initial venography. For patients with central vein abnormalities, hospital and home infusion service records and radiology reports were reviewed to determine catheter dwelltime and potential alternative etiologies of central vein stenosis or occlusion. The effect of catheter caliber and dwell time on development of central vein abnormalities was evaluated. Venography performed prior to initial catheter placement showed that 150 patients had normal central veins. Three patients had central vein stenosis, and one had central vein occlusion. Subsequent venograms (n = 154)at the time of additional venous access device placement demonstrated 8 patients with occlusions and 10 with stenoses. Three of the 18 patients with abnormal follow-up venograms were found to have potential alternative causes of central vein abnormalities. Excluding these 3 patients and the 4 patients with abnormal initial venograms, a 7% incidence of central vein stenosis or occlusion was found in patients with prior indwelling catheters and normal initial venograms. Catheter caliber showed no effect on the subsequent development of central vein abnormalities. Patients who developed new or worsened central vein stenosis or occlusion had significantly (p =0.03) longer catheter dwell times than patients without central vein abnormalities. New central vein stenosis or occlusion occurred in 7% of patients following upper arm placement of venous access devices

Primary Infrarenal Aortic Stenting With or Without Iliac Stenting for Isolated and Aortoiliac Stenoses: Single-Centre Experience With Long-Term Follow-Up

International Nuclear Information System (INIS)

Tapping, C. R.; Ahmed, M.; Scott, P. M.; Lakshminarayan, R.; Robinson, G. J.; Ettles, D. F.; Shrivastava, V.

2013-01-01

The purpose of this study was to evaluate the technical success, complications, long-term clinical outcome, and patency after primary infrarenal aortic stenting for aortic and aortoiliac stenosis. Between January 1999 and January 2006, 22 consecutive patients underwent endovascular treatment because of infrarenal aortic stenosis with and without common iliac stenosis (10 men; mean age 64 ± 14 years). Eleven (11 of 22) patients had an isolated aortic stenosis, whereas 11 of 22 had aortic stenosis that extended into the common iliac arteries (CIAs). Thirteen patients were Rutherford classification type 3, and 9 patients were type 4. Statistical analysis included paired Student t test and Kaplan–Meier life table analysis; p < 0.05 was considered significant. Technical and initial clinical success was achieved in all patients. There were three (14 %) procedure-related complications, which included two access-point pseudoaneurysms and one non–flow-limiting left external iliac dissection. Patients were followed-up for a mean period of 88 months (range 60–132). Mean preprocedure ankle brachial pressure indexes (ABPI) were 0.60 ± −0.15 (right) and 0.61 ± −0.16 (left). After the procedure they were 0.86 ± −0.07 (right) and 0.90 ± −0.09 (left). The increase in ABPI was significant (p < 0.05), and this continued throughout follow-up. Four (18 %) patients had recurrence of symptoms during follow-up. These occurred at 36, 48, 48, and 50 months after the original procedure. All four patients were successfully treated with repeat angioplasty procedures. There was a significant difference in primary patency between isolated aortic stenosis (100 %) and aortoiliac stenosis (60 %) (p = 0.031). Cumulative follow-up was 1920 months yielding a reintervention rate of 0.025/events/year. Primary stenting of infrarenal stenosis is safe and successful with a low reintervention rate. It should be considered as first-line treatment for patients with infrarenal aortic

Stent Recanalization of Chronic Portal Vein Occlusion in a Child

International Nuclear Information System (INIS)

Cwikiel, Wojciech; Solvig, Jan; Schroder, Henrik

2000-01-01

An 8-year-old boy with a 21/2 year history of portal hypertension and repeated bleedings from esophageal varices, was referred for treatment. The 3.5-cm-long occlusion of the portal vein was passed and the channel created was stabilized with a balloon-expandable stent; a portosystemic stent-shunt was also created. The portosystemic shunt closed spontaneously within 1 month, while the recanalized segment of the portal vein remained open. The pressure gradient between the intrahepatic and extrahepatic portal vein branches dropped from 17 mmHg to 0 mmHg. The pressure in the portal vein dropped from 30 mmHg to 17 mmHg and the bleedings stopped. The next dilation of the stent was performed 12 months later due to an increased pressure gradient; the gastroesophageal varices disappeared completely. Further dilation of the stent was planned after 2, 4, and 6 years

Occlusion-Aware View Interpolation

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Ince Serdar

2008-01-01

Full Text Available Abstract View interpolation is an essential step in content preparation for multiview 3D displays, free-viewpoint video, and multiview image/video compression. It is performed by establishing a correspondence among views, followed by interpolation using the corresponding intensities. However, occlusions pose a significant challenge, especially if few input images are available. In this paper, we identify challenges related to disparity estimation and view interpolation in presence of occlusions. We then propose an occlusion-aware intermediate view interpolation algorithm that uses four input images to handle the disappearing areas. The algorithm consists of three steps. First, all pixels in view to be computed are classified in terms of their visibility in the input images. Then, disparity for each pixel is estimated from different image pairs depending on the computed visibility map. Finally, luminance/color of each pixel is adaptively interpolated from an image pair selected by its visibility label. Extensive experimental results show striking improvements in interpolated image quality over occlusion-unaware interpolation from two images and very significant gains over occlusion-aware spline-based reconstruction from four images, both on synthetic and real images. Although improvements are obvious only in the vicinity of object boundaries, this should be useful in high-quality 3D applications, such as digital 3D cinema and ultra-high resolution multiview autostereoscopic displays, where distortions at depth discontinuities are highly objectionable, especially if they vary with viewpoint change.

Occlusion-Aware View Interpolation

Directory of Open Access Journals (Sweden)

Janusz Konrad

2009-01-01

Full Text Available View interpolation is an essential step in content preparation for multiview 3D displays, free-viewpoint video, and multiview image/video compression. It is performed by establishing a correspondence among views, followed by interpolation using the corresponding intensities. However, occlusions pose a significant challenge, especially if few input images are available. In this paper, we identify challenges related to disparity estimation and view interpolation in presence of occlusions. We then propose an occlusion-aware intermediate view interpolation algorithm that uses four input images to handle the disappearing areas. The algorithm consists of three steps. First, all pixels in view to be computed are classified in terms of their visibility in the input images. Then, disparity for each pixel is estimated from different image pairs depending on the computed visibility map. Finally, luminance/color of each pixel is adaptively interpolated from an image pair selected by its visibility label. Extensive experimental results show striking improvements in interpolated image quality over occlusion-unaware interpolation from two images and very significant gains over occlusion-aware spline-based reconstruction from four images, both on synthetic and real images. Although improvements are obvious only in the vicinity of object boundaries, this should be useful in high-quality 3D applications, such as digital 3D cinema and ultra-high resolution multiview autostereoscopic displays, where distortions at depth discontinuities are highly objectionable, especially if they vary with viewpoint change.

Application of photogrammetry for analysis of occlusal contacts.

Science.gov (United States)

Shigeta, Yuko; Hirabayashi, Rio; Ikawa, Tomoko; Kihara, Takuya; Ando, Eriko; Hirai, Shinya; Fukushima, Shunji; Ogawa, Takumi

2013-04-01

The conventional 2D-analysis methods for occlusal contacts provided limited information on tooth morphology. This present study aims to detect 3D positional information of occlusal contacts from 2D-photos via photogrammetry. We propose an image processing solution for analysis of occlusal contacts and facets via the black silicone method and a photogrammetric technique. The occlusal facets were reconstructed from a 2D-photograph data-set of inter-occlusal records into a 3D image via photogrammetry. The configuration of the occlusal surface was reproduced with polygons. In addition, the textures of the occlusal contacts were mapped to each polygon. DIFFERENCE FROM CONVENTIONAL METHODS: Constructing occlusal facets with 3D polygons from 2D-photos with photogrammetry was a defining characteristic of this image processing technique. It allowed us to better observe findings of the black silicone method. Compared with conventional 3D analysis using a 3D scanner, our 3D models did not reproduce the detail of the anatomical configuration. However, by merging the findings of the inter-occlusal record, the deformation of mandible and the displacement of periodontal ligaments under occlusal force were reflected in our model. EFFECT OR PERFORMANCE: Through the use of polygons in the conversion of 2D images to 3D images, we were able to define the relation between the location and direction of the occlusal contacts and facets, which was difficult to detect via conventional methods. Through our method of making a 3D polygon model, the findings of inter-occlusal records which reflected the jaw/teeth behavior under occlusal force could be observed 3-dimensionally. Copyright © 2012 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

Current possibilities in occlusal caries management

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Hrvoje Jurić

2013-11-01

Full Text Available Dental caries is a multifactorial disease that affects most populations throughout the world and it is still the primary cause of oral pain and tooth loss. The occlusal surfaces of posterior teeth are the most vulnerable sites for dental caries due to their anatomy. Therefore, the aim of the following article is to summarize current knowledge on occlusal caries development and the possibilities of its prevention. Although the overall caries rate today has fallen for populations in industrialized countries, the rate of occlusal surface caries has not decreased. This may be explained with fact that topically applied fluorides and their mode of action prevent caries better on smooth than on occlusal surfaces. As we know, tooth decay of first permanent molars causes a great deal of different short and long term difficulties for patients. Therefore, there is a continuous need for implementation of programs for caries prevention in permanent teeth. Nowadays, we like to treat our patients by minimally invasive methods. A very important step in our effective preventive treatment is sealing pits and fissures as a cornerstone of occlusal caries management. Reliable assessment of caries activity is also very important for defining treatment needs and plans. A very important decision, which should be made during occlusal caries management, is the selection of restorative material according to the treatment plan. Conclusion. Current possibilities in occlusal caries prevention and management are very effective. Therefore, dentists today do not have any excuse for avoiding the philosophy of Minimally Invasive Dentistry, especially when we talk about caries management of occlusal surfaces in permanent molars.

Occlusion of Heubner's artery

International Nuclear Information System (INIS)

Sato, Manabu; Kidooka, Minoru

1982-01-01

A case of occlusion of the left Heubner's artery in a right-handed, 51-year-old man is reported. Cardinal clinical features were transient right hemiparesis and mental disturbance, especially intellectual defect. Low density areas were found at CT in the globus pallidus, putamen, anterior limb of the internal capsule and a part of the caudate nucleus. It is well known that the occlusion of the Heubner's artery causes transient motor paresis of upper extremity on the contralaterl side. However, in the case where the Heubner's artery is remarkably well developed when compared with the medial striate arteries as was the case in this patient, it should be noted that the occlusion of the Heubner's artery may well causes grave mental disturbance, in addition. (author)

Occlusal considerations for dental implant restorations.

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Bergmann, Ranier H

2014-01-01

When placed, dental implants are put into an ever-changing oral environment in which teeth can continue to migrate. Yet, the implants themselves are ankylosed. This can lead to occlusal instability. Teeth may continue to erupt, leaving the implants in infraocclusion. Teeth may move mesially away from an implant, requiring modification to close an open contact point. Friction in the connection between teeth and implants can lead to intrusion of teeth and damage to the periodontal attachment apparatus. Implant occlusion with shallow incisal guidance minimizes lateral and tipping forces. Cross-arch stabilization allows the best distribution of occlusal forces. The choice of restorative materials influences long-term occlusal stability.

Occlusal adjustment using the bite plate-induced occlusal position as a reference position for temporomandibular disorders: a pilot study

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Chiwata Ichiro

2010-03-01

Full Text Available Abstract Background Many researchers have not accepted the use of occlusal treatments for temporomandibular disorders (TMDs. However, a recent report described a discrepancy between the habitual occlusal position (HOP and the bite plate-induced occlusal position (BPOP and discussed the relation of this discrepancy to TMD. Therefore, the treatment outcome of evidence-based occlusal adjustments using the bite plate-induced occlusal position (BPOP as a muscular reference position should be evaluated in patients with TMD. Methods The BPOP was defined as the position at which a patient voluntarily closed his or her mouth while sitting in an upright posture after wearing an anterior flat bite plate for 5 minutes and then removing the plate. Twenty-one patients with TMDs underwent occlusal adjustment using the BPOP. The occlusal adjustments were continued until bilateral occlusal contacts were obtained in the BPOP. The treatment outcomes were evaluated using the subjective dysfunction index (SDI and the Helkimo Clinical Dysfunction Index (CDI before and after the occlusal adjustments; the changes in these two indices between the first examination and a one-year follow-up examination were then analyzed. In addition, the difference between the HOP and the BPOP was three-dimensionally measured before and after the treatment. Results The percentage of symptom-free patients after treatment was 86% according to the SDI and 76% according to the CDI. The changes in the two indices after treatment were significant (p 0.1. Conclusion Although the results of the present study should be confirmed in other studies, a randomized clinical trial examining occlusal adjustments using the BPOP as a reference position appears to be warranted.

Real-time fusion of coronary CT angiography with x-ray fluoroscopy during chronic total occlusion PCI.

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Ghoshhajra, Brian B; Takx, Richard A P; Stone, Luke L; Girard, Erin E; Brilakis, Emmanouil S; Lombardi, William L; Yeh, Robert W; Jaffer, Farouc A

2017-06-01

The purpose of this study was to demonstrate the feasibility of real-time fusion of coronary computed tomography angiography (CTA) centreline and arterial wall calcification with x-ray fluoroscopy during chronic total occlusion (CTO) percutaneous coronary intervention (PCI). Patients undergoing CTO PCI were prospectively enrolled. Pre-procedural CT scans were integrated with conventional coronary fluoroscopy using prototype software. We enrolled 24 patients who underwent CTO PCI using the prototype CT fusion software, and 24 consecutive CTO PCI patients without CT guidance served as a control group. Mean age was 66 ± 11 years, and 43/48 patients were men. Real-time CTA fusion during CTO PCI provided additional information regarding coronary arterial calcification and tortuosity that generated new insights into antegrade wiring, antegrade dissection/reentry, and retrograde wiring during CTO PCI. Overall CTO success rates and procedural outcomes remained similar between the two groups, despite a trend toward higher complexity in the fusion CTA group. This study demonstrates that real-time automated co-registration of coronary CTA centreline and calcification onto live fluoroscopic images is feasible and provides new insights into CTO PCI, and in particular, antegrade dissection reentry-based CTO PCI. • Real-time semi-automated fusion of CTA/fluoroscopy is feasible during CTO PCI. • CTA fusion data can be toggled on/off as desired during CTO PCI • Real-time CT calcium and centreline overlay could benefit antegrade dissection/reentry-based CTO PCI.

Effect of glove occlusion on the skin barrier

DEFF Research Database (Denmark)

Tiedemann, Daniel; Clausen, Maja Lisa; John, Swen Malthe

2016-01-01

that the negative effect of occlusion in itself is limited, and that only extensive and long-term occlusion will cause barrier impairment. However, studies investigating combined effect of occlusion and exposure to soaps/detergents indicate that occlusion significantly enhances the skin barrier damage caused...... by detergents/soaps in a dose-response fashion....

[High-frequency components of occlusal sound in sliding movement].

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Nagai, K

1990-03-01

We postulated that high-frequency components of the occlusal sound occurring due to the characteristic vibration of teeth can be useful data for confirmation of the stability in occlusion, and studied the high-frequency components in the cases both of an experimental sliding movement and a normal occlusion. The results obtained were as follows. 1. A study on high-frequency components of the occlusal sound in an experimental sliding movement. 1) A study on wave type of the occlusal sound revealed one damped oscillation in an impact form and two in a slide form. 2) Spectrum analysis of the damped oscillation showed a similar spectrum pattern with a peak existing between 16KHz or more and 17KHz or less in both impact and slide cases. 2. A study on high-frequency components of the occlusal sound in a normal occlusion case. 1) The wave type in occlusal sound we have observed in a normal occlusion group and in a prosthetic or operative group was as follows: One damped oscillation shown in an impact form and two damped oscillation in a slide form which were the same as those shown in the case where an interference device was attached. 2) Duration of the sliding movement was short in a normal occlusion group, but was prolonged in a prosthetic or operative group. 3) The incidence of the wave type in occlusal sound was 56.7% in a prosthetic or operative group as compared to 87.8% in a normal occlusion group in an impact form. In contrast, the incidence was 43.3% in a prosthetic or operative group as compared to 12.2% in a normal occlusion group in a slide form. Such difference in the incidence between the wave types suggested that high-frequency components of occlusal sound can be an index for judgement of the stability in occlusion.

The Use of the Profunda Femoral Artery as the Sole Target Vessel to Bypass Aortoiliac Disease in Patients with Critical Limb Ischemia and Concomitant Unreconstructable Infrainguinal Disease.

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Kontopodis, Nikolaos; Lioudaki, Stella; Chronis, Christos; Kalogerakos, Paris; Lazopoulos, George; Papaioannou, Alexandra; Ioannou, Christos V

2018-04-01

Critical limb ischemia (CLI) often results from multilevel occlusive disease. There are occasions where a patent profunda femoral artery (PFA) is the only target artery that can be used as outflow during reconstruction to bypass aortoiliac disease (AOID), with no further option for infrainguinal revascularization. We aim to report results of the use of PFA as the sole target vessel for the treatment of these patients. This is a retrospective, single-center study including CLI patients treated during 36 months. All procedures were included regardless of inflow site. The outcomes examined were hemodynamic improvement, clinical status change, amputation-free and overall survival, and patency of the prosthesis. Univariate analysis was performed to identify possible predictors of adverse outcomes. Twenty-three patients and 27 limbs were included (2 female, mean age 70.6). Sixteen limbs presented rest pain and 11 tissue loss. Inflow was obtained from the axillary (n = 9), contralateral femoral (n = 8), abdominal aorta (n = 2), thoracic aorta (n = 1), ipsilateral external iliac (n = 2), and contralateral external iliac artery (n = 1). Immediately postoperatively ankle-brachial index significantly increased from 0.15 (0-0.5) to 0.50 (0.25-0.9), (P-value limbs presented clinical improvement (3 minimally, 18 moderately, and 3 markedly improved) and 3 presented no change. During a mean follow-up of 15.8 (2-36) months, we recorded 4 deaths and 4 major amputations. Mean predicted overall survival and amputation-free survival were 29.8 (95% confidence interval [CI] 24.5-35.1) and 26.5 months (95% CI 21.1-31.8), respectively. Predicted primary patency was 76% at 3 years. Univariate analysis revealed significant associations only between bypass patency and limp loss (P-value = 0.021). In the presence of CLI due to AOID and unreconstructable infrainguinal disease, the use of PFA as the sole target vessel during bypass is associated with significant rates of clinical

Twelve months follow-up after retrograde recanalization of superficial femoral artery chronic total occlusion

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Joanna Wojtasik-Bakalarz

2017-03-01

Full Text Available Introduction : Fifty percent of cases of peripheral artery disease are caused by chronic total occlusion (CTO of the superficial femoral artery (SFA. Ten–fifteen percent of percutaneous SFA recanalization procedures are unsuccessful. In those cases the retrograde technique can increase the success rate of the procedure, but the long-term follow-up of such procedures is still unknown. Aim : To assess the efficacy and clinical outcomes during long-term follow-up after retrograde recanalization of the SFA. Material and methods: We included patients after at least one unsuccessful percutaneous antegrade recanalization of the SFA. Patients were evaluated for the procedural and clinical follow-up of mean time 13.9 months. Results: The study included 17 patients (7 females, 10 males who underwent percutaneous retrograde recanalization of the SFA from June 2011 to June 2015. The mean age of patients was 63 ±7 years. Retrograde puncture of the distal SFA was successful in all cases. A retrograde procedure was performed immediately after antegrade failure in 4 (23.5% patients and after a previously failed attempt in 13 (76.5% patients. The procedure was successful in 15 (88.2% patients, and unsuccessful in 2 (11.8% patients. Periprocedural complications included 1 peripheral distal embolization (successfully treated with aspiration thrombectomy, 1 bleeding event from the puncture site and 7 puncture site hematomas. During follow-up the all-cause mortality rate was 5.8% (1 patient, non-cardiac death. The primary patency rate at 12 months was 88.2% and secondary patency 100%. Conclusions : The retrograde SFA puncture seems to be a safe and successful technique for CTO recanalization and is associated with a low rate of perioperative and long-term follow-up complications.

Transient basilar artery occlusion monitored by transcranial color Doppler presenting with a spectacular shrinking deficit: a case report

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Del Sette Massimo

2010-01-01

Full Text Available Abstract Introduction We describe the case of a 79-year-old Caucasian Italian woman with a transient basilar occlusion monitored by transcranial Doppler, with subsequent recanalization and clinical shrinking deficit. This is the first case of transient basilar occlusive disease diagnosed and monitored by transcranial Doppler. This case is important and needs to be reported because transient basilar occlusion may be easily diagnosed if transcranial Doppler is performed. Case presentation A 79-year-old woman affected by chronic atrial fibrillation and not treated with oral anticoagulants, cardioverted to sinus rhythm during a gastric endoscopy. She then showed a sudden-onset loss of consciousness, horizontal and vertical gaze palsy, tetraparesis and bilateral miosis and coma. Two hours later, the symptoms resolved quickly, leaving no residual neurologic deficits. Transcranial Doppler examination showed a dampened flow in the basilar artery in the emergency examination and a restored flow when the symptoms resolved. Conclusion This is the first case of transient basilar occlusive disease diagnosed and monitored by transcranial Doppler. We believe that transcranial Doppler should be performed in all cases of unexplained acute loss of consciousness, in particular, if associated with signs of brainstem dysfunctions.

Neuromuscular dentistry: Occlusal diseases and posture.

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Khan, Mohd Toseef; Verma, Sanjeev Kumar; Maheshwari, Sandhya; Zahid, Syed Naved; Chaudhary, Prabhat K

2013-01-01

Neuromuscular dentistry has been a controversial topic in the field of dentistry and still remains debatable. The issue of good occlusion and sound health has been repeatedly discussed. Sometimes we get complains of sensitive teeth and sometimes of tired facial muscles on getting up in the morning. Owing to the intimate relation of masticatory apparatus with the cranium and cervico-scapular muscular system, the disorders in any system, draw attention from concerned clinicians involved in management, to develop an integrated treatment protocol for the suffering patients. There may be patients reporting to the dental clinics after an occlusal restoration or extraction, having pain in or around the temporomandibular joint, headache or neck pain. Although their esthetic demands must not be undermined during the course of treatment plan, whenever dental treatment of any sort is planned, occlusion/bite should be given prime importance. Very few dentist are able to diagnose the occlusal disease and of those who diagnose many people resort to aggressive treatment modalities. This paper aims to report the signs of occlusal disease, and discuss their association with TMDs and posture.

Medical therapy, percutaneous coronary intervention and prognosis in patients with chronic total occlusions.

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Ladwiniec, Andrew; Allgar, Victoria; Thackray, Simon; Alamgir, Farquad; Hoye, Angela

2015-12-01

There is little published data reporting outcomes for those found to have a chronic total coronary occlusion (CTO) that is electively treated medically versus those treated by percutaneous coronary intervention (PCI). We sought to compare long-term clinical outcomes between patients treated by PCI and elective medical therapy in a consecutive cohort of patients with an identified CTO. Patients found to have a CTO on angiography between January 2002 and December 2007 in a single tertiary centre were identified using a dedicated database. Those undergoing CTO PCI and elective medical therapy to the CTO were propensity matched to adjust for baseline clinical and angiographic differences. In total, 1957 patients were identified, a CTO was treated by PCI in 405 (20.7%) and medical therapy in 667 (34.1%), 885 (45.2%) patients underwent coronary artery bypass graft surgery. Of those treated by PCI or medical therapy, propensity score matching identified 294 pairs of patients, PCI was successful in 177 patients (60.2%). All-cause mortality at 5 years was 11.6% for CTO PCI and 16.7% for medical therapy HR 0.63 (0.40 to 1.00, p=0.052). The composite of 5-year death or myocardial infarction occurred in 13.9% of the CTO PCI group and 19.6% in the medical therapy group, HR 0.64 (0.42 to 0.99, p=0.043). Among the CTO PCI group, if the CTO was revascularised by any means during the study period, 5-year mortality was 10.6% compared with 18.3% in those not revascularised in the medical therapy group, HR 0.50 (0.28-0.88, p=0.016). Revascularisation, but not necessarily PCI of a CTO, is associated with improved long-term survival relative to medical therapy alone. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Iatrogenic injuries of the common femoral artery (CFA) and external iliac artery (EIA) during endograft placement: an underdiagnosed entity.

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Hingorani, Anil P; Ascher, Enrico; Marks, Natalie; Shiferson, Alexander; Patel, Nirav; Gopal, Kapil; Jacob, Theresa

2009-09-01

Early limb occlusions following endovascular treatment of aorto-iliac aneurysmal disease is not uncommon (4%-13%). To assess whether the femoral artery entry site could potentially cause this complication, we prospectively evaluated the ipsilateral common femoral artery (CFA) and distal external iliac artery (EIA) with intraoperative duplex scans (IDS). There were 134 patients with infrarenal nonruptured abdominal aorto-iliac aneurysms treated with endografts since 2002 at our institution. Age ranged from 65 to 89 years (mean: 77 +/- 7 years). Aneuryx (n = 41), Zenith (n = 50), and Excluder (n = 43) endografts were used for repair. All procedures were performed via open exposure of the CFA. Introducer diameter varied from 12 mm to 22 mm. All patients underwent IDS of the CFA and distal EIA after repair of the arteriotomies. In 34 patients (25%), we documented intimal dissections causing severe (>70%) stenoses. Of the 271 arteries that were examined, 38 (14%) had abnormal findings that demanded intervention. These were repaired with flap excision, tacking sutures revision, or patch angioplasty (n = 36). Repeat IDS confirmed the adequacy of the repair. No statistical difference was noted if the site of larger introducer sheath and the incidence of flap formation. In addition, 10 small flaps or plaques were visualized but did not create significant stenosis. No differences were noted in the incidence of positive duplex exams between each type graft (P = .4). No early or late iliac limb occlusions were noted. Follow-up of 94% was obtained. Completion arterial duplex scans are helpful in detecting a substantial number of clinically unsuspected technical defects caused by introducer sheaths. Timely diagnosis and repair of these defects may decrease the incidence of early limb occlusion following endograft placement.

Estimation of Absorbed Dose in Occlusal Radiography

International Nuclear Information System (INIS)

Yoo, Young Ah; Choi, Karp Shick; Lee, Sang Han

1990-01-01

The purpose of this study was to estimate absorbed dose of each important anatomic site of phantom (RT-210 Head and Neck Section R, Humanoid Systems Co., U.S.A.) head in occlusal radiography. X-radiation dosimetry at 12 anatomic sites in maxillary anterior topography, maxillary posterior topography, mandibular anterior cross-section, mandibular posterior cross-section, mandibular anterior topographic, mandibular posterior topographic occlusal projection was performed with calcium sulfate thermoluminescent dosimeters under 70 Kvp and 15 mA, 1/4 second (8 inch cone ) and 1 second (16 inch cone) exposure time. The results obtained were as follows: Skin surface produced highest absorbed dose ranged between 3264 mrad and 4073 mrad but there was little difference between projections. In maxillary anterior topographic occlusal radiography, eyeballs, maxillary sinuses, and pituitary gland sites produced higher absorbed doses than those of other sites. In maxillary posterior topographic occlusal radiography, exposed eyeball site and exposed maxillary sinus site produced high absorbed doses. In mandibular anterior cross-sectional occlusal radiography, all sites were produced relatively low absorbed dose except eyeball sites. In Mandibular posterior cross-sectional occlusal radiography, exposed eyeball site and exposed maxillary sinus site were produced relatively higher absorbed doses than other sites. In mandibular anterior topographic occlusal radiography, maxillary sinuses, submandibular glands, and thyroid gland sites produced high absorbed doses than other sites. In mandibular posterior topographic occlusal radiography, submandibular gland site of the exposed side produced high absorbed dose than other sites and eyeball site of the opposite side produced relatively high absorbed dose.

Combined surface and volumetric occlusion shading

KAUST Repository

Schott, Matthias O.; Martin, Tobias; Grosset, A. V Pascal; Brownlee, Carson; Hollt, Thomas; Brown, Benjamin P.; Smith, Sean T.; Hansen, Charles D.

2012-01-01

In this paper, a method for interactive direct volume rendering is proposed that computes ambient occlusion effects for visualizations that combine both volumetric and geometric primitives, specifically tube shaped geometric objects representing streamlines, magnetic field lines or DTI fiber tracts. The proposed algorithm extends the recently proposed Directional Occlusion Shading model to allow the rendering of those geometric shapes in combination with a context providing 3D volume, considering mutual occlusion between structures represented by a volume or geometry. © 2012 IEEE.

Combined surface and volumetric occlusion shading

KAUST Repository

Schott, Matthias O.

2012-02-01

In this paper, a method for interactive direct volume rendering is proposed that computes ambient occlusion effects for visualizations that combine both volumetric and geometric primitives, specifically tube shaped geometric objects representing streamlines, magnetic field lines or DTI fiber tracts. The proposed algorithm extends the recently proposed Directional Occlusion Shading model to allow the rendering of those geometric shapes in combination with a context providing 3D volume, considering mutual occlusion between structures represented by a volume or geometry. © 2012 IEEE.

Avanços nos materiais e no tratamento endovascular de oclusões arteriais crônicas totais: um relato de caso Advances in materials and endovascular treatment of chronic total arterial occlusions: a case report

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Daniel Queiroz Neves

2012-09-01

Full Text Available As oclusões arteriais crônicas totais com forte componente cálcico são ainda nos dias atuais, um fator muitas vezes limitante para o tratamento endovascular devido à dificuldade em transpor estas lesões com fios-guia e cateteres habitualmente utilizados. Revisamos a literatura e descrevemos um caso de tratamento endovascular de uma oclusão total de artéria ilíaca externa, onde o uso de novos materiais desenvolvidos especificamente para o tratamento deste tipo de lesão foi determinante para o sucesso do caso.Chronic arterial occlusions with great calcium component are usually a factor of limitation to endovascular treatment to the difficulty to transpose these lesions with guidewires and catheters commonly used. We reviewed the literature and described a case of endovascular treatment of a total occlusion of external iliac artery, where the use of new materials developed specifically to the treatment of such injuries was critical to the success of the case.

Perfusion CT compared to H{sub 2}{sup 15}O/O{sup 15}O PET in patients with chronic cervical carotid artery occlusion

Energy Technology Data Exchange (ETDEWEB)

Kamath, Amita; Chien, Jeffrey D.; Dillon, William P.; Wintermark, Max [University of California, San Francisco, Department of Radiology, Neuroradiology Section, San Francisco, CA (United States); Smith, Wade S. [University of California, Department of Neurology, San Francisco, CA (United States); Powers, William J. [University of North Carolina, Department of Neurology, Chapel Hill, NC (United States); Cianfoni, Alessandro [Catholic University of Sacred Heart, Department of Bioimages and Radiological Sciences, Rome (Italy); Videen, Tom [Washington University School of Medicine, Departments of Neurology and Radiology, St. Louis, MO (United States); Lawton, Michael T. [University of California, San Francisco, CA (United States). Department of Neurosurgery; Finley, Bruce [Northern California PET Imaging Center, Sacramento, CA (United States)

2008-09-15

The purpose of this study was to compare the results of perfusion computed tomography (PCT) with those of {sup 15}O{sub 2}/H{sub 2}{sup 15}O positron emission tomography (PET) in a subset of Carotid Occlusion Surgery Study (COSS) patients. Six patients enrolled in the COSS underwent a standard-of-care PCT in addition to the {sup 15}O{sub 2}/H{sub 2}{sup 15}O PET study used for selection for extracranial-intracranial bypass surgery. PCT and PET studies were coregistered and then processed separately by different radiologists. Relative measurement of cerebral blood flow (CBF) and oxygen extraction fraction (OEF) were calculated from PET. PCT datasets were processed using different arterial input functions (AIF). Relative PCT and PET CBF values from matching regions of interest were compared using linear regression model to determine the most appropriate arterial input function for PCT. Also, PCT measurements using the most accurate AIF were evaluated for linear regression with respect to relative PET OEF values. The most accurate PCT relative CBF maps with respect to the gold standard PET CBF were obtained when CBF values for each arterial territory are calculated using a dedicated AIF for each territory (R{sup 2}=0.796, p<0.001). PCT mean transit time (MTT) is the parameter that showed the best correlation with the count-based PET OEF ratios (R{sup 2}=0.590, p<0.001). PCT relative CBF compares favorably to PET relative CBF in patients with chronic carotid occlusion when processed using a dedicated AIF for each territory. The PCT MTT parameter correlated best with PET relative OEF. (orig.)

Biomechanics of occlusion--implications for oral rehabilitation.

Science.gov (United States)

Peck, C C

2016-03-01

The dental occlusion is an important aspect of clinical dentistry; there are diverse functional demands ranging from highly precise tooth contacts to large crushing forces. Further, there are dogmatic, passionate and often diverging views on the relationship between the dental occlusion and various diseases and disorders including temporomandibular disorders, non-carious cervical lesions and tooth movement. This study provides an overview of the biomechanics of the masticatory system in the context of the dental occlusion's role in function. It explores the adaptation and precision of dental occlusion, its role in bite force, jaw movement, masticatory performance and its influence on the oro-facial musculoskeletal system. Biomechanics helps us better understand the structure and function of biological systems and consequently an understanding of the forces on, and displacements of, the dental occlusion. Biomechanics provides insight into the relationships between the dentition, jaws, temporomandibular joints, and muscles. Direct measurements of tooth contacts and forces are difficult, and biomechanical models have been developed to better understand the relationship between the occlusion and function. Importantly, biomechanical research will provide knowledge to help correct clinical misperceptions and inform better patient care. The masticatory system demonstrates a remarkable ability to adapt to a changing biomechanical environment and changes to the dental occlusion or other components of the musculoskeletal system tend to be well tolerated. © 2015 John Wiley & Sons Ltd.

Dental occlusion and temporomandibular disorders.

Science.gov (United States)

Stone, J Caitlin; Hannah, Andrew; Nagar, Nathan

2017-10-27

Data sourcesMedline, Scopus and Google Scholar.Study selectionTwo reviewers selected studies independently. English language clinical studies assessing the association between temporomandibular disorders (TMD) and features of dental occlusion were considered.Data extraction and synthesisStudy quality was assessed based on the Newcastle-Ottawa Scale (NOS) and a narrative synthesis was presented.ResultsIn all 25 studies (17 case-control, eight comparative) were included. Overall there was a high variability between occlusal features and TMD diagnosis. Findings were consistent with a lack of clinically relevant association between TMD and dental occlusion. Only two studies were associated with TMD in the majority (≥50%) of single variable analyses in patient populations. Only mediotrusive interferences are associated with TMD in the majority of multiple variable analyses.ConclusionsThe findings support the absence of a disease-specific association, there is no ground to hypothesise a major role for dental occlusion in the pathophysiology of TMDs. Dental clinicians are thus encouraged to move forward and abandon the old-fashioned gnathological paradig.

Diagnóstico diferencial de trombose aortoilíaca e mieloencefalite protozoária equina: relato de caso Differential diagnosis between aorto-iliac thrombosis and equine protozoal myeloencephalitis: case report

Directory of Open Access Journals (Sweden)

P.B. Escodro

2010-10-01

Full Text Available Relata-se o caso de uma égua de atividade de polo, que apresentou inicialmente claudicação leve no membro posterior esquerdo, a qual evoluiu para ataxia e atrofia da musculatura glútea do lado esquerdo, com diagnóstico de trombose aortoilíaca (TAI. A paciente foi tratada com suspeita de mieloencefalite protozoária equina, devido à semelhança dos sinais clínicos com essa doença, porém o líquido cefalorraquidiano apresentou-se negativo para anticorpos anti-Sarcocystis neurona. A palpação transretal indicou uma massa na bifurcação aortoilíaca esquerda. Na avaliação ultrassonográfica, visualizou-se imagem hiperecoica aderida ao endotélio vascular, sugerindo TAI atingindo a estenose de 70% da luz arterial.The case of a mare used for polo is reported. The animal showed clinical signs of soft lameness of the hindlimb, evolving to ataxia and gluteal muscle atrophy, with aorto-iliac thrombosis (AIT. The patient was treated with the suspect of equine protozoal myeloencephalitis (EPM, due to the resemblance of clinical signs. Cerebrospinal fluid analysis was negative for antibodies against Sarcocystis neurona. The transrectal examination indicated a mass in the left aorto-iliac bifurcation. In the ultrasonographic evaluation, a hyperechoic image adhered to the vascular endothelium was observed, suggesting (AIT, occupying 70% of arterial lumen. The present article has the objective of pointing out the importance of the differential diagnosis between AIT and EPM in horses with ataxia in hindlimbs and muscular atrophy.

Sequential change of hemodynamic reserve in patients with major cerebral artery occlusion of severe stenosis

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Hasegawa, Y.; Yamaguchi, T.; Tsuchiya, T. (National Cardiovascular Center, Osaka (Japan). Cerebrovascular Div.); Minematsu, K. (National Cardiovascular Center, Osaka (Japan). Research Inst.); Nishimura, T. (National Cardiovascular Inst., Osaka (Japan). Dept. of Diagnostic Radiology)

1992-02-01

To identify regional vasodilatory capacity and its sequential change, we evaluated prospectively a total of 78 acetazolamide tests in 51 patients with occlusion or greater than 75% stenosis of the carotid or middle cerebral arteries. The relative distribution of cerebral blood flow was determined by single photon emission computed tomography using N-isopropyl-p-({sup 123}I)-iodoamphetamine before and after intravenous injection of acetazolamide. Reduced vasodilatory capacity was demonstrated in 20 patients (38%), including 5 patients with hemodynamic transient ischemic attacks or infarction. Follow-up acetazolamide tests revealed asymptomatic progression of the arterial lesion (from stenosis to occlusion) in 1 patient and almost complete improvement of vasodilatory capacity in 5 patients, including 3 without surgical intervention. During an average follow-up period of 18.5 months, 4 patients died from cardiac causes or neoplasm; no neurovascular events occurred. Much larger numbers of patients with longer observation periods will be necessary to clarify the contribution of chronic hemodynamic failure to subsequent stroke. However, the present data indicate that the acetazolamide test is useful for assessing the course of high grade stenosis or occlusion of major cerebral arteries. (orig.).

Outcome of Diabetic and Non-Diabetic Patients Undergoing Successful Percutaneous Coronary Intervention of Chronic Total Occlusion

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Bahram Sohrabi

2011-05-01

Full Text Available Introduction: Diabetes mellitus is associated with an increased risk of adverse clinical outcomes after percutaneous coronary intervention (PCI. The prognosis of patients with diabetes mellitus and chronic total occlusion (CTO treated with PCI is poorly investigated. Current study evaluates outcome of successful PCI on CTO in patients with and without diabetes. Methods: One hundred and sixty three patients treated with successful PCI on CTO between January 2009 and March 2011 were prospectively identified from the PCI registry at the Madani Heart Center, Tabriz, Iran. Patients were followed for 15±3 months, were evaluated for the occurrence of major adverse cardiac events (MACE comprising death, acute myocardial infarction, and need for repeat revascularization.Results: No differences were found in baseline clinical and procedural variables between patients with (n=34 and without diabetes (n=129, unless for hypertension (p=0.03. Hospitalization period after PCI in diabetics (3.26±0.61 days and non-diabetics (2.86±0.52 days was similar. In-hospital MACE occurred in 8 (23.5% individuals of diabetics and 10 (7.8% individuals of non-diabetics (p=0.02, among them revascularization was significantly higher in diabetics (20.6% vs. 7%, p=0.04. Follow-up events in diabetic and non-diabetic groups were 12 (35.3% and 37 (28.5%, respectively (p was not significant. Conclusion: In patients undergoing successful PCI on CTO, diabetes is associated with higher in-hospital adverse events; however diabetes does not affect long term outcomes in these patients.

Impact on adenosine stress cardiac magnetic resonance for recanalisation and follow up of chronic total coronary occlusions

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Heyne, J.P. [Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Jens-Peter.Heyne@med.uni-jena.de; Goernig, M. [Clinic for Internal Medicine I, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Matthias.Goernig@med.uni-jena.de; Feger, J. [Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Joachim.Feger@email.de; Kurrat, C. [Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Claudia.Kurrat@med.uni-jena.de; Werner, G.S. [Clinic for Internal Medicine I, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Gerald.Werner@Klinikum-Darmstadt.de; Figulla, H.R. [Clinic for Internal Medicine I, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Hans.Figulla@med.uni-jena.de; Kaiser, W.A. [Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Werner.Kaiser@med.uni-jena.de

2007-09-15

Objective: To evaluate the impact on cardiac magnetic resonance imaging (CMRI) with adenosine stress and delayed enhancement for indication and follow up after interventional recanalisation of chronic total coronary occlusions (CTOs). Material and methods: Twenty consecutive patients (15 males; 5 females; mean age 65 years) with CTO verified by cardiac catheterisation referred to CMRI. Sixteen of them got CMRI before and after coronary recanalisation. Wall motion abnormalities (WMAs), first pass perfusion with adenosine and viability were assessed using a 1.5 T MR scanner (Sonata; Siemens). CMRI results were compared with clinical classifications, the results of cardiac catheterisation and follow up angiography. Results: Sixteen patients had a successful recanalisation, 15 of the occluded coronary artery and one of collateral donor artery stenosis. After recanalisation all stress-induced progressive or new wall motion abnormalities (WMAs) of the corresponding segments and in the collateral donor territory (5 patients) and all adenosine induced perfusion defects (PD) or delay (12 patients) were regredient. 13/16 patients showed no transmural and one patient transmural delayed enhancement (DE) indicating myocardial scar. In 10/16 patients CSS grading of angina improved after recanalisation. Conclusion: After successful recanalisation of CTOs, patients with preinterventional stress-induced PDs and WMAs in viable myocardium did not display any signs of stress-induced ischemia postinterventionally. A comprehensive CMRI approach, including assessment of rest and stress WMAs, first pass perfusion and myocardial viability represents an important tool for the pre-interventional decision to recanalise CTOs and follow up.

Occlusion classifiers for picture rate conversion

NARCIS (Netherlands)

Bartels, C.L.L.; Haan, de G.; Rabbani, Majid

2009-01-01

Occlusion detection is an essential ingredient in high quality picture rate up-conversion and view interpolation applications. Many integrated approaches to occlusion detection and classification have been proposed, particularly in the stereo literature. However, due to their high complexity and

The role of "rescue saccades" in tracking objects through occlusions.

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Zelinsky, Gregory J; Todor, Andrei

2010-12-29

We hypothesize that our ability to track objects through occlusions is mediated by timely assistance from gaze in the form of "rescue saccades"-eye movements to tracked objects that are in danger of being lost due to impending occlusion. Observers tracked 2-4 target sharks (out of 9) for 20 s as they swam through a rendered 3D underwater scene. Targets were either allowed to enter into occlusions (occlusion trials) or not (no occlusion trials). Tracking accuracy with 2-3 targets was ≥ 92% regardless of target occlusion but dropped to 74% on occlusion trials with four targets (no occlusion trials remained accurate; 83%). This pattern was mirrored in the frequency of rescue saccades. Rescue saccades accompanied approximatlely 50% of the Track 2-3 target occlusions, but only 34% of the Track 4 occlusions. Their frequency also decreased with increasing distance between a target and the nearest other object, suggesting that it is the potential for target confusion that summons a rescue saccade, not occlusion itself. These findings provide evidence for a tracking system that monitors for events that might cause track loss (e.g., occlusions) and requests help from the oculomotor system to resolve these momentary crises. As the number of crises increase with the number of targets, some requests for help go unsatisfied, resulting in degraded tracking.

Clinical Aspects of Combination of Ceramic and Acrylic Occlusal Surfaces

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Z. Ozhohan

2017-03-01

Full Text Available The objective of the research was to develop and substantiate the methods of constructing the occlusal surfaces when manufacturing aesthetic fixed restorations through the combination of different materials. Materials and methods. The study included 65 patients with ceramic and acrylic occlusal surfaces of aesthetic fixed dental prostheses. Group I included 21 patients with a combination of ceramic and acrylic occlusal surfaces. Group II included 22 patients with a combination of ceramic occlusal surfaces. Group III included 22 patients with a combination of acrylic occlusal surfaces. The patients were observed 3, 6 and 12 months after prosthetic repair. Results. The greatest increase in the occlusal contact surface area of fixed restorations was observed in Group I, that is, when combining dental prostheses with ceramic and acrylic occlusal surfaces. Considering uneven abrasion of the occlusal surfaces, we do not recommend to combine different materials when veneering the occlusal surface of the antagonistic teeth. Conclusions. This study demonstrated the important role of the correct combination of materials when veneering the occlusal surfaces. Physical and chemical properties of materials, namely the abrasion resistance play a significant role in the long-term denture functioning. The smallest increase in the occlusal contact surface area was observed in Group II when combining ceramic occlusal surfaces. It was due to a good abrasion resistance of ceramics as compared to acrylic resin as well as the presence of the glazed layer which prevents the premature abrasion of the occlusal surfaces of the antagonistic teeth due to lower surface roughness. The combination of acrylic resin and ceramics when constructing the occlusal surfaces of fixed restorations in Group I demonstrated the highest rate of the increase in the occlusal contact surface area – 9.93%. It was due to a low hardness of acrylic resin and its high surface roughness. In

The prevalence of questionable occlusal caries

DEFF Research Database (Denmark)

Makhija, Sonia K; Gilbert, Gregg H; Funkhouser, Ellen

2012-01-01

Questionable occlusal caries (QOC) can be defined as clinically suspected caries with no cavitation or radiographic evidence of occlusal caries. To the authors' knowledge, no one has quantified the prevalence of QOC, so this quantification was the authors' objective in conducting this study...

Computed tomography in basilar artery occlusion in childhood

International Nuclear Information System (INIS)

Mori, Koreaki; Miwa, Soichi; Handa, Hajime

1978-01-01

A case of basilar artery occlusion in a 13-year-old boy is presented. Eighteen other cases of such occlusion in childhood in the relevant literature were analyzed, and then all nineteen cases were compared to adult cases. In comparison with adult cases, the following points were clear: (1) In children as well as in adults, basilar artery occlusion is more common in males. (2) As is well known, arteriosclerosis is the commonest cause in adults. In children, however, idiopathic and/or congenital occlusion are more common causes. (3) The main clinical manifestations in childhood as well as in maturity are consciousness disturbance, hemiplegia or quadriplegia, and pupillary abnormalities. (4) An occlusion of the proximal third of the basilar artery is common in adults, whereas an occlusion of the middle third is common in childhood. (5) Diagnosis is based on clinical manifestations, cerebral angiography, and computed tomography. (6) In contrast to the poor prognosis in adults, the prognosis is fairly in children. (author)

Influence of the fast-processing technique on the number of the occlusal contacts and occlusal vertical dimension of complete dentures.

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Atashrazm, Parsa; Alavijeh, Leila Zamani; Afshar, Maryam Sadat Sadrzadeh

2011-03-01

Occlusal errors during acryl processing affect the retention and stability of complete dentures. The aim of the present study was to assess the influence of a short curing technique on the number of occlusal contacts and the occlusal vertical dimension (OVD) of complete dentures. Complete dentures were prepared. The number of occlusal contacts was recorded in centric relation (CR) using 60 µ articulation paper. The OVD was recorded with the waxed trial denture in place. Dentures were then invested and processed with compression molding and short cure water bath technique. The number of occlusal contacts was recorded again. The amount of pin opening was measured for all of the complete dentures on the articulator. Data were analyzed with paired t-test to determine the alterations. The mean number of occlusal contacts before and after processing was 10.9 ± 2.4 and 6.3 ± 3.1 respectively (4.7 ± 1.9 decrease; p negative effect on the morphologic pattern of artificial teeth of complete dentures and thus should be used carefully.

A study on occlusal stability in shortened dental arches.

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Sarita, Paulo T N; Kreulen, Cees M; Witter, Dick J; van't Hof, Martin; Creugers, Nico H J

2003-01-01

The aim of this study was to verify the hypothesis that shortened dental arches constitute a risk to occlusal stability. Using cluster samples, 725 subjects with shortened dental arches comprising intact anterior regions and zero to eight occluding pairs of posterior teeth and 125 subjects with complete dental arches were selected. Subjects with shortened dental arches were classified into eight categories according to arch length and symmetry. Parameters for occlusal stability were interdental spacing, occlusal tooth wear, occlusal contact of incisors in intercuspal position, and vertical and horizontal overlap. Additionally, tooth mobility and overeruption of unopposed teeth were assessed. Influence of independent variables (dental arch category, age, gender, and residence) on the parameters for occlusal stability was assessed by one-way ANOVA and Tukey's multiple range tests. Extreme shortened dental arches (zero to two pairs of occluding premolars) had significantly more interdental spacing, occlusal contact of incisors, and vertical overlap compared to complete dental arches. Occlusal wear and prevalence of mobile teeth were highest in these categories. The category with three to four occluding premolars had significantly more interdental spacing and, for the older age group, more anterior teeth in occlusal contact compared to complete dental arches. Age was consistently associated with increased changes in occlusal integrity. Signs of increased risk to occlusal stability seemed to occur in extreme shortened dental arches, whereas no such evidence was found for intermediate categories of shortened dental arches.

Cerebral blood flow and CO2 reactivity in transient ischemic attacks: comparison between TIAs due to the ICA occlusion and ICA mild stenosis

International Nuclear Information System (INIS)

Tsuda, Y.; Kimura, K.; Yoneda, S.; Etani, H.; Asai, T.; Nakamura, M.; Abe, H.

1983-01-01

Hemispheric mean cerebral blood flow (CBF), together with its CO2 reactivity in response to hyperventilation, was investigated in 18 patients with transient ischemic attacks (TIAs) by intraarterial 133Xe injection method in a subacute-chronic stage of the clinical course. In 8 patients, the lesion responsible for symptoms was regarded as unilateral internal carotid artery (ICA) occlusion, and in 10 patients, it was regarded as unilateral ICA mild stenosis (less than 50% stenosis in diameter). Resting flow values were significantly decreased in the affected hemisphere of TIA due to the ICA occlusion as compared with the unaffected hemisphere of the same patient, regarded as the relative control. It was not decreased in the affected hemisphere of TIA due to the ICA mild stenosis as compared with the control. With respect to the responsiveness of CBF to changes in PaCO2, it was preserved in both TIAs, due to the ICA occlusion and ICA mild stenosis. Vasoparalysis was not observed in either types of TIAs in the subacute-chronic stage. However, in the relationship of blood pressure and CO2 reactivity, expressed as delta CBF(%)/delta PaCO2, pressure-dependent CO2 reactivity as a group was observed with significance in 8 cases of TIA due to the ICA occlusion, while no such relationship was noted in 10 cases of TIA due to the ICA mild stenosis. Moreover, clinical features were different between TIAs due to the ICA occlusion and ICA mild stenosis, i.e., more typical, repeatable TIA (6.3 +/- 3.7 times) with shorter duration (less than 30 minutes) was observed in TIAs due to the ICA mild stenosis, while more prolonged, less repeatable TIA (2.4 +/- 1.4 times) was observed in TIAs due to fixed obstruction of the ICA. From these observations, two different possible mechanisms as to the pathogenesis of TIA might be expected

Occlusion Issues in Early Renaissance Art

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Barbara Gillam

2011-12-01

Full Text Available Early Renaissance painters innovatively attempted to depict realistic three-dimensional scenes. A major problem was to produce the impression of overlap for surfaces that occlude one another in the scene but are adjoined in the picture plane. Much has been written about perspective in art but little about occlusion. Here I examine some of the strategies for depicting occlusion used by early Renaissance painters in relation to ecological considerations and perceptual research. Perceived surface overlap is often achieved by implementing the principle that an occluding surface occludes anything behind it, so that occlusion perception is enhanced by a lack of relationship of occluding contour to occluded contours. Some well-known figure-ground principles are also commonly used to stratify adjoined figures. Global factors that assist this stratification include the placement of figures on a ground plane, a high viewpoint, and figure grouping. Artists of this period seem to have differed on whether to occlude faces and heads, often carefully avoiding doing so. Halos were either eliminated selectively or placed oddly to avoid such occlusions. Finally, I argue that the marked intransitivity in occlusion by architecture in the paintings of Duccio can be related to the issue of perceptual versus cognitive influences on the visual impact of paintings.

Central Venous Occlusion in the Hemodialysis Patient.

Science.gov (United States)

Krishna, Vinay Narasimha; Eason, Joseph B; Allon, Michael

2016-11-01

Central venous stenosis (CVS) is encountered frequently among hemodialysis patients. Prior ipsilateral central venous catheterization and cardiac rhythm device insertions are common risk factors, but CVS can also occur in the absence of this history. Chronic CVS can cause thrombosis with partial or complete occlusion of the central vein at the site of stenosis. CVS is frequently asymptomatic and identified as an incidental finding during imaging studies. Symptomatic CVS presents most commonly as an upper- or lower-extremity edema ipsilateral to the CVS. Previously unsuspected CVS may become symptomatic after placement of an ipsilateral vascular access. The likelihood of symptomatic CVS may be affected by the central venous catheter (CVC) location; CVC side; duration of CVC dependence; type, location, and blood flow of the ipsilateral access; and extent of collateral veins. Venous angiography is the gold standard for diagnosis. Percutaneous transluminal angioplasty and stent placement can improve the stenosis and alleviate symptoms, but CVS typically recurs frequently, requiring repeated interventions. Refractory symptomatic CVS may require ligation of the ipsilateral vascular access. Because no available treatment option is curative, the goal should be to prevent CVS by minimizing catheters and central vein instrumentation in patients with chronic kidney disease and dialysis patients. Copyright © 2016 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

Modeling self-occlusions in dynamic shape and appearance tracking

KAUST Repository

Yang, Yanchao

2013-12-01

We present a method to track the precise shape of a dynamic object in video. Joint dynamic shape and appearance models, in which a template of the object is propagated to match the object shape and radiance in the next frame, are advantageous over methods employing global image statistics in cases of complex object radiance and cluttered background. In cases of complex 3D object motion and relative viewpoint change, self-occlusions and disocclusions of the object are prominent, and current methods employing joint shape and appearance models are unable to accurately adapt to new shape and appearance information, leading to inaccurate shape detection. In this work, we model self-occlusions and dis-occlusions in a joint shape and appearance tracking framework. Experiments on video exhibiting occlusion/dis-occlusion, complex radiance and background show that occlusion/dis-occlusion modeling leads to superior shape accuracy compared to recent methods employing joint shape/appearance models or employing global statistics. © 2013 IEEE.

Influence of denture adhesives on occlusion and disocclusion times.

Science.gov (United States)

Abdelnabi, Mohamed Hussein; Swelem, Amal Ali; Al-Dharrab, Ayman A

2016-03-01

The effectiveness of adhesives in enhancing several functional aspects of complete denture performance has been well established. The direct influence of adhesives on occlusal contact simultaneity has not yet been investigated. The purpose of this crossover clinical trial was to evaluate quantitatively the influence of adhesives on occlusal balance by recording timed occlusal contacts; namely occlusion time (OT) and disocclusion time during right (DT-right) and left (DT-left) excursions by using computerized occlusal analysis. A crossover clinical trial was adopted. Assessments were carried out while participants (n=49) wore their dentures first without then with adhesives. Computerized occlusal analysis using the T-Scan III system was conducted to perform baseline computer-guided occlusal adjustment for conventionally fabricated dentures. Retention and stability assessment using the modified Kapur index and recording of OT and DT-right and DT-left values using the T-Scan III were subsequently carried out for all dentures, first without adhesives and then after application of adhesive. All T-Scan procedures were carried out by the same clinician. Wilcoxon signed-rank test was used to analyze the Kapur index scores and occlusal parameters (α=.05). Stability and retention of conventional dentures ranged initially from good to very good. However, adhesive application resulted in significant improvement (PAdhesives significantly decreased OT and DT durations in initially well-fitting complete dentures with fairly well balanced occlusion, and further enhanced denture stability and occlusal contact simultaneity. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Predictors of early stent occlusion among plastic biliary stents.

Science.gov (United States)

Khashab, Mouen A; Kim, Katherine; Hutfless, Susan; Lennon, Anne Marie; Kalloo, Anthony N; Singh, Vikesh K

2012-09-01

A major disadvantage of plastic biliary stents is their short patency rates. The aim of this study was to identify predictors of early stent occlusion among patients receiving conventional plastic biliary stents. Early stent occlusion was defined as worsening cholestatic liver test results of a severity sufficiently significant to warrant ERCP with stent exchange prior to the planned stent exchange, or as symptoms of cholangitis. The association of cumulative stent diameter, demographics, stricture location, procedure indication, Charlson comorbidity index, history of prior early stent occlusion, presence of gallbladder, and performance of sphincteromy with the occurrence of early stent occlusion was studied using logistic regression and multivariate analysis. Our patient cohort comprised 343 patients (mean age 59.3 years) who underwent 561 ERCP procedures with the placement of one or more plastic biliary stents (mean number of stents per procedure 1.2, mean total diameter of stents per procedure 12 Fr). Early stent occlusion occurred in 73 (13 %) procedures. Female gender was protective against early stent occlusion (adjusted OR 0.54, 95 % CI 0.32-0.90, p = 0.02), while hilar stricture location was independently associated with a significantly increased risk of early stent occlusion (adjusted OR 3.41, 95 % CI 1.68-6.90, p = 0.0007). Early occlusion of conventional biliary stents occurred in 13 % of cases. While female gender decreased the risk of early stent occlusion, hilar stricture location was a significant predictor of early stent occlusion. Our results suggest that physicians should consider early elective stent exchange in patients with hilar strictures.

Chronic thromboembolic pulmonary hypertension: diagnostic impact of multislice-CT and selective pulmonary-DSA

International Nuclear Information System (INIS)

Pitton, M.B.; Kemmerich, G.; Herber, S.; Schweden, F.; Thelen, M.; Mayer, E.

2002-01-01

Purpose: To evaluate the diagnostic impact of multislice-CT and selective pulmonary DSA in chronic thromboembolic pulmonary hypertension (CTEPH). Methods: 994 vessel segments of 14 consecutive patients with CTEPH were investigated with multislice-CT (slice thickness 3 mm, collimation 2.5 mm, reconstruction intervall 2 mm) and selective pulmonary DSA posterior-anterior, 45 oblique, and lateral projection. Analysis was performed by 2 investigators independently for CT and DSA. Diagnostic criteria were occlusions and non-occlusive changes like webs and bands, irregularities of the vessel wall, diameter reduction and thromboembolic depositions at different levels from central pulmonary arteries to subsegmental arteries. Reference diagnosis was made by synopsis of CT and DSA by consensus. Results: Concerning patency CT and DSA showed concordant findings overall in 88.9%, 92.9% for segmental arteries and 85.4% for subsegmental arteries. Concerning any thromboembolic changes, multislice-CT was significantly inferior to selective DSA (concordance 67.0% overall, 70.4% for segments and 63.6% for subsegments). Non-occlusive changes of the vessels were significantly underdiagnosed by CT (concordance of CT versus DSA: 23.1%). Conclusion: Multislice-CT and selective pulmonary DSA are equivalent for diagnosis of vessel occlusions at the level of segmental and subsegmental arteries. However, for visualisation of the non-occlusive thromboembolic changes of the vessel wall selective pulmonary DSA is still superior compared to multislice-CT. Multislice-CT and selective pulmonary DSA are complementary tools for diagnosis and treatment planning of chronic thromboembolic pulmonary hypertension (CTEPH). (orig.) [de

[Case report of occlusal treatment with full mouth reconstruction].

Science.gov (United States)

Oizumi, Makoto

2008-07-01

A 70-year-old woman presented with a complaint of masticatory pain and disturbance. She had collapse of occlusal support and vertical dimension decrease. This case used provisional restoration for increasing vertical dimension and reconstruction of anterior guidance. After confirming occlusal stability, she was treated with fixed prosthesis and removable partial dentures. This patient was followed for 6 and a half years with no prosthetic complications, because the reconstruction of bilateral occlusal support and anterior guidance were performed. It is important to reconstruct the occlusal support and anterior guidance in cases of prosthetic treatment of occlusal collapse.

[Occlusal schemes of complete dentures--a review of the literature].

Science.gov (United States)

Tarazi, E; Ticotsky-Zadok, N

2007-01-01

Occlusal scheme is defined as the form and the arrangement of the occlusal contacts in natural and artificial dentition. The choice of an occlusal scheme will determine the pattern of occlusal contacts between opposing teeth during centric relation and functional movement of the mandible. With dentures, the quantity and the intensity of these contacts determine the amount and the direction of the forces that are transmitted through the bases of the denture to the residual ridges. That is why the occlusal scheme is an important factor in the design of complete dentures. Three occlusal schemes are viewed in this review: bilateral balanced occlusion, monplane occlusion, and linear occlusion scheme. Each scheme represents a different concept of occlusion. Comparisons between these schemes are also reviewed and analyzed. The reasoning underlying the bilateral balanced occlusion scheme is that stability of the dentures is attained when bilateral contacts exist throughout all dynamic and static states of the denture during function. Anatomic teeth are used: the upper anterior teeth are set to satisfy aesthetics, and the posterior teeth are arranged in a compensatory curve and a medial curve. This scheme is adequate for well developed residual ridges, with skeletal class I relation. With highly resorbed residual ridges, the vectors of force that are transmitted through anatomic cusps will dislodge the lower denture and thus impair the comfort and efficiency of mastication experienced by the patient. In order to accommodate to the special needs posed by highly resorbed residual ridges and skeletal relations that are not class I, the monoplane scheme of occlusion was designed. This scheme consists of non anatomic (cuspless) teeth, which are set so that the anterior teeth provide the aesthetics, the premolars and the first molars are used for chewing, and the second molars do not occlude (although sometimes they are specifically used to establish bilateral contacts in lateral

Occlusal stability in shortened dental arches.

NARCIS (Netherlands)

Witter, D.J.; Creugers, N.H.J.; Kreulen, C.M.; Haan, A. de

2001-01-01

Shortened dental arches consisting of anterior and premolar teeth have been shown to meet oral functional demands. However, the occlusal stability may be at risk as a result of tooth migration. The aim of this nine-year study was to investigate occlusal stability in shortened dental arches as a

Improved recovery of regional left ventricular function after PCI of chronic total occlusion in STEMI patients: a cardiovascular magnetic resonance study of the randomized controlled EXPLORE trial.

Science.gov (United States)

Elias, Joëlle; van Dongen, Ivo M; Hoebers, Loes P; Ouweneel, Dagmar M; Claessen, Bimmer E P M; Råmunddal, Truls; Laanmets, Peep; Eriksen, Erlend; van der Schaaf, René J; Ioanes, Dan; Nijveldt, Robin; Tijssen, Jan G; Hirsch, Alexander; Henriques, José P S

2017-07-19

The Evaluating Xience and left ventricular function in PCI on occlusiOns afteR STEMI (EXPLORE) trial did not show a significant benefit of percutaneous coronary intervention (PCI) of the concurrent chronic total occlusion (CTO) in ST-segment elevation myocardial infarction (STEMI) patients on global left ventricular (LV) systolic function. However a possible treatment effect will be most pronounced in the CTO territory. Therefore, we aimed to study the effect of CTO PCI compared to no-CTO PCI on the recovery of regional LV function, particularly in the CTO territory. Using cardiovascular magnetic resonance (CMR) we studied 180 of the 302 EXPLORE patients with serial CMR (baseline and 4 months follow-up). Segmental wall thickening (SWT) was quantified on cine images by an independent core laboratory. Dysfunctional segments were defined as SWT PCI compared to no-CTO PCI (ΔSWT 17 ± 27% vs 11 ± 23%, p = 0.03). This recovery was most pronounced in the dysfunctional but viable segments(TEI PCI compared with no-CTO PCI is associated with a greater recovery of regional systolic function in the CTO territory, especially in the dysfunctional but viable segments. Further research is needed to evaluate the use of CMR in selecting post-STEMI patients for CTO PCI and the effect of regional LV function recovery on clinical outcome. Trialregister.nl NTR1108 , Date registered NTR: 30-okt-2007.

Influence of the quality of the finished occlusion on postretention occlusal relapse.

Science.gov (United States)

de Freitas, Karina Maria Salvatore; Janson, Guilherme; de Freitas, Marcos Roberto; Pinzan, Arnaldo; Henriques, José Fernando Castanha; Pinzan-Vercelino, Célia Regina Maio

2007-10-01

In this study, we aimed to evaluate the influence of the quality of the finished occlusion on postretention occlusal stability. The sample comprised 87 patients with Class I malocclusion, treated with extraction of the 4 first premolars and edgewise mechanics; they were divided into 2 groups, according to the quality of their finished occlusions. Group 1 included 44 subjects (23 boys, 21 girls) with posttreatment peer assessment rating (PAR) scores from 0 to 5. The mean pretreatment age was 13.74 years (SD 2.14). The mean treatment time was 1.92 years (SD 0.57), the mean retention time was 1.75 years (SD 0.96), and the mean time of posttreatment evaluation was 5.17 years (SD 1.82). Group 2 included 43 subjects (22 boys, 21 girls) with posttreatment PAR scores greater than 5. The mean initial age was 13.34 years (SD 1.35). The mean treatment time was 2.20 years (SD 0.66), the mean retention time was 1.77 years (SD 0.78), and the mean posttreatment evaluation was 5.47 years (SD 1.60). The PAR and the Little irregularity indexes were measured on the dental casts at pretreatment, posttreatment, and postretention. Intergroup comparisons were made with independent t tests, and the Pearson correlation coefficient was applied to the PAR score for the whole sample at the times evaluated. Well-finished patients had lower posttreatment and postretention PAR scores and greater changes during the treatment and posttreatment periods than did the poorly finished patients. For the Little irregularity index, the only difference between the groups was at the posttreatment stage; group 1 had a smaller irregularity score than group 2. The correlation coefficients showed that the greater the treatment changes, the smaller the posttreatment PAR score and the greater the relapse. But the higher the posttreatment PAR score, the higher the postretention PAR score. It was concluded that the greater the quality of the orthodontic finished occlusion, the greater are the treatment changes and

Revascularization Techniques for Acute Basilar Artery Occlusion : Technical Considerations and Outcome in the Setting of Severe Posterior Circulation Steno-Occlusive Disease.

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Siebert, Eberhard; Bohner, Georg; Zweynert, Sarah; Maus, Volker; Mpotsaris, Anastasios; Liebig, Thomas; Kabbasch, Christoph

2018-04-12

To describe the clinical and radiological characteristics, frequency, technical aspects and outcome of endovascular treatment of acute basilar artery occlusion (ABO) in the setting of vertebrobasilar steno-occlusive disease. Retrospective analysis of databases of two universitary stroke centers including all consecutive patients from January 2013 until May 2017 undergoing thrombectomy for a) acute stroke due to basilar artery occlusion and either significant basilar artery stenosis or vertebral artery stenosis/occlusion as well as b) presumed embolic basilar artery occlusions. Demographics, stroke characteristics, time metrics, recanalization results and outcome were recorded. Interventional strategies were evaluated concerning the thrombectomy technique, additional angioplasty, type of approach with respect to lesion pattern (ipsilateral to steno-occlusive VA lesion: dirty road or contralateral: clean road) and sequence of actions. Out of 157 patients treated for ABO 38 (24.2%) had associated significant vertebrobasilar steno-occlusive lesions. An underlying significant basilar artery stenosis was present in 23.7% and additionally significant steno-occlusive vertebral lesions were present in 81.5%. Thrombectomy was performed with primary aspiration in 15.8% and with stent-retrievers in 84.2%. Successful revascularization (TICI 2b-3) was achieved in 86.8%. In 52.6% additional stent angioplasty was performed, in 7.9% balloon angioplasty only. The clean road approach was used in 22.5% of cases, the dirty road in 77.4%. Final modified Rankin scale (mRS) was 0-2 in 6 patients (15.8%) and 3-5 in 32 (84.2%). The in-hospital mortality was 36.8%. There were no statistically significant differences in outcome compared to presumed cases of embolisms. Endovascular treatment of ABO with underlying significant vertebrobasilar steno-occlusive lesions is effective and reasonably safe. Specific procedural strategies apply depending on individual patient pathology and anatomy

[Gnathosonics study of the occlusal stability of orthodontic patients].

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Jiang, Ruo-Ping; Tyson, Kenneth W

2008-02-18

To analysis the stability of the occlusion before and after the orthodontic treatment by gnathosonics; To evaluate the reliability of the stethoscope method by comparing the subjective(stethoscopy) and objective(digital occlusal sound recording) methods of checking the occlusal sound. Sixty-four new patients with malocclusion were selected as the before treatment group, these patients were not subject to any previous orthodontic treatment, facial surgery or injury; the treatment complete group included 15 patients who were just debonded the fixed appliance. Both stethoscope and digital occlusal sound recording were used to evaluate the occlusal sound. The occlusal stability before and after orthodontic treatment was compared depending on the results from the objective examination. The stability of the occlusion between different types of malocclusion before treatment was compared also. The veracity and reliability of the stethoscope method were analysis using the objective method as the golden standard. (1) 43.75%(28/64) of the 64 new patients showed unstable occlusal sound. ANOVA test showed that there were no statistically significant differences between the unstable rates in different type of malocclusion. (2) 40% (6/15) of the 15 treatment complete patients had unstable occlusions. (3) There were no statistically significant differences between the unstable rate pre- and post-treatment. (4) The veracity of the stethoscopes was 81.01% (64/79). (5) Kappa test showed that the stethoscopes and the digital recording method were consistent; the Kappa value was 0.488, Pocclusion rate between the two groups, and between the different types of malocclusion before treatment. (2) Using stethoscopes method to check the occlusal sound is reliable. The veracity could be improved significantly with increased experiences.

Investigation of redox status in chronic cerebral hypoperfusion-induced neurodegeneration in rats

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Anil Kumar Saxena

2015-06-01

Full Text Available Aging related reduction in cerebral blood flow (CBF has been linked with neurodegenerative disorders including Alzheimer's disease and dementia. Experimentally, a condition of chronic cerebral hypoperfusion due to reduced CBF can be induced by permanent bilateral occlusion of common carotid arteries (2-vessel occlusion, 2VO in rats. Since oxidative stress, leading to neuronal apoptosis and death, is one of the mechanisms, which is thought to play a significant role in chronic degenerative neurological disorders, the present study was planned to assess the ROS status by measuring the levels of anti-oxidant enzymes that might occur during chronic cerebral hypoperfusion. Antioxidant enzymes namely glutathione peroxidase (GPx, superoxide dismutase (SOD, and catalase were measured in the brain tissue at eight weeks of 2VO induction in rats. Results show significantly elevated levels of GPx, SOD, and catalase enzymes as compared with the control group. It is possible that compensatory rise in antioxidant enzymes occurs in response to increased oxidative stress following ischemic insult.

Concepts of occlusion in prosthodontics: A literature review, part I

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V Rangarajan

2015-01-01

Full Text Available Occlusion and its relationship to the function of the stomatognathic system have been widely studied in dentistry since many decades. This series of articles describe about occlusion in the complete denture, fixed partial denture, and implants. Part I and II of this articles series describe concepts and philosophies of occlusion in complete denture. So far, available research has not concluded a superior tooth form or occlusal scheme to satisfy the requirements of completely edentulous patients with respect to comfort, mastication, phonetics, and esthetics. Since then, several balanced and nonbalanced articulation concepts were proposed in the literature. A balanced articulation appears to be most appropriate because of tooth contacts observed during nonfunctional activities of patients. This article discusses about evolution of different concepts of occlusion and occlusal schemes in complete denture occlusion.

Depicting Occlusion in Early Renaissance Art

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Barbara Gillam

2011-05-01

Full Text Available The artist attempting to give the impression of three-dimensional relationships must convey somehow that one surface is in front of another. There is a large and venerable literature in Psychology on this subject, showing how figure-ground, border ownership and amodal completion and continuation are determined but there is almost no discussion of how artist's have recruited these and other principles to create convincing impressions of occlusion. Even Gombrich (Art & Illusion 1960 only considers the situation in which a figure has to be imagined from very partial cues, not how juxtaposed elements in art are parsed perceptually into occluding and occluded surfaces. In this paper I shall discuss approaches to occlusion present in early Renaissance art and the degree to which the principles now well-known to Psychologists were discovered and used, as artists increasingly depicted naturalistic scenes. Among the preoccupations of these artists, as indicated by their work, were whether and how much to occlude faces (and the related issue of the management of haloes, occlusion of and by architectural features, and the importance or otherwise of transitivity in occlusion relationships within the scene. They also clearly used the ground plane, high viewpoints and arrangements of contour terminations, as well as more conventional figural cues, to disambiguate perceived occlusion or to avoid the confusion of multiple surfaces.

Transcranial Doppler US as an alternative to angiography and balloon occlusion in estimating risk of carotid occlusion

International Nuclear Information System (INIS)

Feaster, S.H.; Powers, A.; Laws, E.R.

1990-01-01

This paper demonstrates the reliability of transcranial Doppler (TCD) US in the evaluation of the adequacy of collateral vessel cerebral blood flow in patients being considered for carotid ligation or occlusion. TCD was utilized in 12 patients in an attempt to study collateral vessel blood flow during endovascular balloon occlusion of a carotid artery. This was correlated with TCD measurements performed during manual carotid compression and with cerebral angiography. Changes of blood flow velocity were measured in the ipsilateral MCA and ACA. Excellent correlation was noted between the TCD measurements during manual carotid compression and actual endovascular balloon occlusion. There was also qualitative agreement with the cross-compression angiogram

Relationship of Occlusal Schemes with the Occurrence of Temporomandibular Disorders

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Dina H. Sugiaman

2013-07-01

Full Text Available Masticatory system is a complex functional unit of the body responsible for mastication, speech, and deglutition process. Temporomandibular disorders (TMD is used to describe all functional disturbances of the masticatory system. The etiology of TMD is multifactorial, such as occlusal disharmony and emotional stress. The relationship between occlusion and TMD has been highly debated in dentistry, one of the occlusal factors is the occlusal scheme. Occlusal schemes are defined as bilateral canine guidance, unilateral canine guidance, group function and balanced occlusion. However, studies about the relationship of occlusal schemes and the occurrence of the TMD are still limited and remained controversial. Objective: To investigate the relationship of occlusal schemes witht he occurrence of TMD. Methods: A cross-sectional study was conducted at the Faculty of Dentistry, Uniiversitas Indonesia. A total of 127 students were included in this study. Subjects were examined based on Clinical Helkimo Index and divided into TMD and non-TMD groups. Subjects were categorized as non-TMD groups if the value of the clinical Helkimo index was 0 and as TMD group when the value ranged between 1-25. Results: Balanced occlusion schemes has a greater risk of TMD occurrence with odds ratio value 5.6 and 95% confidence interval 1.188 to 26.331 (p=0.021. Conclusion: Balanced occlusion has a significant relationship with the occurrence of TMD.

Relationship of myocardial hibernation, scar, and angiographic collateral flow in ischemic cardiomyopathy with coronary chronic total occlusion.

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Wang, Li; Lu, Min-Jie; Feng, Lei; Wang, Juan; Fang, Wei; He, Zuo-Xiang; Dou, Ke-Fei; Zhao, Shi-Hua; Yang, Min-Fu

2018-03-07

The relationship between myocardial viability and angiographic collateral flow is not fully elucidated in ischemic cardiomyopathy (ICM) with coronary artery chronic total occlusion (CTO). We aimed to clarify the relationship between myocardial hibernation, myocardial scar, and angiographic collateral flow in these patients. Seventy-one consecutive ICM patients with 122 CTOs and 652 dysfunctional segments within CTO territories were retrospectively analyzed. Myocardial hibernation (perfusion-metabolism mismatch) and the extent of 18 F-fluorodeoxyglucose (FDG) abnormalities were assessed using 99m Tc-sestamibi and 18 F-FDG imaging. Myocardial scar was evaluated by late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) imaging. Collateral flow observed on coronary angiography was assessed using Rentrop classification. In these patients, neither the extent nor frequency of myocardial hibernation or scar was related to the status of collateral flow. Moreover, the matching rate in determining myocardial viability was poor between any 2 imaging indices. The extent of 18 F-FDG abnormalities was linearly related to the extent of LGE rather than myocardial hibernation. Of note, nearly one-third (30.4%) of segments with transmural scar still had hibernating tissue. Hibernation and non-transmural scar had higher sensitivity (63.0% and 66.7%) than collateral flow (37.0%) in predicting global functional improvement. Angiographic collateral cannot accurately predict myocardial viability, and has lower sensitivity in prediction of functional improvement in CTO territories in ICM patients. Hence, assessment of myocardial viability with non-invasive imaging modalities is of importance. Moreover, due to the lack of correlation between myocardial hibernation and scar, these two indices are complementary but not interchangeable.

Part-time occlusion therapy for amblyopia in older children.

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Singh, Inderpreet; Sachdev, Nishant; Brar, Gagandeep S; Kaushik, Sushmita

2008-01-01

To compare the efficacy of part-time versus full-time occlusion for treatment of amblyopia in children aged 7-12 years. Prospective interventional case series. One hundred children between 7-12 years of age with anisometropic (57), strabismic (25) and mixed (18) unilateral amblyopia were randomized (simple randomization) into four groups (25 each) to receive two hours, four hours, six hours or full-time occlusion therapy. Children were regularly followed up at six-weekly intervals for a minimum of three visits. Intragroup visual improvement was analyzed using paired t-test while intergroup comparisons were done using ANOVA and unpaired t-test. All four groups showed significant visual improvement after 18 weeks of occlusion therapy ( P amblyopia therapy with 11 eyes (44%), 17 eyes (68%), 22 eyes (88%) and 23 eyes (92%) being amblyopia responders in the four groups respectively, with the least number of responders in the two hours group. In mild to moderate amblyopia (vision 20/30 to 20/80), there was no significant difference in visual outcome among the four groups ( P =0.083). However, in severe amblyopia (vision 20/100 or worse), six hours ( P =0.048) and full-time occlusion ( P =0.027) treatment were significantly more effective than two hours occlusion. All grades of part-time occlusion are comparable to full-time occlusion in effectiveness of treatment for mild to moderate amblyopia in children between 7-12 years of age unlike in severe amblyopia, where six hours and full-time occlusion were more effective than two hours occlusion therapy.

Hydrocolloid occlusion for the treatment of neurovascular corns

DEFF Research Database (Denmark)

Petersen, Lars Jelstrup; Beck, Jan Walther; Reumert, L N

1991-01-01

The goal of this study was to determine the effect of hydrocolloid occlusion on neurovascular corns. The design was an observer-blinded, randomized, controlled study. Thirty consecutive patients participated in the trial. The patients received curettage alone or curettage with hydrocolloid...... occlusion. Six treatments were given over 12 weeks. A follow-up examination was performed 3 months after termination of the trial. Outcome measures were the size of the corns, a discomfort score, and an overall judgment of the trial. The results demonstrated no benefit of occlusion for symptoms or signs...... of neurovascular corns. The patients treated with occlusion were, however, generally more satisfied than the conventional group....

Radiation Retinopathy Associated with Central Retinal Vein Occlusion

Institute of Scientific and Technical Information of China (English)

Yan; Liu; FengWen

2007-01-01

Purpose: To report a case of radiation retinopathy associated with central retinal vein occlusion.Methods: The clinical features and fundus fluorescein angiography of this case were analyzed.Results: The patient had been treated with radiotherapy for her nasopharyngeal carcinoma, and presented with sudden visual loss in the left eye. The funduscopic examination and fluorescein angiography showed the features of radiation retinopathy in both eyes, and central retinal vein occlusion in the left eye.Conclusions: Radiation retinopathy can be associated with central retinal vein occlusion in the same eye, and it seems that the endothelial cell loss caused by radiation retinopathy may lead to retinal vein occlusion.

Volumetric ambient occlusion for real-time rendering and games.

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Szirmay-Kalos, L; Umenhoffer, T; Toth, B; Szecsi, L; Sbert, M

2010-01-01

This new algorithm, based on GPUs, can compute ambient occlusion to inexpensively approximate global-illumination effects in real-time systems and games. The first step in deriving this algorithm is to examine how ambient occlusion relates to the physically founded rendering equation. The correspondence stems from a fuzzy membership function that defines what constitutes nearby occlusions. The next step is to develop a method to calculate ambient occlusion in real time without precomputation. The algorithm is based on a novel interpretation of ambient occlusion that measures the relative volume of the visible part of the surface's tangent sphere. The new formula's integrand has low variation and thus can be estimated accurately with a few samples.

Part-time occlusion therapy for amblyopia in older children

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Singh Inderpreet

2008-01-01

Full Text Available Aim: To compare the efficacy of part-time versus full-time occlusion for treatment of amblyopia in children aged 7-12 years. Materials and Methods: Prospective interventional case series. One hundred children between 7-12 years of age with anisometropic (57, strabismic (25 and mixed (18 unilateral amblyopia were randomized (simple randomization into four groups (25 each to receive two hours, four hours, six hours or full-time occlusion therapy. Children were regularly followed up at six-weekly intervals for a minimum of three visits. Statistical Analysis: Intragroup visual improvement was analyzed using paired t-test while intergroup comparisons were done using ANOVA and unpaired t-test. Results: All four groups showed significant visual improvement after 18 weeks of occlusion therapy ( P < 0.001. Seventy-three (73% of the total 100 eyes responded to amblyopia therapy with 11 eyes (44%, 17 eyes (68%, 22 eyes (88% and 23 eyes (92% being amblyopia responders in the four groups respectively, with the least number of responders in the two hours group. In mild to moderate amblyopia (vision 20/30 to 20/80, there was no significant difference in visual outcome among the four groups ( P =0.083. However, in severe amblyopia (vision 20/100 or worse, six hours ( P =0.048 and full-time occlusion ( P =0.027 treatment were significantly more effective than two hours occlusion. Conclusion: All grades of part-time occlusion are comparable to full-time occlusion in effectiveness of treatment for mild to moderate amblyopia in children between 7-12 years of age unlike in severe amblyopia, where six hours and full-time occlusion were more effective than two hours occlusion therapy.

Influence of angiographic collateral circulation on myocardial perfusion in patients with chronic total occlusion of a single coronary artery and no prior myocardial infarction.

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Aboul-Enein, Fatma; Kar, Saibal; Hayes, Sean W; Sciammarella, Maria; Abidov, Aiden; Makkar, Raj; Friedman, John D; Eigler, Neal; Berman, Daniel S

2004-06-01

The functional role of various angiographic grades for coronary collaterals remains controversial. The aim of this study was to assess the influence of the Rentrop angiographic grading of coronary collaterals on myocardial perfusion in patients with single-vessel chronic total occlusion (CTO) and no prior myocardial infarction (MI). The study included 56 patients with single-vessel CTO and no prior MI who underwent rest-stress myocardial perfusion SPECT and coronary angiography within 6 mo. All patients had angiographic evidence of coronary collaterals. Patients were divided according to the Rentrop classification: Group I had grade 1 or 2 (n = 25) and group II had grade 3 collaterals (n = 31). Group I had a higher frequency of resting regional wall motion abnormalities on left ventriculography (52.6% vs. 19.2% [P = 0.019]). The mean perfusion scores of the overall population showed severe and extensive stress perfusion defects (summed stress score of 14.1 +/- 7.1 and summed difference score of 12.9 +/- 6.9) but minimal resting perfusion defects (summed rest score of 1.0 +/- 2.7). No perfusion scores differed between the 2 groups. The perfusion findings suggested that chronic stunning rather than hibernation is the principal cause of regional wall motion abnormalities in these patients. In the setting of single-vessel CTO and no prior MI, coronary collaterals appear to protect against resting perfusion defects. Excellent angiographic collaterals may prevent resting regional wall motion abnormalities but do not appear to protect against stress-induced perfusion defects.

[Occlusal anomalies in the deciduous and mixed bites].

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Legovic, M; Mady, L

1998-01-01

In 311 examines (177 boys and 134 girls) with primary dentition and 535 examinees (285 boys and 250 girls) with mixed dentition in Istria--Croatia, the frequency of orthodontic and occlusive anomalies in regard of space plane and premature extraction of c, m1 and m2 are investigated. The orthodontic anomalies are defected in 46.95%, premature loss in 11.25% and occlusive anomalies in 40.85% of examinees with primary dentition, while in mixed dentition the 58.69% of examinees have orthodontic anomaly, the 17.20% premature loss and the 48.97% of examinees have occlusal anomaly. In both phases of dentition the most frequent are occlusive anomalies in the following planes: sagittal, vertical and sagittal-vertical.

Occlusal plane location in edentulous patients: a review.

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Shetty, Sanath; Zargar, Nazia Majeed; Shenoy, Kamalakanth; Rekha, V

2013-09-01

Occlusal plane orientation is an important factor in the construction of a complete denture. Occlusal plane could be oriented using landmarks in the mandibular arch as well as in the maxillary arch. In the mandibular arch there are few landmarks which could be used to orient the occlusal plane like the retromolar pad, corner of the lips (lower lip length) whereas the maxillary arch has a number of landmarks, of which the ala-tragal line is the most commonly used and the same being the most controversial. In the following article different landmarks and its accuracy for orientating the occlusal plane in an edentulous subject as studied by various authors has been discussed.

[Study on retention and stability of linear occlusal complete dentures].

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Zhang, Ping; Xu, Jun

2003-01-01

To learn retention and stability of linear occlusal complete dentures by investigating the subjective feelings of patient and the value of retention force. Static retention forces of maxillary and mandibular dentures were measured for 25 patients wearing linear occlusal dentures by using Hz-1 retention dynamometer. The subjective feelings of patients in functional state were gained simultaneously through questionnaire. Linear occlusal dentures demonstrate good retention in static and dynamic state. Among patients with severe resorption of residual ridge (RRR), mandibular linear occlusal dentures (shown good retentive subjective feelings) demonstrate significantly smaller retention force than those with slight or medium degree of RRR. There is no correlation between the subjective feelings and the values of retention forces of mandibular dentures. The subjective feelings of patients wearing new linear occlusal dentures are much better than that of old anatomic occlusal dentures. Linear occlusal dentures improve the performances of dentures by enhancing their stability during mastication movement.

Proximal Occlusion of Medium-Sized Vessels with the Penumbra Occlusion Device: A Study of Safety and Efficacy

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Jambon, E.; Petitpierre, F. [Pellegrin Hospital, Department of Radiology (France); Brizzi, V.; Dubuisson, V. [Pellegrin Hospital, Department of Surgery (France); Bras, Y. Le; Grenier, N.; Cornelis, F., E-mail: cornelisfrancois@gmail.com [Pellegrin Hospital, Department of Radiology (France)

2017-02-15

PurposeTo retrospectively investigate the safety and efficacy of hybrid proximal coiling of various medium-sized vessels (4 to 8 mm) using the Penumbra Occlusion Device (POD).Materials and MethodsFrom October 2014 to February 2016, 37 proximal embolizations were performed with PODs in 36 patients (mean age: 50.8, range: 10–86; 29 male, 7 female). Vessel occlusions were achieved under fluoroscopic guidance using a 2.7 French microcatheter. Among the 36 vessels targeted, 16 were splenic arteries, 11 renal arteries, 4 mesenteric arteries, 3 arteriovenous fistulae, 1 iliac artery, and 1 gonadal vein. Intermittent follow-up angiography was performed to assess the flow for final occlusion. Outcomes and complications were assessed by clinical and/or imaging follow-up.ResultsTo produce proximal occlusion of the intended vessels, the POD was used alone in 19 embolizations (51.4 %). In 12 procedures (32.4 %), POD was used as a coil constrainer to secure the coil construct. In 6 procedures (16.2 %), additional embolic devices were used to achieve vessel occlusion after initial POD deployment. After a mean follow-up of 3.2 months, no POD migration was observed but two complications occurred (5.4 %): one post embolic syndrome and one extensive infarction with splenic abscess.ConclusionThe POD system allows safe and effective proximal embolization of medium-sized vessels in a variety of clinical settings.

Collation of chewing efficiency and dentures with diverse occlusal schemes

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Vijay Kumar Peddinti

2017-01-01

Full Text Available Background: Rehabilitation of an edentulous patient nurtures satisfaction and this lies in the chewing ability provided by the prosthesis. Aim: To evaluate and compare the masticatory efficiencies of complete dentures with different occlusal schemes. Materials and Methods: Fourteen completely edentulous patients from the age group of 50-70 years were selected according to the inclusion criteria followed in this study. The dentures were made with three different occlusal schemes, i.e., anatomic occlusion without balancing, anatomic occlusion with balancing, and lingualized occlusion and stored in water till the date of denture insertion. Post-insertion instructions were given to the patients at the time of delivery of the dentures. Patients were recalled after seven days and then masticatory efficiency was performed. The test was performed using boiled peanuts and Sieve system. Statistical Analysis: One-way analysis of variance (ANOVA test and unpaired t-test were carried out. Results: The obtained masticatory efficiency values with anatomic occlusion without balancing, anatomic occlusion with balancing, and lingualized occlusion LO were analyzed using one-way ANOVA test and unpaired “t” test. The tests showed that lingualized scheme had highest masticatory efficiency. Conclusion: Within the scope of this study, it can be concluded that the masticatory efficiency will be generally higher in patients provided with complete dentures fabricated using the lingualized occlusal scheme.

Compliance with occlusion therapy for childhood amblyopia.

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Wallace, Michael P; Stewart, Catherine E; Moseley, Merrick J; Stephens, David A; Fielder, Alistair R

2013-09-17

Explore compliance with occlusion treatment of amblyopia in the Monitored and Randomized Occlusion Treatment of Amblyopia Studies (MOTAS and ROTAS), using objective monitoring. Both studies had a three-phase protocol: initial assessment, refractive adaptation, and occlusion. In the occlusion phase, participants were instructed to dose for 6 hours/day (MOTAS) or randomized to 6 or 12 hour/day (ROTAS). Dose was monitored continuously using an occlusion dose monitor (ODM). One hundred and fifty-two patients (71 male, 81 female; 122 Caucasian, 30 non-Caucasian) of mean ± SD age 68 ± 18 months participated. Amblyopia was defined as an interocular acuity difference of at least 0.1 logMAR and was associated with anisometropia in 50, strabismus in 44, and both (mixed) in 58. Median duration of occlusion was 99 days (interquartile range 72 days). Mean compliance was 44%, mean proportion of days with no patch worn was 42%. Compliance was lower (39%) on weekends compared with weekdays (46%, P = 0.04), as was the likelihood of dosing at all (52% vs. 60%, P = 0.028). Compliance was lower when attendance was less frequent (P amblyopia type, and severity were not associated with compliance. Mixture modeling suggested three subpopulations of patch day doses: less than 30 minutes; doses that achieve 30% to 80% compliance; and doses that achieve around 100% compliance. This study shows that compliance with patching treatment averages less than 50% and is influenced by several factors. A greater understanding of these influences should improve treatment outcome. (ClinicalTrials.gov number, NCT00274664).

Object tracking by occlusion detection via structured sparse learning

KAUST Repository

Zhang, Tianzhu

2013-06-01

Sparse representation based methods have recently drawn much attention in visual tracking due to good performance against illumination variation and occlusion. They assume the errors caused by image variations can be modeled as pixel-wise sparse. However, in many practical scenarios these errors are not truly pixel-wise sparse but rather sparsely distributed in a structured way. In fact, pixels in error constitute contiguous regions within the object\\'s track. This is the case when significant occlusion occurs. To accommodate for non-sparse occlusion in a given frame, we assume that occlusion detected in previous frames can be propagated to the current one. This propagated information determines which pixels will contribute to the sparse representation of the current track. In other words, pixels that were detected as part of an occlusion in the previous frame will be removed from the target representation process. As such, this paper proposes a novel tracking algorithm that models and detects occlusion through structured sparse learning. We test our tracker on challenging benchmark sequences, such as sports videos, which involve heavy occlusion, drastic illumination changes, and large pose variations. Experimental results show that our tracker consistently outperforms the state-of-the-art. © 2013 IEEE.

Mesenteric vascular occlusion: Comparison of ancillary CT findings between arterial and venous occlusions and independent CT findings suggesting life-threatening events

International Nuclear Information System (INIS)

Wong, Yon Cheong; Wu, Cheng Hsien; Wang, Li Jen; Chen, Huan Wu; Lin, Being Chuan; Huang, Chen Chih

2013-01-01

To compare the ancillary CT findings between superior mesenteric artery thromboembolism (SMAT) and superior mesenteric vein thrombosis (SMVT), and to determine the independent CT findings of life-threatening mesenteric occlusion. Our study was approved by the institution review board. We included 43 patients (21 SMAT and 22 SMVT between 1999 and 2008) of their median age of 60.0 years, and retrospectively analyzed their CT scans. Medical records were reviewed for demographics, management, surgical pathology diagnosis, and outcome. We compared CT findings between SMAT and SMVT groups. Multivariate analysis was conducted to determine the independent CT findings of life-threatening mesenteric occlusion. Of 43 patients, 24 had life-threatening mesenteric occlusion. Death related to mesenteric occlusion was 32.6%. A thick bowel wall (p < 0.001), mesenteric edema (p < 0.001), and ascites (p = 0.009) were more frequently associated with SMVT, whereas diminished bowel enhancement (p = 0.003) and paralytic ileus (p = 0.039) were more frequent in SMAT. Diminished bowel enhancement (OR = 20; p = 0.007) and paralytic ileus (OR = 16; p = 0.033) were independent findings suggesting life-threatening mesenteric occlusion. The ancillary CT findings occur with different frequencies in SMAT and SMVT. However, the independent findings indicating life-threatening mesenteric occlusion are diminished bowel wall enhancement and paralytic ileus.

Soft occlusal splint therapy in the management of myofascial pain dysfunction syndrome: A follow-up study

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Naikmasur Venkatesh

2008-01-01

Full Text Available Background and Objectives: Myofascial Pain Dysfunction Syndrome (MPDS has been recognized as the most common, nontooth-related chronic orofacial pain condition that confronts dentists. A variety of therapies has been described in literature for its management. The present study is a prospective study carried out to evaluate the efficacy of occlusal splint therapy and compare it with pharmacotherapy (using analgesics and muscle relaxants in the management of Myofascial Pain Dysfunction Syndrome. Materials and Methods: Forty patients in the age range of 17-55 years were included in the study and randomly assigned to one of two equally sized groups, A and B. Group A patients received a combination of muscle relaxants and analgesics while Group B patients received soft occlusal splint therapy. All the patients were evaluated for GPI, VAS, maximum comfortable mouth opening, TMJ clicking and tenderness during rest and movement as well as for the number of tender muscles at the time of diagnosis, after the 1 st week of initiation of therapy and every month for three months of follow-up. Results: There was a progressive decrease in GPI scores, number of tender muscles, TMJ clicking and tenderness with various jaw movements and significant improvement in mouth opening in patients on occlusal splint therapy during the follow-up period as compared to the pharmacotherapy group. Conclusion: Occlusal splint therapy has better long-term results in reducing the symptoms of MPDS. It has better patient compliance, fewer side effects, and is more cost-effective than pharmacotherapy; hence, it can be chosen for the treatment of patients with MPDS.

The success of opening single chronic total occlusion lesions to improve myocardialviabilitytrial (SOS-COMEDY): Study protocol of a prospective multicenter study.

Science.gov (United States)

Huang, Rongchong; Song, Xiantao; Zhang, Haishan; Tian, Wen; Huang, Zheng; Zhang, Xingwei; Yang, Junqing; Zhang, Dongfeng; Wu, Jian; Zhong, Lei; Ting, Henry H

2018-04-01

Success of opening single (SOS)-comedy is a prospective multicenter study to compare the improvement in the decrease of myocardial viability by percutaneous coronary intervention (PCI) with that by optimal medical therapy (OMT) alone in patients with chronic total occlusion (CTO) of a single coronary artery. The risks and the benefits of both options (PCI and OMT) were listed in a CTO decision aid (DA). Eligible participants detected by invasive coronary angiography (ICA) or coronary computed tomography angiography (CCTA) were divided into PCI or OMT groups according to patients' choice after shared-decision making process with DA. Participants will undergo positron emission tomography/computed tomography (PET/CT), cardiac magnetic resonance (CMR) and transthoracic echocardiography (TTE), and proceed to ICA and revascularization if possible. Blinded core laboratory interpretation will be performed for ICA, CCTA, PET/CT, CMR, and TTE. All participants will be followed up for 12 months. The primary endpoint is the improvement to the decrease of myocardial viability from baseline assessed with the use of PET/CT after 12-month follow-up. All of the patients are appropriately consented before enrolling in this study, which has been approved by the Ethics Committee. Results of SOS-COMEDY will be helpful to develop a strategy for single CTO patients.

Chronic intrinsic transient tracheal occlusion elicits diaphragmatic muscle fiber remodeling in conscious rodents.

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Barbara K Smith

Full Text Available BACKGROUND: Although the prevalence of inspiratory muscle strength training has increased in clinical medicine, its effect on diaphragm fiber remodeling is not well-understood and no relevant animal respiratory muscle strength training-rehabilitation experimental models exist. We tested the postulate that intrinsic transient tracheal occlusion (ITTO conditioning in conscious animals would provide a novel experimental model of respiratory muscle strength training, and used significant increases in diaphragmatic fiber cross-sectional area (CSA as the primary outcome measure. We hypothesized that ITTO would increase costal diaphragm fiber CSA and further hypothesized a greater duration and magnitude of occlusions would amplify remodeling. METHODOLOGY/PRINCIPAL FINDINGS: Sprague-Dawley rats underwent surgical placement of a tracheal cuff and were randomly assigned to receive daily either 10-minute sessions of ITTO, extended-duration, 20-minute ITTO (ITTO-20, partial obstruction with 50% of cuff inflation pressure (ITTO-PAR or observation (SHAM over two weeks. After the interventions, fiber morphology, myosin heavy chain composition and CSA were examined in the crural and ventral, medial, and dorsal costal regions. In the medial costal diaphragm, with ITTO, type IIx/b fibers were 26% larger in the medial costal diaphragm (p<0.01 and 24% larger in the crural diaphragm (p<0.05. No significant changes in fiber composition or morphology were detected. ITTO-20 sessions also yielded significant increases in medial costal fiber cross-sectional area, but the effects were not greater than those elicited by 10-minute sessions. On the other hand, ITTO-PAR resulted in partial airway obstruction and did not generate fiber hypertrophy. CONCLUSIONS/SIGNIFICANCE: The results suggest that the magnitude of the load was more influential in altering fiber cross-sectional area than extended-duration conditioning sessions. The results also indicated that ITTO was

Cerebral Perfusion Long Term after Therapeutic Occlusion of the Internal Carotid Artery in Patients Who Tolerated Angiographic Balloon Test Occlusion

NARCIS (Netherlands)

Gevers, S.; Heijtel, D.; Ferns, S. P.; van Ooij, P.; van Rooij, W. J.; van Osch, M. J.; van den Berg, R.; Nederveen, A. J.; Majoie, C. B.

2012-01-01

BACKGROUND AND PURPOSE: Therapeutic carotid occlusion is an established technique for treatment of large and giant aneurysms of the (CA, in patients with synchronous venous filling on angiography during BTO. Concern remains that hemodynamic alterations after permanent occlusion will predispose the

Temporal changes in outcomes of women and men undergoing percutaneous coronary intervention for chronic total occlusion: 2005-2013.

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Toma, Aurel; Stähli, Barbara E; Gick, Michael; Ferenc, Miroslaw; Mashayekhi, Kambis; Buettner, Heinz Joachim; Neumann, Franz-Josef; Gebhard, Catherine

2018-06-01

Percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) has undergone impressive progress during the last decade, both in strategies and equipment. It is unknown whether technical refinement has translated into improved outcomes in women undergoing CTO-PCI. A total of 2002 consecutive patients (17% females, mean age 65.2 ± 10.7 years) undergoing PCI of at least one CTO lesion at our center between 01/2005 and 12/2013 were evaluated. The incidence of adverse events was compared between two time series (2005-2009 and 2010-2013). A significant increase in adverse lesion characteristics over time was noted in both, women and men (p men but not in women (p trend  men and p trend =0.9 in women). The incidence of procedural complications was significantly higher in women as compared to men and increased over the study period in women (p men. Accordingly, multivariate logistic regression analysis identified female sex as a strong predictor of PCI-related complications in recent years, while this was not the case in earlier years (adjusted HR 2.03, 95% CI 0.62-6.6, p = 0.2 and adjusted HR 4.7, 95% CI 1.8-12.3, p = 0.002, respectively, p men (log rank = 0.046), while no changes were observed in women. While higher success rates and a reduced rate of MACE have been achieved in men, the incidence of procedural complications in women undergoing CTO-PCI has increased over time.

Preprosthetic therapy utilizing a temporary occlusal acrylic splint: a case report.

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Badel, Tomislav; Kraljeviç, Sonja; Panduriç, Josip; Marotti, Miljenko

2004-05-01

This case report describes the complex occlusal rehabilitation of a patient with signs and symptoms of temporomandibular disorders with utilization of an occlusal acrylic splint as a means of initial treatment for neuromuscular reprogramming and repositioning of the condyle within the mandibular fossa for occlusal stability, thus allowing adaptation to a new occlusal vertical dimension.

Intravitreal triamcinolone acetonide injections in the treatment of retinal vein occlusions.

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Roth, Daniel B; Cukras, Catherine; Radhakrishnan, Ravi; Feuer, William J; Yarian, David L; Green, Stuart N; Wheatley, Harold M; Prenner, Jonathan

2008-01-01

To report the visual acuity response after intravitreal triamcinolone injection in patients with macular edema due to retinal vein occlusions. Retrospective nonrandomized interventional series of 172 consecutive patients with macular edema due to retinal vein occlusions who were treated with intravitreal triamcinolone acetonide injection. Patients underwent Snellen visual acuity testing and ophthalmoscopic examination at baseline and 1, 3, 6, and 12 months after intravitreal triamcinolone acetonide injection. All subtypes of retinal vein occlusions showed significant improvements in mean visual acuity 1 month after injection. This improvement in visual acuity was maintained over the 12-month period for all but the central retinal vein occlusion group. Seventy-one (41.3%) of the 172 patients received more than one intravitreal triamcinolone injection for unresolved or recurrent macular edema. This study demonstrates a benefit associated with intravitreal triamcinolone acetonide injection for retinal vein occlusions that was maintained by patients with branch retinal vein occlusions and hemiretinal vein occlusions over a 12-month period. Visual acuity improvement was not maintained in patients with central retinal vein occlusions with this course of treatment.

Progression of Diabetic Capillary Occlusion: A Model.

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Xiao Fu

2016-06-01

Full Text Available An explanatory computational model is developed of the contiguous areas of retinal capillary loss which play a large role in diabetic maculapathy and diabetic retinal neovascularization. Strictly random leukocyte mediated capillary occlusion cannot explain the occurrence of large contiguous areas of retinal ischemia. Therefore occlusion of an individual capillary must increase the probability of occlusion of surrounding capillaries. A retinal perifoveal vascular sector as well as a peripheral retinal capillary network and a deleted hexagonal capillary network are modelled using Compucell3D. The perifoveal modelling produces a pattern of spreading capillary loss with associated macular edema. In the peripheral network, spreading ischemia results from the progressive loss of the ladder capillaries which connect peripheral arterioles and venules. System blood flow was elevated in the macular model before a later reduction in flow in cases with progression of capillary occlusions. Simulations differing only in initial vascular network structures but with identical dynamics for oxygen, growth factors and vascular occlusions, replicate key clinical observations of ischemia and macular edema in the posterior pole and ischemia in the retinal periphery. The simulation results also seem consistent with quantitative data on macular blood flow and qualitative data on venous oxygenation. One computational model applied to distinct capillary networks in different retinal regions yielded results comparable to clinical observations in those regions.

Does compliance with amblyopia management improve following supervised occlusion treatment?

Science.gov (United States)

El-Ghrably, I A; Longville, D; Gnanaraj, L

2007-01-01

To demonstrate improvement in compliance following supervised occlusion therapy for amblyopia in children who had failed to respond to outpatient treatment. Retrospective review of the visual outcome of 30 children who were admitted to an ophthalmology ward for 1-day intensive supervised occlusion. These children had documented poor compliance and previously failed to respond to the outpatient occlusion treatment. During their stay a trained ophthalmology nurse educated parents regarding amblyopia and the benefits of occlusion therapy. Visual acuity (VA) of the amblyopic and fellow eyes was recorded on admission, discharge, and at each subsequent visit. The compliance was recorded from parent's history and also indirectly by noticing improvement in vision. The mean supervised occlusion was 7.4 hours (range 4-12 hours). The compliance with occlusion therapy improved in 23 children (77%) after discharge. The mean duration of occlusion after discharge improved to 4 hours (range 1-12 hours). The mean follow-up was 18 months (range 4-24 months). Though there was no dramatic improvement in VA at discharge there was a statistically significant improvement in VA between admission and last recorded VA (pocclusion following discharge, 21 (91%) gained at least one line of acuity in their amblyopic eye on the last assessment of their VA and five of them achieved 6/12. Of the seven children who did not comply with occlusion following discharge, only one patient gained one line improvement in his amblyopic eye. This study shows that supervised occlusion treatment and parental education was effective in children who had initially failed traditional outpatient treatment.

Occlusion detection via structured sparse learning for robust object tracking

KAUST Repository

Zhang, Tianzhu

2014-01-01

Sparse representation based methods have recently drawn much attention in visual tracking due to good performance against illumination variation and occlusion. They assume the errors caused by image variations can be modeled as pixel-wise sparse. However, in many practical scenarios, these errors are not truly pixel-wise sparse but rather sparsely distributed in a structured way. In fact, pixels in error constitute contiguous regions within the object’s track. This is the case when significant occlusion occurs. To accommodate for nonsparse occlusion in a given frame, we assume that occlusion detected in previous frames can be propagated to the current one. This propagated information determines which pixels will contribute to the sparse representation of the current track. In other words, pixels that were detected as part of an occlusion in the previous frame will be removed from the target representation process. As such, this paper proposes a novel tracking algorithm that models and detects occlusion through structured sparse learning. We test our tracker on challenging benchmark sequences, such as sports videos, which involve heavy occlusion, drastic illumination changes, and large pose variations. Extensive experimental results show that our proposed tracker consistently outperforms the state-of-the-art trackers.

Successful Reversal of Chronic Incapacitating Post-TIPS Encephalopathy by Balloon Occlusion of the Stent

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Daphna Fenyves

1994-01-01

Full Text Available Transjugular intrahepatic portosystemic shunt (TIPS placement is a new technique allowing decompression of the portal system without the need for abdominal surgery or general anesthetic. This promising procedure appears safe, and is being evaluated in the context of life threatening uncontrollable variceal hemorrhage as well as ascites refractory to medical treatment. Following TIPS, portal flow diversion is associated with hepatic encephalopathy in up to 25% of patients. This is most often mild and treatable but may become uncontrollable, incapacitating and even life threatening in up to 3 to 5% of cases. The authors present two patients in whom such life threatening encephalopathy and stupor was reversed by transjugular balloon occlusion of the TIPS.

A change in humidification system can eliminate endotracheal tube occlusion.

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Doyle, Alex; Joshi, Manasi; Frank, Peter; Craven, Thomas; Moondi, Parvez; Young, Peter

2011-12-01

Inadequate airway humidification can result in endotracheal tube occlusion. There is evidence that heat and moisture exchangers (HMEs) are more prone to endotracheal tube occlusion than heated humidifiers (HHs) that contain a heated wire circuit. We aimed to compare the incidence of endotracheal tube occlusion while introducing a new dual-heated wire circuit HH in place of an established hydrophobic HME. This was a prospective observational study. All patients who required intubation were included in our analysis. Univariate statistical analysis was performed using a Fisher exact test. P humidification exclusively by HH. In the subsequent 18-month period, there were no further episodes of endotracheal tube occlusion. Our study demonstrates that there is a significant increase in the incidence of endotracheal tube occlusion when using a hydrophobic HME compared with an HH and that using a dual-heated wire circuit HH can eliminate endotracheal tube occlusion. Copyright © 2011 Elsevier Inc. All rights reserved.

Retinal vein occlusion: pathophysiology and treatment options

OpenAIRE

Karia, Niral

2010-01-01

Niral KariaDepartment of Ophthalmology, Southend Hospital, Prittlewell Chase, Westcliff on Sea, Essex, United KingdomAbstract: This paper reviews the current thinking about retinal vein occlusion. It gives an overview of its pathophysiology and discusses the evidence behind the various established and emerging treatment paradigms.Keywords: central, hemispheric, branch, retinal vein occlusion, visual loss

Hepatic veno-occlusive disease associated with comfrey ingestion.

Science.gov (United States)

Yeong, M L; Swinburn, B; Kennedy, M; Nicholson, G

1990-01-01

A 23 year old man presented with hepatic veno-occlusive disease and severe portal hypertension and subsequently died from liver failure. Light microscopy and hepatic angiography showed occlusion of sublobular veins and small venous radicles of the liver, associated with widespread haemorrhagic necrosis of hepatocytes. The patient had been on a predominantly vegetarian diet and, prior to his illness, took comfrey leaves which are known to contain hepatotoxic pyrrolizidine alkaloids. Comfrey is widely used as a herbal remedy, but so far has only been implicated in two other documented cases of human hepatic veno-occlusive disease. A possible causal association of comfrey and this patient's veno-occlusive disease is suggested by the temporal relationship of the ingestion of comfrey to his presentation, the histological changes in the liver and the exclusion of other known causes of the disease.

[Single- and multi-unit fixed dental prostheses in relation to the occlusal system].

Science.gov (United States)

Witter, D J; Gerritsen, A E; van Spijker, A; Creugers, N H J

2013-02-01

Occlusion concepts based on functional aspects offer more solid ground in the diagnostic process and in the treatment of (reduced) dentitions than morphologically and mechanically oriented occlusion concepts. Nevertheless, for occlusal reconstruction morphologically oriented guidelines are necessary. These guidelines are based on the border movements and positions of the mandible in the orofacial system, and on the location and modelling of the occlusal contacts in the occlusal system. The modelling of single- and multi-unit fixed dental prostheses must harmonize with the occlusal system. Moreover, an important feature is the relation of the anterior teeth which enables mutually protected occlusion. Characteristics of a healthy orofacial and occlusal system are: absence of pathology, perceived sufficient oral functions, variability inform and function, and adaptive capacity. When designing single- or multiunit fixed dental prostheses, a pragmatic starting point is to maintain the existing occlusion and the existing speech pattern unless arguments can be provided for alterations. The occlusal design should aim at optimizing oral functions, such as mandibular and occlusal stability.

Differentiation between active and chronic Crohn's disease using MRI small-bowel motility examinations — Initial experience

International Nuclear Information System (INIS)

Bickelhaupt, S.; Froehlich, J.M.; Cattin, R.; Patuto, N.; Tutuian, R.; Wentz, K.U.; Culmann, J.L.; Raible, S.; Bouquet, H.; Bill, U.; Patak, M.A.

2013-01-01

Aim: To evaluate the influence of locally active Crohn's disease on systemic small-bowel motility in patients with chronic Crohn's disease compared to healthy individuals. Material and methods: Fifteen healthy individuals (11 men, four women; mean age 37 years) and 20 patients with histopathologically proven active (n = 15; 10 women, 5 men; mean age 45 years) or chronic (n = 5; four women, one man; mean age 48 years) Crohn's disease were included in this institutional review board-approved, retrospective study. Magnetic resonance imaging (MRI; 1.5 T) was performed after standardized preparation. Two-dimensional (2D) cine sequences for motility acquisition were performed in apnoea (27 s). Motility assessment was performed using dedicated software in three randomly chosen areas of the small-bowel outside known Crohn's disease-affected hotspots. The main quantitative characteristics (frequency, amplitude, occlusion rate) were compared using Student's t-test and one-way analysis of variance (ANOVA). Results: Three randomly chosen segments were analysed in each participant. Patients with active Crohn's disease had significantly (p < 0.05) reduced contraction frequencies (active Crohn's disease: 2.86/min; chronic: 4.14/min; healthy: 4.53/min) and luminal occlusion rates (active: 0.43; chronic: 0.70; healthy: 0.73) compared to healthy individuals and patients with chronic Crohn's disease. Contraction amplitudes were significantly reduced during active Crohn's disease (6.71 mm) compared to healthy participants (10.14 mm), but this only reached borderline significance in comparison to chronic Crohn's disease (8.87 mm). Mean bowel lumen diameter was significantly (p = 0.04) higher in patients with active Crohn's disease (16.91 mm) compared to healthy participants (14.79 mm) but not in comparison to patients with chronic Crohn's disease (13.68). Conclusion: The findings of the present study suggest that local inflammatory activity of small-bowel segments in patients with

Occlusal designs on masticatory ability and patient satisfaction with complete denture: a systematic review.

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Zhao, Ke; Mai, Qing-Qing; Wang, Xiao-Dong; Yang, Wen; Zhao, Li

2013-11-01

To systematically review clinical outcomes of different occlusal designs of complete dentures. Using a various key words, an electronic search of clinical trials published in English and Chinese literature was performed from four databases: Medline/PubMed, EMBASE, Cochrane Library, and CBM. Furthermore, a manual searching of the relevant journals and the bibliographies of reviews was performed. General satisfaction, masticatory ability, retention, and stability were major criteria for the evaluation of the outcomes. Studies met these criteria were selected for a full-text reading. The whole processes were performed by two reviewers independently. This systematic review started with 1030 articles, which were finally narrowed down to seven, according to the inclusion criteria. The following occlusal designs were included and analyzed: anatomic occlusion, balanced occlusion, canine guidance occlusion, lingualized occlusion, monoplane occlusion, and bilateral-balanced and canine-guided design. Three of the seven studies showed that lingualized occlusion had ratings of higher patients' satisfaction than other occlusion designs. On the other hand, the canine-guided occlusion dentures demonstrated equal or better clinical performances than bilateral-balanced dentures. Because of the heterogeneity and bias of the studies, it was not possible to analyze the data statistically. Lingualized occlusion and canine-guided occlusion can be successfully applied in the fabrication of complete dentures. Canine guided occlusion has also been shown to be satisfactory. More well-controlled randomized trials are needed regarding canine-guided occlusion and the relationship between alveolar ridge resorption, different occlusal schemes and patient satisfaction. The conventional prosthodontic wisdom that complete dentures require a balanced occlusal design is not supported by the included literature. A suitable occlusal scheme would be a critical factor for a successful complete denture

The correction of occlusal vertical dimension on tooth wear

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Rostiny Rostiny

2007-12-01

Full Text Available The loss of occlusal vertical dimension which is caused by tooth wear is necessarily treated to regain vertical dimension. Correctional therapy should be done as early possible. In this case, simple and relatively low cost therapy was performed. In unserve loss of occlusal vertical dimension, partial removable denture could be used and the improvement of lengthening anterior teeth using composite resin to improve to regain vertical dimensional occlusion.

Directional Atherectomy in Iliac Stent Failure: Clinical Technique and Histopathologic Correlation

International Nuclear Information System (INIS)

Ettles, Duncan F.; MacDonald, Alastair W.; Burgess, Paul A.; Nicholson, Anthony A.; Dyet, John F.

1998-01-01

Purpose: To assess the feasibility and efficacy of directional atherectomy in the treatment of iliac stent stenosis or occlusion and to evaluate the histologic composition of excised atherectomy specimens. Methods: Directional atherectomy of six occluded and 10 severely stenosed iliac stents was undertaken in 12 patients at a mean interval of 28 months (range 3-69 months) after stent insertion for occlusive aortoiliac disease. In cases of stent occlusion, atherectomy was preceded by low-dose thrombolysis. In all patients stent clearance with return of femoral pulses was achieved within 24 hr and there were no significant complications. All excised specimens were sent for histologic examination. Results: Eleven patients (92%) remain symptom free with unlimited walking distance at a mean follow-up interval of 11.5 months (range 3-31 months) after treatment. Histologic examination revealed typical myointimal hyperplasia at three excision sites, intimal fibrosis at three sites, atheroma at four sites and organized thrombus at six sites. Conclusion: Atherectomy offers an effective treatment in iliac stent occlusion and restenosis with no significant adverse effects. Debulking of these lesions seems to offer a more logical approach than simple balloon angioplasty. Clinical and duplex follow-up confirms satisfactory outcome within the first year but longer-term results are not yet known. The histologic data obtained demonstrate that stent restenosis and occlusion are likely to be multifactorial, and challenge the assumption that myointimal hyperplasia is the sole cause of iliac stent occlusion

Influence of occlusal contact area on cusp defection and stress distribution.

Science.gov (United States)

Costa, Anna Karina Figueiredo; Xavier, Thaty Aparecida; Paes-Junior, Tarcisio José Arruda; Andreatta-Filho, Oswaldo Daniel; Borges, Alexandre Luiz Souto

2014-11-01

The purpose of this study was to evaluate the effect of occlusal contact area for loading on the cuspal defection and stress distribution in a first premolar restored with a high elastic modulus restorative material. The Rhinoceros 4.0 software was used for modeling the three-dimensional geometries of dental and periodontal structures and the inlay restoration. Thus, two different models, intact and restored teeth with three occlusal contact areas, 0.1, 0.5 and 0.75 mm(2), on enamel at the occlusal surface of buccal and lingual cusps. Finite element analysis (FEA) was performed with the program ANSYS (Workbench 13.0), which generated a mesh with tetrahedral elements with greater refinement in the regions of interest, and was constrained at the bases of cortical and trabecular bone in all axis and loaded with 100 N normal to each contact area. To analysis of maximum principal stress, the smaller occlusal contact area showed greater compressive stress in region of load application for both the intact and inlay restored tooth. However, tensile stresses at the occlusal isthmus were similar for all three tested occlusal contact areas (60 MPa). To displacement of the cusps was higher for teeth with inlay (0.46-0.48 mm). For intact teeth, the smaller contact area showed greater displacement (0.10 mm). For teeth with inlays, the displacement of the cusps were similar in all types of occlusal area. Cuspal displacement was higher in the restored tooth when compared to the intact tooth, but there were no significant variations even with changes in the occlusal contact area. RELEVANCE CLINICAL: Occlusal contacts have a great influence on the positioning of teeth being able to maintain the position and stability of the mandible. Axial loads would be able to generate more uniform stress at the root presenting a greater concentration of load application in the point and the occlusal surface. Thus, is necessary to analyze the relationship between these occlusal contacts as dental

[Characteristics of experimental occlusal interference-induced masticatory mechanical hyperalgesia of rats].

Science.gov (United States)

Li, Xuejiao; Cao, Ye; Xie, Qiufei

2014-10-01

To investigate the relationship between the existence of occlusal interference and masticatory muscle hyperalgesia by exploring the stimulus-response relationship between the duration of occlusal interference and masticatory muscle mechanical withdrawal threshold. Occlusal interference with 0.4 mm-thick crowns on rat molars was removed under anaesthesia at 2, 3, 4, 5, and 6 d after wear, and masticatory muscle mechanical withdrawal threshold was tested at 1, 3, 5, 7, 10, 14, 21 and 28 d. Decreased mechanical withdrawal thresholds were detected in temporal muscles and masseter muscles on both sides following occlusal interference (P 0.05). No significant differences were detected between the contralateral side with the ipsilateral side (P occlusal interference at 5 d, and the existence of the occlusal interference is positively correlated with the duration of the mechanical hyperalgesia.

Left atrial appendage occlusion

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Ahmad Mirdamadi

2013-01-01

Full Text Available Left atrial appendage (LAA occlusion is a treatment strategy to prevent blood clot formation in atrial appendage. Although, LAA occlusion usually was done by catheter-based techniques, especially percutaneous trans-luminal mitral commissurotomy (PTMC, it can be done during closed and open mitral valve commissurotomy (CMVC, OMVC and mitral valve replacement (MVR too. Nowadays, PTMC is performed as an optimal management of severe mitral stenosis (MS and many patients currently are treated by PTMC instead of previous surgical methods. One of the most important contraindications of PTMC is presence of clot in LAA. So, each patient who suffers of severe MS is evaluated by Trans-Esophageal Echocardiogram to rule out thrombus in LAA before PTMC. At open heart surgery, replacement of the mitral valve was performed for 49-year-old woman. Also, left atrial appendage occlusion was done during surgery. Immediately after surgery, echocardiography demonstrates an echo imitated the presence of a thrombus in left atrial appendage area, although there was not any evidence of thrombus in pre-pump TEE. We can conclude from this case report that when we suspect of thrombus of left atrial, we should obtain exact history of previous surgery of mitral valve to avoid misdiagnosis clotted LAA, instead of obliterated LAA. Consequently, it can prevent additional evaluations and treatments such as oral anticoagulation and exclusion or postponing surgeries including PTMC.

Design of the Monitored Occlusion Treatment of Amblyopia Study (MOTAS)

OpenAIRE

Stewart, C E; Fielder, A R; Stephens, D A; Moseley, M J

2002-01-01

Background/aims: The effectiveness of occlusion therapy for the treatment of amblyopia is a research priority. The authors describe the design of the Monitored Occlusion Treatment for Amblyopia Study (MOTAS) and its methodology. MOTAS will determine the dose-response relation for occlusion therapy as a function of age and category of amblyopia.

Ocular neovascularization in eyes with a central retinal artery occlusion or a branch retinal artery occlusion

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Mason lll JO

2015-06-01

Full Text Available John O Mason III,1,2 Shyam A Patel,1 Richard M Feist,1,2 Michael A Albert Jr,1,2 Carrie Huisingh,1 Gerald McGwin Jr,1,3 Martin L Thomley1,2 1Department of Ophthalmology, University of Alabama School of Medicine, Birmingham, AL, USA; 2Retina Consultants of Alabama, Callahan Eye Foundation Hospital, Birmingham, AL, USA; 3Department of Epidemiology, School of Public Health, University of Alabama at Birmingham, Birmingham, AL, USA Purpose: To investigate the ocular neovascularization (ONV rate in eyes with a branch retinal artery occlusion (BRAO or a central retinal artery occlusion (CRAO, and to study factors that may influence the ONV rate secondary to CRAO.Methods: This was a retrospective case series of consecutive patients (286 total eyes: 83 CRAOs and 203 BRAOs who were diagnosed with a retinal artery occlusion from 1998 to 2013 at the Retina Consultants of Alabama and University of Alabama at Birmingham, Birmingham, AL, USA. Generalized estimating equations were used to evaluate the association between hypothesized risk factors and ONV development.Results: Twelve (14.5% of the 83 eyes with a CRAO developed ONV. Eleven of 12 eyes (91.7% had iris neovascularization, ten of 12 eyes (83.3% had neovascular glaucoma, and two of 12 eyes (16.7% had neovascularization of the optic disc. The average time for ONV development secondary to CRAO was 30.7 days, ranging from the date of presentation to 137 days. Only two (<1.0% of the 203 eyes with a BRAO developed iris neovascularization. Diabetes mellitus type 2 was a risk factor for ONV development following a CRAO with an adjusted odds ratio of 5.2 (95% confidence interval: 1.4–19.8 (P=0.02.Conclusion: ONV is an important complication of CRAO and is a less-frequent complication of BRAO. Patients with a CRAO, especially those with diabetes mellitus type 2, should be closely monitored for the first 6 months for ONV. Keywords: neovascularization, neovascular glaucoma, retinal artery occlusion, central

Long-term survival benefit of revascularization compared with medical therapy in patients with coronary chronic total occlusion and well-developed collateral circulation.

Science.gov (United States)

Jang, Woo Jin; Yang, Jeong Hoon; Choi, Seung-Hyuk; Song, Young Bin; Hahn, Joo-Yong; Choi, Jin-Ho; Kim, Wook Sung; Lee, Young Tak; Gwon, Hyeon-Cheol

2015-02-01

The purpose of this study was to compare the long-term clinical outcomes of patients with chronic total occlusion (CTO) and well-developed collateral circulation treated with revascularization versus medical therapy. Little is known about the clinical outcomes and optimal treatment strategies of CTO with well-developed collateral circulation. We screened 2,024 consecutive patients with at least 1 CTO detected on coronary angiogram. Of these, we analyzed data from 738 patients with Rentrop 3 grade collateral circulation who were treated with medical therapy alone (n = 236), coronary artery bypass grafting (n = 170) or percutaneous coronary intervention (n = 332; 80.1% successful). Patients who underwent revascularization and medical therapy (revascularization group, n = 502) were compared with those who underwent medical therapy alone (medication group, n = 236) in terms of cardiac death and major adverse cardiac events (MACE), defined as the composite of cardiac death, myocardial infarction, and repeat revascularization. During a median follow-up duration of 42 months, multivariate analysis revealed a significantly lower incidence of cardiac death (hazard ratio [HR]: 0.29; 95% confidence interval [CI]: 0.15 to 0.58; p collateral circulation, aggressive revascularization may reduce the risk of cardiac mortality and MACE. Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Extravasal occlusion of large vessels with titanic clips: efficiency, indications, and contraindications.

Science.gov (United States)

Vasilenko, Yu V; Kim, A I; Kotov, S A

2002-11-01

The mechanism of extravasal occlusion of blood vessels with titanic clips "Atrauclip" and "Ligaclip extra" was studied in order to reveal indications and contraindications to their use. Occlusion with the clips of both types was ineffective in vessels with a diameter of >7.0 mm. Arteritis or the presence of an intravascular occlusion facility in the vessel were also the contraindications for clip occlusion. In overcases the procedure of occlusion with titanic clips was efficient and atraumatic.

Treatment of hemobilia by transcatheter vascular occlusion

International Nuclear Information System (INIS)

Vaughan, R.; Roesch, J.; Keller, F.S.; Antonovic, R.; Veterans Administration Medical Center, Portland, OR

1984-01-01

Four cases of hemobilia treated by transcatheter arterial occlusion are presented and reviewed with 30 similar cases reported in the literature. Transcatheter vascular occlusion successfully controlled hemorrhage in all 34 patients. No obvious liver parenchymal damage appeared in 26 patients; transient elevation of liver enzymes occurred in 6 patients (18%) including one in our series; two of the patients reviewed died of acute hepatic insufficiency following nonselective hepatic artery embolization. Hemobilia should be considered when gastrointestinal hemorrhage occurs after abdominal trauma, liver biopsy or other manipulative liver procedures. Hepatic angiography establishes the diagnosis and selective vascular occlusion is the treatment of choice for control of intractable or recurrent hemorrhage. Techniques and precautions for the diagnosis and transcatheter therapy of hemobilia are discussed. (orig.)

A framework for classification and segmentation of branch retinal artery occlusion in SD-OCT

Science.gov (United States)

Guo, Jingyun; Shi, Fei; Zhu, Weifang; Chen, Haoyu; Chen, Xinjian

2016-03-01

Branch retinal artery occlusion (BRAO) is an ocular emergency which could lead to blindness. Quantitative analysis of BRAO region in the retina is very needed to assessment of the severity of retinal ischemia. In this paper, a fully automatic framework was proposed to classify and segment BRAO based on 3D spectral-domain optical coherence tomography (SD-OCT) images. To the best of our knowledge, this is the first automatic 3D BRAO segmentation framework. First, a support vector machine (SVM) based classifier is designed to differentiate BRAO into acute phase and chronic phase, and the two types are segmented separately. To segment BRAO in chronic phase, a threshold-based method is proposed based on the thickness of inner retina. While for segmenting BRAO in acute phase, a two-step segmentation is performed, which includes the bayesian posterior probability based initialization and the graph-search-graph-cut based segmentation. The proposed method was tested on SD-OCT images of 23 patients (12 of acute and 11 of chronic phase) using leave-one-out strategy. The overall classification accuracy of SVM classifier was 87.0%, and the TPVF and FPVF for acute phase were 91.1%, 5.5%; for chronic phase were 90.5%, 8.7%, respectively.

Mechanism of vaso-occlusion in sickle cell anemia

Science.gov (United States)

Lei, Huan; Karniadakis, George

2012-11-01

Vaso-occlusion crisis is one of the key hallmark of sickle cell anemia. While early studies suggested that the crisis is caused by blockage of a single elongated cell, recent experimental investigations indicate that vaso-occlusion is a complex process triggered by adhesive interactions among different cell groups in multiple stages. Based on dissipative particle dynamics, a multi-scale model for the sickle red blood cells (SS-RBCs), accounting for diversity in both shapes and cell rigidities, is developed to investigate the mechanism of vaso-occlusion crisis. Using this model, the adhesive dynamics of single SS-RBC was investigated in arterioles. Simulation results indicate that the different cell groups (deformable SS2 RBCs, rigid SS4 RBCs, leukocytes, etc.) exhibit heterogeneous adhesive behavior due to the different cell morphologies and membrane rigidities. We further simulate the tube flow of SS-RBC suspensions with different cell fractions. The more adhesive SS2 cells interact with the vascular endothelium and further trap rigid SS4 cells, resulting in vaso-occlusion in vessels less than 15 μm . Under inflammation, adherent leukocytes may also trap SS4 cells, resulting in vaso-occlusion in even larger vessels. This work was supported by the NSF grant CBET-0852948 and the NIH grant R01HL094270.

Mesiodistal tooth angulation to segmental occlusal plane in panoramic radiography

International Nuclear Information System (INIS)

Kim, Jae Duk; Kim, Jin Soo; You, Choong Hyun

2005-01-01

To evaluate the stability of the segmental occlusal plane and anatomical line as the reference line for measuring the mesiodistal tooth angulation in panoramic radiography and to determine the mean angle and the range of the mesiodistal tooth angulation in Korean population with normal occlusions. Twenty nine subjects (15 men, 14 women) with normal occlusion were selected. A total of 29 panoramic radiograms were taken at normal head position and then 10 images of 5 subjects selected were repeatedly taken with repositioning 2 times at each of the head down (V-shaped occlusion) and up (horizontal occulsion) for evaluation of stability of adopted reference lines by using PM2002CC (Planmeca, Finland). The images were traced with adoption of two test reference lines and the long axes of the teeth. The mesial angles formed by each reference line and the long axes of the teeth were measured and analyzed. With anatomical reference line, the mesiodistal tooth angulations of the molars showed the significant difference by over 5 degree between the normal and each changed head position. With segmented occlusal reference line, deviations of mesiodistal tooth angulations by the two changed head positions were less than 1 degree. The means, standard deviations, and maximum and minimum values of mesiodistal tooth angulations to segmental occlusal reference line on panoramic radiography were determined. It would appear that mesiodistal tooth angulations to segmental occlusal plane as reference line in panograms are predictable as standards of normal occlusion and useful for evaluation of tooth arrangement between adjacent teeth.

Mesiodistal tooth angulation to segmental occlusal plane in panoramic radiography

Energy Technology Data Exchange (ETDEWEB)

Kim, Jae Duk; Kim, Jin Soo; You, Choong Hyun [Chosun University College of Medicine, Kwangju (Korea, Republic of)

2005-03-15

To evaluate the stability of the segmental occlusal plane and anatomical line as the reference line for measuring the mesiodistal tooth angulation in panoramic radiography and to determine the mean angle and the range of the mesiodistal tooth angulation in Korean population with normal occlusions. Twenty nine subjects (15 men, 14 women) with normal occlusion were selected. A total of 29 panoramic radiograms were taken at normal head position and then 10 images of 5 subjects selected were repeatedly taken with repositioning 2 times at each of the head down (V-shaped occlusion) and up (horizontal occulsion) for evaluation of stability of adopted reference lines by using PM2002CC (Planmeca, Finland). The images were traced with adoption of two test reference lines and the long axes of the teeth. The mesial angles formed by each reference line and the long axes of the teeth were measured and analyzed. With anatomical reference line, the mesiodistal tooth angulations of the molars showed the significant difference by over 5 degree between the normal and each changed head position. With segmented occlusal reference line, deviations of mesiodistal tooth angulations by the two changed head positions were less than 1 degree. The means, standard deviations, and maximum and minimum values of mesiodistal tooth angulations to segmental occlusal reference line on panoramic radiography were determined. It would appear that mesiodistal tooth angulations to segmental occlusal plane as reference line in panograms are predictable as standards of normal occlusion and useful for evaluation of tooth arrangement between adjacent teeth.

Arterial occlusive disease after radiotherapy

International Nuclear Information System (INIS)

Piedbois, P.; Mazeron, J.J.; Le Bourgeois, J.P.; Becquemin, J.P.; Blanc, I.; Lange, F.; Melliere, D.

1990-01-01

Fourteen cases of arterial occlusion or severe narrowing following radiotherapy are studied in order to assess the possible etiological role of such therapy in arterial lesion. Surgical results are also discussed in terms of long-term efficacy. The average time of occurrence after radiotherapy was 8 years post-radiotherapy. This series includes 7 supra-aortic trunk stenoses and 7 abdominal aorta trunk stenoses. The doses received in the volumes iradiated ranged from 47 to 70 Gy with standard fractionation. Association of atherosclerotic risk factors was present in 12 patients, but stenoses were usually confined to irradiated areas, and at imes occurred in uncommon sites. Surgical management included 11 by-passes, 2 endarterectomies and one percutaneous transluminal angioplasty. All patients experienced immediate and satisfactory functional improvements. Three patients were re-operated on because of the re-occlusion of the by-pass and graft infection. On the whole, stenoses in previously irradiated areas showed no particular difficulties for surgical treatment. It was concluded that radiotherapy seems to be a definite risk factor for arterial occlusion or narrowing, especially in association in association with atherosclerotic risk factors. (author). 45 refs.; 3 figs.; 2 tabs

Outcomes of the single-stent versus kissing-stents technique in asymmetric complex aortoiliac bifurcation lesions.

Science.gov (United States)

Suh, Yongsung; Ko, Young-Guk; Shin, Dong-Ho; Kim, Jung-Sun; Kim, Byeong-Keuk; Choi, Donghoon; Hong, Myeong-Ki; Jang, Yangsoo

2015-07-01

This study investigated the outcomes of single-stent vs kissing-stents techniques in asymmetric complex aortoiliac bifurcation (ACAB) lesions. We retrospectively investigated 80 consecutive patients (69 males, 66.6 ± 8.7 years) treated with a single stent and 30 patients (26 males, 67.1 ± 7.7 years) treated with kissing stents for ACAB between January 2005 and December 2012 from a single-center cohort. A ACAB lesion was defined as a symptomatic unilateral common iliac artery stenosis (>50%) combined with intermediate stenosis (30%-50%) in the contralateral common iliac artery ostium. The primary end point was the primary patency of the ACAB. The baseline clinical characteristics did not differ significantly between the single-stent and the kissing-stents group. Technical success was achieved in all patients. The single-stent group required fewer stents (1.3 ± 0.5 vs 2.3 ± 0.8; P stent group (3%) required bailout kissing stents because of plaque shift to the contralateral side. The major complication rates were 8% in single-stent vs 13% in the kissing-stent group, which was similar (P = .399). At 3 years, the single-stent and kissing-stents group had similar rates of primary patency (89% vs 87%; P = .916) and target lesion revascularization-free survival (93% vs 87%; P = .462). The single-stent technique in ACAB was safe and showed midterm outcomes comparable with those of kissing stents. Considering the benefits, such as fewer stents, less bilateral femoral access, and the availability of contralateral access for future intervention, the single-stent technique may be an advantageous treatment option in ACAB. Copyright © 2015 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

Sealing Occlusal Dentin Caries in Permanent Molars

DEFF Research Database (Denmark)

Qvist, Vibeke; Borum, Mette Kit; Møller, Kirsten Dynes

2017-01-01

The purpose of this study was to investigate the possibility of postponing restorative intervention of manifest occlusal caries in young, permanent dentition by non-invasive sealing. This RCT-designed study included 521 occlusal lesions in 521 patients aged 6 to 17 y. Based on clinical and radiog......The purpose of this study was to investigate the possibility of postponing restorative intervention of manifest occlusal caries in young, permanent dentition by non-invasive sealing. This RCT-designed study included 521 occlusal lesions in 521 patients aged 6 to 17 y. Based on clinical...... longevity of sealings and restorations until retreatments, and 3) compare effectiveness of sealings and restorations to halt caries progression in sealed lesions and beneath restorations. Furthermore, we aimed to identify factors influencing longevity and the effectiveness of sealings and restorations.......001). The median survival time for sealings not replaced by restorations was 7.3 y (CI, 6.4 y to NA). Survival of sealings was increased in patients with low caries risk and/or excellent oral hygiene, second molars compared with first molars, and lesions not extending the middle one-third of the dentin. Survival...

Bilateral retinal vein occlusion and rubeosis irides: lessons to learn.

Science.gov (United States)

Md Noh, Umi Kalthum; Ahem, Amin; Mustapha, Mushawiahti

2013-01-01

Uncontrolled hypertension is well- known to give rise to systemic complications involving multiple central organs. Artherosclerosis leads to damage of the retinal vessels wall, contributing to venous stasis, thrombosis and finally, occlusion. Retinal vein occlusions compromise vision through development of ischaemic maculopathy, macular oedema, and rubeotic glaucoma. Laser photocoagulation remains the definitive treatment for ischaemic vein occlusion with secondary neovascularization. Timely treatment with anti- vascular endothelial growth factor prevents development of rubeotic glaucoma. We hereby report an unusual case of bilateral retinal vein occlusion complicated by rubeosis irides, which was successfully managed to improve vision and prevent rubeotic glaucoma.

Comorbidity in patients with branch retinal vein occlusion

DEFF Research Database (Denmark)

Bertelsen, Mette; Linneberg, Allan; Rosenberg, Thomas

2012-01-01

To evaluate comorbidity before and after the diagnosis of branch retinal vein occlusion to determine whether it is a consequence of arterial thickening and therefore could serve as a diagnostic marker for other comorbidities and to evaluate the risk factors for the development of such occlusion....

Occlusion-Aware Fragment-Based Tracking With Spatial-Temporal Consistency.

Science.gov (United States)

Sun, Chong; Wang, Dong; Lu, Huchuan

2016-08-01

In this paper, we present a robust tracking method by exploiting a fragment-based appearance model with consideration of both temporal continuity and discontinuity information. From the perspective of probability theory, the proposed tracking algorithm can be viewed as a two-stage optimization problem. In the first stage, by adopting the estimated occlusion state as a prior, the optimal state of the tracked object can be obtained by solving an optimization problem, where the objective function is designed based on the classification score, occlusion prior, and temporal continuity information. In the second stage, we propose a discriminative occlusion model, which exploits both foreground and background information to detect the possible occlusion, and also models the consistency of occlusion labels among different frames. In addition, a simple yet effective training strategy is introduced during the model training (and updating) process, with which the effects of spatial-temporal consistency are properly weighted. The proposed tracker is evaluated by using the recent benchmark data set, on which the results demonstrate that our tracker performs favorably against other state-of-the-art tracking algorithms.

Celiac artery stenosis/occlusion treated by interventional radiology

International Nuclear Information System (INIS)

Ikeda, Osamu; Tamura, Yoshitaka; Nakasone, Yutaka; Yamashita, Yasuyuki

2009-01-01

Severe stenosis/occlusion of the proximal celiac trunk due to median arcuate ligament compression (MALC), arteriosclerosis, pancreatitis, tumor invasion, and celiac axis agenesis has been reported. However, clinically significant ischemic bowel disease attributable to celiac axis stenosis/occlusion appears to be rare because the superior mesenteric artery (SMA) provides for rich collateral circulation. In patients with celiac axis stenosis/occlusion, the most important and frequently encountered collateral vessels from the SMA are the pancreaticoduodenal arcades. Patients with celiac artery stenosis/occlusion are treated by interventional radiology (IR) via dilation of the pancreaticoduodenal arcade. In patients with dilation of the pancreaticoduodenal arcade on SMA angiograms, IR through this artery may be successful. Here we provide several tips on surmounting these difficulties in IR including transcatheter arterial chemoembolization for hepatocellular carcinoma, an implantable port system for hepatic arterial infusion chemotherapy to treat metastatic liver tumors, coil embolization of pancreaticoduodenal artery aneurysms, and arterial stimulation test with venous sampling for insulinomas.

Celiac artery stenosis/occlusion treated by interventional radiology

Energy Technology Data Exchange (ETDEWEB)

Ikeda, Osamu [Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, 1-1-1, Honjo Kumamoto 860-8505 (Japan)], E-mail: osamu-3643ik@do9.enjoy.ne.jp; Tamura, Yoshitaka; Nakasone, Yutaka; Yamashita, Yasuyuki [Department of Diagnostic Radiology, Kumamoto University Graduate School of Medical and Pharmaceutical Sciences, 1-1-1, Honjo Kumamoto 860-8505 (Japan)

2009-08-15

Severe stenosis/occlusion of the proximal celiac trunk due to median arcuate ligament compression (MALC), arteriosclerosis, pancreatitis, tumor invasion, and celiac axis agenesis has been reported. However, clinically significant ischemic bowel disease attributable to celiac axis stenosis/occlusion appears to be rare because the superior mesenteric artery (SMA) provides for rich collateral circulation. In patients with celiac axis stenosis/occlusion, the most important and frequently encountered collateral vessels from the SMA are the pancreaticoduodenal arcades. Patients with celiac artery stenosis/occlusion are treated by interventional radiology (IR) via dilation of the pancreaticoduodenal arcade. In patients with dilation of the pancreaticoduodenal arcade on SMA angiograms, IR through this artery may be successful. Here we provide several tips on surmounting these difficulties in IR including transcatheter arterial chemoembolization for hepatocellular carcinoma, an implantable port system for hepatic arterial infusion chemotherapy to treat metastatic liver tumors, coil embolization of pancreaticoduodenal artery aneurysms, and arterial stimulation test with venous sampling for insulinomas.

Endovascular strategy for the elective treatment of concomitant aortoiliac aneurysm and symptomatic large bowel diverticular disease.

Science.gov (United States)

Illuminati, Giulio; Ricco, Jean-Baptiste; Schneider, Fabrice; Caliò, Francesco G; Ceccanei, Gianluca; Pacilè, Maria A; Pizzardi, Giulia; Palumbo, Piergaspare; Vietri, Francesco

2014-07-01

The purpose of this study was to evaluate the strategy for treatment of patients presenting with asymptomatic diverticular disease of the large bowel associated with an asymptomatic aortoiliac aneurysmal (AAA) disease. Sixty-nine patients were included in this retrospective study. The patients were divided into 5 groups according to the type and sequence of the surgical treatment: 32 patients (47%) underwent colectomy followed by a staged open AAA repair (group A); 10 patients (14%) were treated with open AAA repair followed by a staged colectomy (group B); 13 patients (18%) received endovascular aneurysm repair (EVAR) followed by a staged bowel resection (group C); 8 patients (12%) had a bowel resection followed by staged EVAR (group D); and 6 patients (9%) underwent simultaneous open AAA repair and bowel resection (group E). Primary end points were mortality and complications after any of the procedures. Secondary end point was the time interval between the staged procedures. The cumulative death rate for delayed treatment of AAA was 6.5% and 0% for delayed treatment of diverticular disease [P=0.22]. The mean time interval between the staged procedures was 11 days for EVAR/colon resection (group C and group D) and 73 days for open AAA repair/colon resection (group A and group B; P<0.01). EVAR allows a significant reduction in the time required between AAA repair and colon resection, but no definite rule can be established regarding the sequence of staged procedures. Combined procedures should be reserved for selected cases. Copyright © 2014 Elsevier Inc. All rights reserved.

Does partial occlusion promote normal binocular function?

Science.gov (United States)

Li, Jingrong; Thompson, Benjamin; Ding, Zhaofeng; Chan, Lily Y L; Chen, Xiang; Yu, Minbin; Deng, Daming; Hess, Robert F

2012-10-03

There is growing evidence that abnormal binocular interactions play a key role in the amblyopia syndrome and represent a viable target for treatment interventions. In this context the use of partial occlusion using optical devices such as Bangerter filters as an alternative to complete occlusion is of particular interest. The aims of this study were to understand why Bangerter filters do not result in improved binocular outcomes compared to complete occlusion, and to compare the effects of Bangerter filters, optical blur and neutral density (ND) filters on normal binocular function. The effects of four strengths of Bangerter filters (0.8, 0.6, 0.4, 0.2) on letter and vernier acuity, contrast sensitivity, stereoacuity, and interocular suppression were measured in 21 observers with normal vision. In a subset of 14 observers, the partial occlusion effects of Bangerter filters, ND filters and plus lenses on stereopsis and interocular suppression were compared. Bangerter filters did not have graded effect on vision and induced significant disruption to binocular function. This disruption was greater than that of monocular defocus but weaker than that of ND filters. The effect of the Bangerter filters on stereopsis was more pronounced than their effect on monocular acuity, and the induced monocular acuity deficits did not predict the induced deficits in stereopsis. Bangerter filters appear to be particularly disruptive to binocular function. Other interventions, such as optical defocus and those employing computer generated dichoptic stimulus presentation, may be more appropriate than partial occlusion for targeting binocular function during amblyopia treatment.

CT findings of middle cerebral artery occlusion

International Nuclear Information System (INIS)

Shiokawa, Yoshiaki; Saito, Isamu; Segawa, Hiromu; Fujimaki, Takamitsu; Tsutsumi, Kazuo

1987-01-01

In each case, we selected the CT scan showing the maximum extent of the low-density area (LDA) during the course of the occlusion and classified the findings into the following five types: basal ganglia type, extensive subcortical type, hemispheric type, branch type, and normal (no LDA) type. The angiographic occlusion sites of MCA were divided into 4 patterns; the origin of MCA, the distal M1 portion, MCA trifurcation, and one branch of the M2. The overall mortality rate was 33 %, while the morbidity rate was 53 %. The older the patient, the poorer the prognosis. In the 17 cases of MCA-origin occlusion, 12 cases (71 %) showed the basal ganglia type of LDA; their prognoses varied. In the 12 cases of MCA trifurcation occlusion, 10 cases (83 %) revealed an extensive subcortical type of LDA, and all showed a poor prognosis. In the MCA occlusion, the angiography-CT correlation seemed to depend on where and how the occlusion had occurred. Cerebral thrombosis frequently occurred at the origin of MCA, while cerebral embolism was more usually found to occlude the MCA trifurcation. In order to assess the collateral circulation quantitatively, we determined the IC-M2 time, that is, the conduction time of the contrast media from the intracranial carotid siphone (IC) to the insular portion of the MCA (M2) through the leptomeningeal anastomosis. Of the 29 cases admitted within 24 hours after the onset and which yet showed no LDA on the initial CT scan, all 13 cases with IC-M2 times of less than 5 seconds showed the basal ganglia type of LDA. On the other hand, the 16 cases with IC-M2 times of more than 5 seconds always demonstrated a large LDA, of either the extensive subcortical type or the hemispheric type. This IC-M2 time is useful in anticipating the extent of infarction before a CT scan demonstrates LDA and in predicting a patient's prognosis in the acute stage. (J.P.N.)

CT findings of middle cerebral artery occlusion

Energy Technology Data Exchange (ETDEWEB)

Shiokawa, Yoshiaki; Saito, Isamu; Segawa, Hiromu; Fujimaki, Takamitsu; Tsutsumi, Kazuo

1987-04-01

In each case, we selected the CT scan showing the maximum extent of the low-density area (LDA) during the course of the occlusion and classified the findings into the following five types: basal ganglia type, extensive subcortical type, hemispheric type, branch type, and normal (no LDA) type. The angiographic occlusion sites of MCA were divided into 4 patterns; the origin of MCA, the distal M1 portion, MCA trifurcation, and one branch of the M2. The overall mortality rate was 33 %, while the morbidity rate was 53 %. The older the patient, the poorer the prognosis. In the 17 cases of MCA-origin occlusion, 12 cases (71 %) showed the basal ganglia type of LDA; their prognoses varied. In the 12 cases of MCA trifurcation occlusion, 10 cases (83 %) revealed an extensive subcortical type of LDA, and all showed a poor prognosis. In the MCA occlusion, the angiography-CT correlation seemed to depend on where and how the occlusion had occurred. Cerebral thrombosis frequently occurred at the origin of MCA, while cerebral embolism was more usually found to occlude the MCA trifurcation. In order to assess the collateral circulation quantitatively, we determined the IC-M2 time, that is, the conduction time of the contrast media from the intracranial carotid siphone (IC) to the insular portion of the MCA (M2) through the leptomeningeal anastomosis. Of the 29 cases admitted within 24 hours after the onset and which yet showed no LDA on the initial CT scan, all 13 cases with IC-M2 times of less than 5 seconds showed the basal ganglia type of LDA. On the other hand, the 16 cases with IC-M2 times of more than 5 seconds always demonstrated a large LDA, of either the extensive subcortical type or the hemispheric type. This IC-M2 time is useful in anticipating the extent of infarction before a CT scan demonstrates LDA and in predicting a patient's prognosis in the acute stage. (J.P.N.).

Occlusal accommodation and mouthguards for prevention of orofacial trauma.

Science.gov (United States)

Geary, Julian Lindsay; Clifford, Thomas Joseph; Kinirons, Martin James

2009-01-01

The aim of this study was to investigate the effect of two types of occlusal accommodation on the arch separation in centric and eccentric arch positions and to assess the opposing tooth contacts in professionally made, thermoformed sports mouthguards. Maxillary and mandibular alginate impressions, a wax interocclusal record of centric occlusion together with maxillary/condylar face-bow registrations, were recorded clinically for 10 undergraduate dental students who are sports activist volunteers of the School of Medicine and Dentistry, Queen's University Belfast. Two ethylene vinyl acetate thermoformed maxillary mouthguards were made for each player (N = 20) using a standardised procedure. Ten mouthguards served both as the control (i.e. the non-accommodated) group and also the accommodated, occlusally 'imprinted' group. The other 10 mouthguards served as the accommodated, occlusally 'ground' group. Casts were articulated, each non-accommodated and accommodated mouthguard was seated and the extent of the interocclusal opening was recorded in all three arch relationships. The number of mouthguard and mandibular tooth contacts were also recorded in each position. The increased vertical occlusal dimension that was found in the presence of non-accommodated mouthguards equated to the full-sheet thickness of the material that was used to form the mouthguards. Only mouthguards accommodated by grinding retained high levels of occlusal contact in all arch relationships that were tested. Within the limitations of this study, the modification of the occlusal surface made by flat grinding reduced the arch separation in eccentric movements and increased the opposing tooth contacts in custom-made mouthguards. This may contribute to increased comfort, compliance and the protective effect of these appliances thus resulting in a reduction of injuries to the teeth, arches and soft tissues.

Occlusion-amblyopia following high dose oral levodopa combined with part time patching

OpenAIRE

Mihir Kothari

2014-01-01

Part time occlusion therapy is not reported to cause occlusion (reverse) amblyopia. However, when combined with high dose oral levodopa, an increase in the plasticity of the visual cortex can lead to occlusion amblyopia. In this case report, we describe a six year old child who developed occlusion amblyopia following part time patching combined with oral levodopa.

Occlusion-amblyopia following high dose oral levodopa combined with part time patching.

Science.gov (United States)

Kothari, Mihir

2014-12-01

Part time occlusion therapy is not reported to cause occlusion (reverse) amblyopia. However, when combined with high dose oral levodopa, an increase in the plasticity of the visual cortex can lead to occlusion amblyopia. In this case report, we describe a six year old child who developed occlusion amblyopia following part time patching combined with oral levodopa.

Shape tracking with occlusions via coarse-to-fine region-based sobolev descent

KAUST Repository

Yang, Yanchao

2015-05-01

We present a method to track the shape of an object from video. The method uses a joint shape and appearance model of the object, which is propagated to match shape and radiance in subsequent frames, determining object shape. Self-occlusions and dis-occlusions of the object from camera and object motion pose difficulties to joint shape and appearance models in tracking. They are unable to adapt to new shape and appearance information, leading to inaccurate shape detection. In this work, we model self-occlusions and dis-occlusions in a joint shape and appearance tracking framework. Self-occlusions and the warp to propagate the model are coupled, thus we formulate a joint optimization problem. We derive a coarse-to-fine optimization method, advantageous in tracking, that initially perturbs the model by coarse perturbations before transitioning to finer-scale perturbations seamlessly. This coarse-to-fine behavior is automatically induced by gradient descent on a novel infinite-dimensional Riemannian manifold that we introduce. The manifold consists of planar parameterized regions, and the metric that we introduce is a novel Sobolev metric. Experiments on video exhibiting occlusions/dis-occlusions, complex radiance and background show that occlusion/dis-occlusion modeling leads to superior shape accuracy. © 2014 IEEE.

Identification and adjustment of experimental occlusal interference using functional magnetic resonance imaging.

Science.gov (United States)

Oda, Masafumi; Yoshino, Kenichi; Tanaka, Tatsurou; Shiiba, Shunji; Makihara, Eri; Miyamoto, Ikuya; Nogami, Shinnosuke; Kito, Shinji; Wakasugi-Sato, Nao; Matsumoto-Takeda, Shinobu; Nishimura, Shun; Murakami, Keita; Koga, Masahiro; Kawagishi, Shigenori; Yoshioka, Izumi; Masumi, Shin-Ichi; Kimura, Mitsutaka; Morimoto, Yasuhiro

2014-10-10

The purpose of this study was to use functional magnetic resonance imaging (fMRI) to quantify changes in brain activity during experimental occlusal interference. Fourteen healthy volunteers performed a rhythmical tapping occlusion task with experimental occlusal interference of the right molar tooth at 0 mm (no occlusion), 0.5 mm, and 0.75 mm. The blood-oxygen-level dependent (BOLD) signal was quantified using statistical parametric mapping and compared between rest periods and task periods. In tapping tasks with experimental occlusal interference of 0.75 mm or 0.5 mm, there was clear activation of the contralateral teeth-related primary sensory cortex and Brodmann's area 46. At 0 and 30 minutes after removal of the experimental occlusal interference, the activation clearly appeared in the bilateral teeth-related primary sensory cortices and Brodmann's area 46. At 60 minutes after the removal of the experimental occlusal interference, the activation of Brodmann's area 46 had disappeared, and only the bilateral teeth-related primary sensory cortices were active. The present results suggest that adjustments for experimental occlusal interference can be objectively evaluated using fMRI. We expect that this method of evaluating adjustments in occlusal interference, combined with fMRI and the tapping task, could be applied clinically in the future.

Carotid near-occlusion frequently has high peak systolic velocity on Doppler ultrasound

Energy Technology Data Exchange (ETDEWEB)

Khangure, Simon R.; Machnowska, Matylda; Fox, Allan J.; Hojjat, Seyed-Parsa; Aviv, Richard I. [Sunnybrook Health Sciences Centre, Department of Medical Imaging, Neuroradiology Division, Toronto, ON (Canada); University of Toronto, Department of Medical Imaging, Division of Neuroimaging, Toronto (Canada); Benhabib, Hadas [Sunnybrook Health Sciences Centre, Department of Medical Imaging, Neuroradiology Division, Toronto, ON (Canada); Groenlund, Christer [Umeaa University, Department of Radiation Sciences, Biomedical Engineering, Umeaa (Sweden); Herod, Wendy [Department of Surgery, Sunnybrook Health Sciences Centre, Toronto (Canada); Maggisano, Robert [Department of Surgery, Sunnybrook Health Sciences Centre, Toronto (Canada); University of Toronto, Division of Vascular Surgery, Department of Surgery, Toronto (Canada); Sjoeberg, Anders [Umeaa University, Department of Radiation Sciences, Biomedical Engineering, Umeaa (Sweden); Umeaa University, Department of Pharmacology and Clinical Neuroscience, Umeaa (Sweden); Wester, Per [Umeaa University, Department of Public Health and Clinical Medicine, Umeaa (Sweden); Karolinska Institutet Danderyds Hospital, Department of Clinical Sciences, Stockholm (Sweden); Hopyan, Julia [University of Toronto, Division of Neurology, Department of Medicine, Toronto (Canada); Johansson, Elias [Umeaa University, Department of Pharmacology and Clinical Neuroscience, Umeaa (Sweden); Umeaa University, Department of Public Health and Clinical Medicine, Umeaa (Sweden)

2018-01-15

Carotid near-occlusion is a tight atherosclerotic stenosis of the internal carotid artery (ICA) resulting in decrease in diameter of the vessel lumen distal to the stenosis. Near-occlusions can be classified as with or without full collapse, and may have high peak systolic velocity (PSV) across the stenosis, mimicking conventional > 50% carotid artery stenosis. We aimed to determine how frequently near-occlusions have high PSV in the stenosis and determine how accurately carotid Doppler ultrasound can distinguish high-velocity near-occlusion from conventional stenosis. Included patients had near-occlusion or conventional stenosis with carotid ultrasound and CT angiogram (CTA) performed within 30 days of each other. CTA examinations were analyzed by two blinded expert readers. Velocities in the internal and common carotid arteries were recorded. Mean velocity, pulsatility index, and ratios were calculated, giving 12 Doppler parameters for analysis. Of 136 patients, 82 had conventional stenosis and 54 had near-occlusion on CTA. Of near-occlusions, 40 (74%) had high PSV (≥ 125 cm/s) across the stenosis. Ten Doppler parameters significantly differed between conventional stenosis and high-velocity near-occlusion groups. However, no parameter was highly sensitive and specific to separate the groups. Near-occlusions frequently have high PSV across the stenosis, particularly those without full collapse. Carotid Doppler ultrasound does not seem able to distinguish conventional stenosis from high-velocity near-occlusion. These findings question the use of ultrasound alone for preoperative imaging evaluation. (orig.)

Object tracking by occlusion detection via structured sparse learning

KAUST Repository

Zhang, Tianzhu; Ghanem, Bernard; Xu, Changsheng; Ahuja, Narendra

2013-01-01

occlusion through structured sparse learning. We test our tracker on challenging benchmark sequences, such as sports videos, which involve heavy occlusion, drastic illumination changes, and large pose variations. Experimental results show that our tracker

Robust 3D Face Recognition in the Presence of Realistic Occlusions

NARCIS (Netherlands)

Alyuz, Nese; Gökberk, B.; Spreeuwers, Lieuwe Jan; Veldhuis, Raymond N.J.; Akarun, Lale

2012-01-01

Facial occlusions pose significant problems for automatic face recognition systems. In this work, we propose a novel occlusion-resistant three-dimensional (3D) facial identification system. We show that, under extreme occlusions due to hair, hands, and eyeglasses, typical 3D face recognition systems

Discordant relationship between Essure microinsert position and tubal occlusion.

Science.gov (United States)

Hou, Melody Y

2016-07-27

Hysteroscopic sterilisation with Essure requires confirmation of tubal occlusion by hysterosalpingogram or microinsert position by transvaginal sonography 3 months after placement before women can rely on the method for pregnancy prevention. A 39-year-old woman underwent hysteroscopic sterilisation via Essure, with successful bilateral tubal occlusion documented on hysterosalpingogram. She had a subsequent unintended pregnancy and termination, and presented with persistent pelvic pain and other non-specific symptoms. She underwent a laparoscopic-assisted vaginal hysterectomy with bilateral salpingectomy, with complete resolution of her symptoms. Pathological evaluation demonstrated a perforated Essure microinsert and ipsilateral tubal occlusion, and a correctly placed Essure microinsert with ipsilateral tubal patency. Clinicians should be cautious about the assumption that correctly placed microinserts based on ultrasonography, hysterosalpingogram or laparoscopic evaluation assures occlusion success. 2016 BMJ Publishing Group Ltd.

Adaptive Self-Occlusion Behavior Recognition Based on pLSA

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Hong-bin Tu

2013-01-01

Full Text Available Human action recognition is an important area of human action recognition research. Focusing on the problem of self-occlusion in the field of human action recognition, a new adaptive occlusion state behavior recognition approach was presented based on Markov random field and probabilistic Latent Semantic Analysis (pLSA. Firstly, the Markov random field was used to represent the occlusion relationship between human body parts in terms an occlusion state variable by phase space obtained. Then, we proposed a hierarchical area variety model. Finally, we use the topic model of pLSA to recognize the human behavior. Experiments were performed on the KTH, Weizmann, and Humaneva dataset to test and evaluate the proposed method. The compared experiment results showed that what the proposed method can achieve was more effective than the compared methods.

Percutaneous Retrograde Recanalization of the Celiac Artery by Way of the Superior Mesenteric Artery for Chronic Mesenteric Ischemia

International Nuclear Information System (INIS)

Joseph, George; Chacko, Sujith Thomas

2013-01-01

A 52-year-old man presented with recurrent postprandial abdominal pain, sitophobia, and progressive weight loss. Chronic mesenteric ischemia (CMI) due to subtotal occlusion of the superior mesenteric artery (SMA) and flush occlusion of the celiac artery (CA) was diagnosed. Retrograde recanalization of the CA by way of a collateral channel from the SMA was performed using contemporary recanalization equipment. The CA and SMA were then stented, resulting in sustained resolution of CMI-related symptoms.

Occlusion-amblyopia following high dose oral levodopa combined with part time patching

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Mihir Kothari

2014-01-01

Full Text Available Part time occlusion therapy is not reported to cause occlusion (reverse amblyopia. However, when combined with high dose oral levodopa, an increase in the plasticity of the visual cortex can lead to occlusion amblyopia. In this case report, we describe a six year old child who developed occlusion amblyopia following part time patching combined with oral levodopa.

Anesthetic management of descending thoracic aortobifemoral bypass for aortoiliac occlusive disease: Our experience

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Anjum Saiyed

2014-01-01

Full Text Available Background: Complete obstruction of the abdominal aorta at the renal artery level is a difficult surgical problem. Aortic clamping and declamping can lead to profound haemodynamic changes, myocardial infarction, ventricular failure or even death may result. These complications are important challenges in anesthetic management of these patients. Methods :0 Between August, 2010 and April, 2012, descending thoracic aorta to femoral artery bypass grafting was used to revascularize lower limbs in 11 patients in our institute. The anesthetic management of these patients is described here. Epidural catheter placement was done in T 5-6 or T 6-7 space for post operative pain relief. Induction was done by, Inj. Glycopyrolate 0.2 mg, Inj. Fentanyl 5 μg/kg., Inj. Pentothal sodium 5 mg/kg, Inj. Rocuronium 0.9 mg/kg, IPPV done. Left sided double lumen tube was inserted, Maintenance of Anesthesia was done by O 2 + N 2 O (30:70. Increments of Vecuronium and Fentanyl were given Monitoring of Heart rate, arterial pressure, central venous pressure were continuously displayed. The available pharmacological agents were used when there is deviation of more than 15% from base line. Results: In our study, inspite of measures taken to control rise in blood pressure during aortic cross clamping, a rise of 90 mm of Hg in one patient and 60-80 mm of Hg in four patients was observed, which was managed by sodium nitropruside infusion. At the end of surgery seven patients were extubated on the operation table. In remaining four patients DLT was replaced by single lumen endotracheal tube and were shifted to ICU on IPPV. They weaned off gradually in 3-5 hours. In our series blood loss was 400 ml to 1000 ml. There was no mortality in the first 24 hours. Postoperative bleeding was reported in one case which was re-explored and stood well. Conclusion: The anesthetic technique during aortic surgery is directed at minimizing the hemodynamic effects of cross clamping in order to maintain the myocardial oxygen supply demand ratio.

Improving prediction of recanalization in acute large-vessel occlusive stroke.

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Vanacker, P; Lambrou, D; Eskandari, A; Maeder, P; Meuli, R; Ntaios, G; Michel, P

2014-06-01

Recanalization in acute ischemic stroke with large-vessel occlusion is a potent indicator of good clinical outcome. To identify easily available clinical and radiologic variables predicting recanalization at various occlusion sites. All consecutive, acute stroke patients from the Acute STroke Registry and Analysis of Lausanne (2003-2011) who had a large-vessel occlusion on computed tomographic angiography (CTA) (< 12 h) were included. Recanalization status was assessed at 24 h (range: 12-48 h) with CTA, magnetic resonance angiography, or ultrasonography. Complete and partial recanalization (corresponding to the modified Treatment in Cerebral Ischemia scale 2-3) were grouped together. Patients were categorized according to occlusion site and treatment modality. Among 439 patients, 51% (224) showed complete or partial recanalization. In multivariate analysis, recanalization of any occlusion site was most strongly associated with endovascular treatment, including bridging therapy (odds ratio [OR] 7.1, 95% confidence interval [CI] 2.2-23.2), and less so with intravenous thrombolysis (OR 1.6, 95% CI 1.0-2.6) and recanalization treatments performed beyond guidelines (OR 2.6, 95% CI 1.2-5.7). Clot location (large vs. intermediate) and tandem pathology (the combination of intracranial occlusion and symptomatic extracranial stenosis) were other variables discriminating between recanalizers and non-recanalizers. For patients with intracranial occlusions, the variables significantly associated with recanalization after 24 h were: baseline National Institutes of Health Stroke Scale (NIHSS) (OR 1.04, 95% CI 1.02-1.1), Alberta Stroke Program Early CT Score (ASPECTS) on initial computed tomography (OR 1.2, 95% CI 1.1-1.3), and an altered level of consciousness (OR 0.2, 95% CI 0.1-0.5). Acute endovascular treatment is the single most important factor promoting recanalization in acute ischemic stroke. The presence of extracranial vessel stenosis or occlusion decreases

Hypothalamic digoxin, hemispheric chemical dominance, and mesenteric artery occlusion.

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Kurup, Ravi Kumar; Kurup, Paramesware Achutha

2003-12-01

The role of the isoprenoid pathway in vascular thrombosis, especially mesenteric artery occlusion and its relation to hemispheric dominance, was assessed in this study. The following parameters were measured in patients with mesenteric artery occlusion and individuals with right hemispheric, left hemispheric, and bihemispheric dominance: (1) plasma HMG CoA reductase, digoxin, dolichol, ubiquinone, and magnesium levels; (2) tryptophan/tyrosine catabolic patterns; (3) free radical metabolism; (4) glycoconjugate metabolism; and (5) membrane composition. In patients with mesenteric artery occlusion there was elevated digoxin synthesis, increased dolichol and glycoconjugate levels, low ubiquinone, and elevated free radical levels. The RBC membrane Na(+)-K+ ATPase activity and serum magnesium were decreased. There was also an increase in tryptophan catabolites and reduction in tyrosine catabolites in the serum. There was an increase in cholesterol:phospholipid ratio and a reduction in glycoconjugate level of RBC membrane in these patients. The biochemical patterns obtained in mesenteric artery occlusion is similar to those obtained in left-handed/right hemispheric dominant individuals by the dichotic listening test. But all the patients with mesenteric artery occlusion were right-handed/left hemispheric dominant by the dichotic listening test. Hemispheric chemical dominance has no correlation with handedness or the dichotic listening test. Mesenteric artery occlusion occurs in right hemispheric chemically dominant individuals and is a reflection of altered brain function. Hemispheric chemical dominance may thus control the risk for developing vascular thrombosis in individuals.

Increased carboxyhemoglobin level during liver resection with inflow occlusion.

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Godai, Kohei; Hasegawa-Moriyama, Maiko; Kuniyoshi, Tamotsu; Matsunaga, Akira; Kanmura, Yuichi

2013-04-01

Controlling stress responses associated with ischemic changes due to bleeding and ischemia/reperfusion injury is essential for anesthetic management. Endogenous carboxyhemoglobin (COHb) is produced in the oxidative degradation of heme proteins by the stress-response enzyme heme oxygenase. Although the COHb level is elevated in critically ill patients, changes in endogenous COHb during anesthesia have not been well investigated. Therefore, we evaluated changes in endogenous COHb levels in patients undergoing liver resections with inflow occlusion. Levels of COHb were significantly increased after the Pringle maneuver. The inflow occlusion time in patients with increased COHb after the Pringle maneuver (∆COHb > 0.3 %) was significantly longer than in patients without increased COHb (∆COHb < 0.3 %) (P = 0.01). In addition, COHb changes were correlated with inflow occlusion time (P = 0.005, R(2) = 0.21). Neither total blood loss, transfusion volume of packed red blood cells, operation time, nor anesthetic time differed between patients with and without increased COHb. The results indicated that endogenous COHb levels were increased by inflow occlusion in patients undergoing liver resections, which suggests that changes in COHb may correlate with hepatic ischemia/reperfusion injury induced by inflow occlusion.

Sickle cell vaso-occlusion in an animal model

International Nuclear Information System (INIS)

Kurantsin-Mills, J.; Jacobs, H.M.; Lessin, L.S.

1987-01-01

Sickle cell disease is clinically characterized with vaso-occlusive painful crisis which is pleomorphic in terms of frequency of occurrence. The intracellular polymerization of deoxygenated hemoglobin S increases the internal viscosity of the sickle cells exponentially, concurrent with binding of hemoglobin S to the membrane and discocyte-drepanocyte transformation. As a result, the red cells in sickle cell disease are heterogenous with cells of varying density and mean corpuscular hemoglobin concentration which alter the rheological features of the blood in the microcirculation. The cellular, physiological, biochemical and rheological factors that contribute to the vaso-occlusive events are not completely understood. Nonetheless, recent clinical studies have demonstrated that a certain fraction of the dense cells disappear during sickle cell painful crisis. In an attempt to elucidate some of the cellular and rheological factors involved in the initiation of vaso-occlusion, the authors have employed intravital videomicroscopy and radionuclide imaging of indium-III labeled sickle cells to determine the dynamics and sites of vaso-occlusion using the rat exchanged-transfused with sickle (HbSS) erythrocytes as a model

[Occlusion and posture: is there evidence of correlation?].

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Michelotti, A; Manzo, P; Farella, M; Martina, R

1999-11-01

The observation that the masticatory system and the postural body regulating system are anatomically and functionally related, has led to postulate several hypotheses of correlation between occlusal and postural disturbances. In the last decade, these arguments have gained a great social impact, also because they have been broadly spread by the mass-media. As a consequence, there has been a growing number of patients seeking concomitant occlusal and postural treatments. The aim of this study was to review critically the current evidence of correlation between the two systems; this in order to address clinical issues for the management of patients. Methodology of the studies reviewed has been evaluated according to the criteria suggested by Storey and Rugh 20 rif. Although there are some evidences of correlation between occlusion and posture, this appears limited to the cranio-cervical tract of the column and tends to disappear when descending in cranio-caudal direction. On the basis of this review of the literature, it's not advisable to treat postural imbalance by means of occlusal treatment or vice versa, particularly if the therapeutic modalities are irreversible.

Incidence, predicting factors, and clinical outcomes of periprocedural myocardial infarction after percutaneous coronary intervention for chronic total occlusion in the era of new-generation drug-eluting stents.

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Kim, Jin-Ho; Kim, Byeong-Keuk; Kim, Seunghwan; Ahn, Chul-Min; Kim, Jung-Sun; Ko, Young-Guk; Choi, Donghoon; Hong, Myeong-Ki; Jang, Yangsoo

2017-12-20

This study aimed to examine predictors and clinical outcomes of periprocedural myocardial infarction (PMI) after chronic total occlusion (CTO) intervention. There are limited data on the clinical implications of PMI after CTO intervention in the new-generation drug-eluting stent (DES) era. We enrolled 337 patients who underwent CTO intervention and met the study criteria. We evaluated the incidence and predictors of PMI, defined as an increase in creatine kinase-MB ≥3× the upper limit of normal (ULN) after intervention and compared the occurrence rates of major adverse cardiac and cerebrovascular events (MACCE, defined as the composite of cardiac death, myocardial infarction, stent thrombosis, target-vessel revascularization, or cerebrovascular accidents) between the PMI and non-PMI groups. PMI occurred in 23 (6.8%) patients after CTO intervention. Significant independent predictors were previous bypass surgery [odds ratio (OR) = 5.52, 95% confidence interval (CI) = 1.17-25.92; P = 0.03], Japan-CTO score ≥3 (OR = 7.06, 95%CI = 2.57-19.39; P PMI group had a significantly higher MACCE rate than the non-PMI group (23.7 vs. 5.6%, P = 0.008 by log-rank test). PMI was an independent predictor of MACCE (HR = 4.26, 95%CI = 1.35-13.43; P = 0.01). The MACCE rate gradually increased in a CK-MB-dependent fashion and was highest in patients with ≥10× ULN (P = 0.005). Previous bypass surgery, high Japan-CTO score, side branch occlusion, and longer procedure time were strongly related to PMI occurrence after CTO intervention. PMI was significantly associated with worse clinical outcomes in the new-generation DES era. © 2017 Wiley Periodicals, Inc.

Computer modeling of occlusal surfaces of posterior teeth with the CICERO CAD/CAM system.

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Olthoff, L W; Van Der Zel, J M; De Ruiter, W J; Vlaar, S T; Bosman, F

2000-08-01

Static and dynamic occlusal interference frequently needs to be corrected by selective grinding of the occlusal surface of conventional cast and ceramic-fused-to-metal restorations. CAD/CAM techniques allow control of the dimensional contours of these restorations. However, parameters responsible for the occlusal form need to be determined. In most articulators, these parameters are set as default values. Which technique is best for minimizing the introduction of occlusal interference in restorations has not been determined. This study investigated differences in crown structure of a crown designed in static occlusion (STA) with designs adapted for dynamic occlusal interferences. Therefore, values from an optoelectronic registration system (String-Condylocomp, KAVO), an occlusal generated path (OGP) technique and default settings (DEF) were used in the CICERO CAD/CAM system. Morphology of CON, DEF, and OGP crowns was compared with that of the STA crown with respect to differences in a buccolingual section and frequency of occlusal distances in an interocclusal range of 1 mm, measured from the occlusal surface of the crown. All crown types fulfilled the esthetic and morphologic criteria for restorations in clinical dentistry. Difference in the morphology of the OGP crown, compared with that of the STA crown, was greater than that for the CON and DEF crowns. These differences were seen especially in the distobuccal part of the occlusal surface; however, the number of occlusal contacts was considered sufficient to stabilize occlusion. Functional occlusion, adapted to dynamic occlusion in a CICERO crown for the first mandibular molar, can be obtained using data acquired with the String-Condylocomp registration system. The OGP technique was preferred to other techniques because of the simplicity of the technique for eliminating potential problems with opposing teeth during motion. However, this is achieved at the cost of fewer points of contact during occlusion than

Branch retinal artery occlusion in Susac's syndrome

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Ricardo Evangelista Marrocos de Aragão

2015-02-01

Full Text Available Susac's syndrome is a rare disease attribuited to a microangiopathy involving the arterioles of the cochlea, retina and brain. Encefalopathy, hearing loss, and visual deficits are the hallmarks of the disease. Visual loss is due to multiple, recurrent branch arterial retinal occlusions. We report a case of a 20-year-old women with Susac syndrome presented with peripheral vestibular syndrome, hearing loss, ataxia, vertigo, and vision loss due occlusion of the retinal branch artery.

Pathophysiological aspects of sickle cell vaso-occlusion

International Nuclear Information System (INIS)

Nagel, R.L.

1987-01-01

This book contains over 30 selections. Some of the titles are: An Animal Model for Sickle Cell Vaso-Occlusion: A Study Using NMR and Technetium Imaging; Sickle-Cell Vaso-Occlusion in an Animal Model: Intravital Microscopy and Radionuclide Imaging of Selective Sequestration of Dense Cells; Magnetic Resonance Imaging, Percentage of Dense Cells, and Serum Prostanoids as Tools for Objective Assessment of Pain Crisis: A Preliminary Report; and Painful Crisis and Dense Echinocytes: Effects of Hydration and Vasodilators

Experimental Branch Retinal Vein Occlusion Induces Upstream Pericyte Loss and Vascular Destabilization.

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Elisa Dominguez

Full Text Available Branch retinal vein occlusion (BRVO leads to extensive vascular remodeling and is important cause of visual impairment. Although the vascular morphological changes following experimental vein occlusion have been described in a variety of models using angiography, the underlying cellular events are ill defined.We here show that laser-induced experimental BRVO in mice leads to a wave of TUNEL-positive endothelial cell (EC apoptosis in the upstream vascular network associated with a transient edema and hemorrhages. Subsequently, we observe an induction of EC proliferation within the dilated vein and capillaries, detected by EdU incorporation, and the edema resolves. However, the pericytes of the upstream capillaries are severely reduced, which was associated with continuing EC apoptosis and proliferation. The vascular remodeling was associated with increased expression of TGFβ, TSP-1, but also FGF2 expression. Exposure of the experimental animals to hypoxia, when pericyte (PC dropout had occurred, led to a dramatic increase in endothelial cell proliferation, confirming the vascular instability induced by the experimental BRVO.Experimental BRVO leads to acute endothelial cells apoptosis and increased permeability. Subsequently the upstream vascular network remains destabilized, characterized by pericyte dropout, un-physiologically high endothelial cells turnover and sensitivity to hypoxia. These early changes might pave the way for capillary loss and subsequent chronic ischemia and edema that characterize the late stage disease.

Noise reduction technology reduces radiation dose in chronic total occlusions percutaneous coronary intervention: a propensity score-matched analysis.

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Maccagni, Davide; Benincasa, Susanna; Bellini, Barbara; Candilio, Luciano; Poletti, Enrico; Carlino, Mauro; Colombo, Antonio; Azzalini, Lorenzo

2018-03-23

Chronic total occlusions (CTO) percutaneous coronary intervention (PCI) is associated with high radiation dose. Our study aim was to evaluate the impact of the implementation of a noise reduction technology (NRT) on patient radiation dose during CTO PCI. A total of 187 CTO PCIs performed between February 2016 and May 2017 were analyzed according to the angiographic systems utilized: Standard (n = 60) versus NRT (n = 127). Propensity score matching (PSM) was performed to control for differences in baseline characteristics. Primary endpoints were Cumulative Air Kerma at Interventional Reference Point (AK at IRP), which correlates with patient's tissue reactions; and Kerma Area Product (KAP), a surrogate measure of patient's risk of stochastic radiation effects. An Efficiency Index (defined as fluoroscopy time/AK at IRP) was calculated for each procedure. Image quality was evaluated using a 5-grade Likert-like scale. After PSM, n = 55 pairs were identified. Baseline and angiographic characteristics were well matched between groups. Compared to the Standard system, NRT was associated with lower AK at IRP [2.38 (1.80-3.66) vs. 3.24 (2.04-5.09) Gy, p = 0.035], a trend towards reduction for KAP [161 (93-244) vs. 203 (136-363) Gycm 2 , p = 0.069], and a better Efficiency Index [16.75 (12.73-26.27) vs. 13.58 (9.92-17.63) min/Gy, p = 0.003]. Image quality was similar between the two groups (4.39 ± 0.53 Standard vs. 4.34 ± 0.47 NRT, p = 0.571). In conclusion, compared with a Standard system, the use of NRT in CTO PCI is associated with lower patient radiation dose and similar image quality.

Image Based Solution to Occlusion Problem for Multiple Robots Navigation

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Taj Mohammad Khan

2012-04-01

Full Text Available In machine vision, occlusions problem is always a challenging issue in image based mapping and navigation tasks. This paper presents a multiple view vision based algorithm for the development of occlusion-free map of the indoor environment. The map is assumed to be utilized by the mobile robots within the workspace. It has wide range of applications, including mobile robot path planning and navigation, access control in restricted areas, and surveillance systems. We used wall mounted fixed camera system. After intensity adjustment and background subtraction of the synchronously captured images, the image registration was performed. We applied our algorithm on the registered images to resolve the occlusion problem. This technique works well even in the existence of total occlusion for a longer period.

Microfluidics for investigating vaso-occlusions in sickle cell disease.

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Horton, Renita E

2017-07-01

SCD stems from amutation in the beta globin gene. Upon deoxygenation, hemoglobin polymerizes and triggers RBC remodeling. This phenomenon is central to SCD pathogenesis as individuals suffering from the disease are plagued by painful vaso-occlusive crises episodes. These episodes are the result of a combination of processes including inflammation, thrombosis, and blood cell adhesion to the vascular wall which leads to blockages within the vasculature termed vaso-occlusions. Vaso-occlusive episodes deprive tissues of oxygen and are a major contributor to SCD-related complications; unfortunately, the complex mechanisms that contribute to vaso-occlusions are not well understood. Vaso-occlusions can occur in post-capillary venules; hence, the microvasculature is a prime target for SCD therapies. Traditional in vitro systems poorly recapitulate architectural and dynamic flow properties of in vivo systems. However, microfluidic devices can capture features of the native vasculature such as cellular composition, flow, geometry, and ECM presentation. This review, although not comprehensive, highlights microfluidic approaches that aim to improve our current understanding of the pathophysiological mechanisms surrounding SCD. Microfluidic platforms can aid in identifying factors that may contribute to disease severity and can serve as suitable test beds for novel treatment strategies which may improve patient outcomes. © 2017 John Wiley & Sons Ltd.

Occlusal factors are not related to self-reported bruxism.

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Manfredini, Daniele; Visscher, Corine M; Guarda-Nardini, Luca; Lobbezoo, Frank

2012-01-01

To estimate the contribution of various occlusal features of the natural dentition that may identify self-reported bruxers compared to nonbruxers. Two age- and sex-matched groups of self-reported bruxers (n = 67) and self-reported nonbruxers (n = 75) took part in the study. For each patient, the following occlusal features were clinically assessed: retruded contact position (RCP) to intercuspal contact position (ICP) slide length ( 4 mm, a deep bite), horizontal overlap (> 4 mm was considered a large horizontal overlap), incisor dental midline discrepancy (bruxism (dependent variable). Accuracy values to predict self-reported bruxism were unacceptable for all occlusal variables. The only variable remaining in the final regression model was laterotrusive interferences (P = .030). The percentage of explained variance for bruxism by the final multiple regression model was 4.6%. This model including only one occlusal factor showed low positive (58.1%) and negative predictive values (59.7%), thus showing a poor accuracy to predict the presence of self-reported bruxism (59.2%). This investigation suggested that the contribution of occlusion to the differentiation between bruxers and nonbruxers is negligible. This finding supports theories that advocate a much diminished role for peripheral anatomical-structural factors in the pathogenesis of bruxism.

Contemporary treatment of patients with chronic total occlusion: critical appraisal of different state-of-the-art techniques and devices.

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García-García, Héctor M; Kukreja, Neville; Daemen, Joost; Tanimoto, Shuzou; van Mieghem, Carlos; Gonzalo, Nieves; van Weenen, Sander; van der Ent, Martin; Sianos, Georgios; de Feyter, Pim; Serruys, Patrick W

2007-08-01

To describe the contemporary approach of chronic total occlusion (CTO) treatment of patients at the Thoraxcenter, Rotterdam, The Netherlands. Additionally, to make a critical appraisal of the performance of state-of-the-art CTO dedicated guidewires and devices in a prospective registry of patients. During 20 months, a total of 160 consecutive patients (165 CTOs) were enrolled. The mean age was 61.5+/-11.1 years and 83.6% were male. In 91.5% of the patients this was the first attempt to open the CTO and 93.8% were de novo. The overall success rate was 60.6%. A median of 1 guiding catheter was used per case (Range: 1 to 9) and a median of 4 guidewires (Range: 1 to 11; 13 different types). 74.5% patients required more than one guidewire/device for the treatment of the CTO. The guidewires that most frequently crossed the CTO were the following: PT Graphix intermediate 33.0%, Miracle 3 g 27.4% and Crosswire NT 25.5%. The only device tested as a first option for the treatment of the CTOs was the CROSSER. Overall, the CROSSER system was used in 23 (13.9%) patients with a success rate of 60.9%. The Point 9(R) X-80 Laser catheter was used in 10 (6.1%) patients with a success rate of 60%. Another 3 patients were treated with the Point 7(R) laser catheter. Both were used either to facilitate the crossing of the balloon, or to treat primarily in-stent restenosis occlusions. The SafeCross(R) System was used in 15 (9.1%) patients and the success rate in these patients was 46.7%. The most common strategy used in this registry was the use of an over-the-wire balloon in 81.5% of the cases. The parallel wire technique was used in 27.3% of the cases and in 12.7% was converted into a "see-saw" technique. When a large false lumen was created, re-entry into the true lumen was attempted in 21.2% of the cases, by means of IVUS guided approach and/or the use of stiffer guidewires, such as a Confianza guidewire. Retrograde recanalisation was attempted in 10 cases (6.1%), in three cases a

Identification and adjustment of experimental occlusal interference using functional magnetic resonance imaging

OpenAIRE

Oda, Masafumi; Yoshino, Kenichi; Tanaka, Tatsurou; Shiiba, Shunji; Makihara, Eri; Miyamoto, Ikuya; Nogami, Shinnosuke; Kito, Shinji; Wakasugi-Sato, Nao; Matsumoto-Takeda, Shinobu; Nishimura, Shun; Murakami, Keita; Koga, Masahiro; Kawagishi, Shigenori; Yoshioka, Izumi

2014-01-01

Background The purpose of this study was to use functional magnetic resonance imaging (fMRI) to quantify changes in brain activity during experimental occlusal interference. Methods Fourteen healthy volunteers performed a rhythmical tapping occlusion task with experimental occlusal interference of the right molar tooth at 0 mm (no occlusion), 0.5 mm, and 0.75 mm. The blood-oxygen-level dependent (BOLD) signal was quantified using statistical parametric mapping and compared between rest period...

Selection of patients with infrainguinal arterial occlusive disease for percutaneous transluminal angioplasty with duplex scanning

International Nuclear Information System (INIS)

Bostroem Ardin, A.; Hellberg, A.; Ljungman, C.; Logason, K.; Karacagil, S.; Loefberg, A.M.; Andren, B.

2002-01-01

Aim: To evaluate the role of duplex scanning in the selection of patients with infrainguinal arterial occlusive disease for percutaneous transluminal angioplasty (PTA). Material and Methods: From January 1995 through May 2000, 702 patients (952 limbs), with chronic lower extremity ischemia due to infrainguinal atherosclerotic disease diagnosed by duplex scanning, were retrospectively studied. Diagnostic angiography (130 limbs) or infrainguinal PTA (108 limbs) was performed in 238 limbs. Two investigators retrospectively analyzed the duplex examinations and angiographies in a blinded manner and used similar criteria for the interpretation of lesions suitable or not suitable for PTA. Results: The superficial femoral, popliteal and crural artery lesions were correctly selected for PTA in 85%, 66% and 32%, respectively. The accuracy, sensitivity, specificity, negative predictive value and positive predictive value of duplex scanning to appropriately categorize femoropopliteal lesions as suitable or unsuitable for PTA were 89%, 83%, 92%, 94% and 78%, respectively. The accuracy of duplex scanning for predicting the performance of infrainguinal PTA was 83%. Conclusion: Duplex scanning has an important impact on the selection of treatment modalities in limbs with infrainguinal arterial occlusive disease. Femoropopliteal lesions can be reliably selected to PTA according to duplex scan findings

A novel method to determine perineal artery occlusion among male bicyclists.

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Parthiban, Sujeeth; Hotaling, James M; Kathrins, Martin; Baftiri, Amit P; Freels, Sally; Niederberger, Craig S

2015-01-01

Background. Perineal pressure due to bicycle riding has been associated with erectile dysfunction. We developed a novel method to measure the occlusive force exerted over the perineal arteries and determined perineal artery occlusion by a variety of seat designs. Methods. Doppler ultrasonography facilitated perineal artery localization and determination of the force required for perineal artery occlusion in 20 healthy men. Flexiforce(®) sensors were affixed over the proximal and distal aspects of the perineal arteries bilaterally. Individuals completed bicycle rides in the road- and stationary-settings with six distinct seat designs, including those with and without an anterior "nose." Results. The occlusion time proportion of the total ride time was calculated for each trial. The overall occlusion time proportion was 0.59 (95% CI [0.45-0.73]) across all seats and settings. The "no-nose" bicycle seat and the stationary-setting demonstrated significantly lower occlusion proportion times than the traditional nose bicycle seat and road-setting, respectively. However, all bicycle seats yielded an occlusion time proportion of 0.41 or greater. Discussion. Our method of real-time, non-invasive force measurement localized to the perineal arteries may be used to validate future bicycle seat design. It also underscores the significant risk of perineal artery insufficiency in men who are avid bicyclists. This risk may be minimized by using newer "no-nose" bicycle seats.

Comparisons of Hysterosalpingography and Laparoscopy Results in the Diagnosis of Tubal Occlusion

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Rafet Duraker

2011-03-01

Full Text Available Objective: The compliance rate between the hysterosalpingography (HSG and laparoscopy (L/S results in patients who diagnosed tubal occlusion on the HSG was investigated. Also, the incidence of endometriosis was evaluated in the study population. Material and Methods: Medical records of 139 women who were underwent L/S for the investigation of the tubal occlusion were reviewed retrospectively. The concordance rate between the HSG and L/S was investigated. The incidence of endometriosis in patients with no tubal pathology was compared with patients with unilaterally and bilaterally tubal occlusion. Results: Mean age of the women was 31.8±5.7years, mean BMI was measured as 24.6±4.6 kg/m2, and gravida 0 (0-5, mean infertility period was 30.7±3.7 months. Tubal occlusion was confirmed after the L/S in 38.8% of the patients (n=38 who has unilaterally tubal occlusion on the HSG. However, 58.8% (n=20 of the patients who were diagnosed as bilaterally tubal occlusion on the HSG was confirmed with the L/S. The misdiagnosis rate of the HSG was significantly high in women with unilaterally tubal occlusions compared with bilaterally tubal occlusions [(respectively, 61.2%, 51.2% (p: 0.001]. Endometriosis was observed in 28.4% of the patients who had patent tubes and in 13.9% of the patients in the unilaterally tubal occlusion group and and in 22.7% of the patients in the bilaterally tubal occlusion group. But the difference was not statistically significant when groups were compared according to the rate of endometriosis (p=0.24. Conclusion: HSG is the first step diagnostic test for the assessment of the fallopian tubes. Although L/S is more invasive technique than HSG, L/S with chromopertubation is the gold standard test for identifying periadnexal adhesive disease and endometriosis.

Endobronchial Occlusion Stent: A Preliminary Experimental Study

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Choi, Yo Won; Jeong, Woo Kyoung; Lee, Seoung Hoon; Heo, Jeong Nam; Jeon, Seok Chol [Hanyang University College of Medicine, Seoul (Korea, Republic of); Ko, Gi Young; Song, Ho Young [University of Ulsan College of Medicine, Ulsan (Korea, Republic of)

2010-04-15

To evaluate the safety and the technical feasibility of the use of an endobronchial occlusion stent and to get preliminary data for the development of the optimal material required for endobronchial occlusions. A commercialized, self-expandable tracheobronchial stent was modified; one half had a polyurethane cover with an occluded end and the other half was uncovered with a flaring configuration. The occluded end was placed such that it would face the distal lung. Under fluoroscopic guidance, seven stents were placed at the lower lobar bronchus in 6 mini-pigs. The bronchial obstruction was examined immediately after stent placement. Chest radiographs were taken at days 1, 7, 14, and 28 after stent placement and the removed airways from two, two, one, and one mini-pigs sacrificed on corresponding days were examined for the maintenance of bronchial obstruction. Stents were successfully placed and induced the immediate bronchial obstruction in all mini-pigs. Five of seven airways with occlusion stents maintained an obstruction until the mini-pigs were sacrificed. Proximal stent migration occurred in two mini-pigs (29%), and pulmonary consolidations were observed distal to four of the stents (57%). The placement of an endobronchial occlusion stent and the obstruction of targeted bronchi seem to be feasible, but an add-on check valve should be considered to prevent stent migration and obstructive pneumonia

Recognizing subtle near-occlusion in carotid stenosis patients: a computed tomography angiographic study

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Koskinen, Suvi Maaria [University of Helsinki, Clinicum, Department of Neurosciences (Finland); University of Helsinki and Helsinki University Hospital, HUS Medical Imaging Center, Radiology, Helsinki (Finland); Silvennoinen, Heli; Valanne, Leena [University of Helsinki and Helsinki University Hospital, HUS Medical Imaging Center, Radiology, Helsinki (Finland); Ijaes, Petra; Nuotio, Krista; Lindsberg, Perttu J. [University of Helsinki and Helsinki University Hospital, Neurology, Clinical Neurosciences, Helsinki (Finland); University of Helsinki, Molecular Neurology, Research Programs Unit, Helsinki (Finland); Soinne, Lauri [University of Helsinki and Helsinki University Hospital, Neurology, Clinical Neurosciences, Helsinki (Finland)

2017-04-15

Near-occlusion of the internal carotid artery (ICA) is a significant luminal diameter (LD) reduction beyond a tight atherosclerotic carotid stenosis (CS). Recognition of even subtle near-occlusions is essential to prevent underestimation of the stenosis degree. Our goal was to investigate the prevalence of near-occlusion among CS patients using a single standard criterion to facilitate its recognition, even when distal ICA LD reduction is not visually evident in computed tomography angiography (CTA). We analysed carotid artery CTAs of 467 patients with moderate-to-severe CS scheduled for endarterectomy. We performed measurements of the bilateral distal ICA LDs from thin axial source images and utilized a 1.0 mm intra-individual side-to-side distal ICA LD difference to distinguish near-occlusions, based on a previous study, aware of the vagaries of measurement. For analysis stratification, we excluded cases with significant carotid pathology affecting LD measurements. We discovered 126 near-occlusions fulfilling our criterion of ipsilateral near-occlusion: the mean LD side-to-side difference (mm) with 95% confidence interval being 1.8 (1.6, 1.9) and a standard deviation of 0.8 mm. Among the 233 cases not meeting our near-occlusion criterion, we found 140 moderate (50-69%) and 93 severe (70-99%) ipsilateral stenoses. The utilization of 1.0 mm cut-off value for the intra-individual distal ICA LD side-to-side difference to distinguish atherosclerotic ICA near-occlusion leads to a relatively high incidence of near-occlusion. In CTA, recently suggested to be used for near-occlusion diagnosis, a discriminatory 1.0 mm cut-off value could function as a pragmatic tool to enhance the detection of even subtle near-occlusions. (orig.)

Long-term clinical and angiographic results of Sirolimus-Eluting Stent in Complex Coronary Chronic Total Occlusion Revascularization: the SECTOR registry.

Science.gov (United States)

Galassi, Alfredo R; Tomasello, Salvatore D; Costanzo, Luca; Campisano, Maria B; Barrano, Giombattista; Tamburino, Corrado

2011-10-01

Drug-eluting stents showed a better angiographic and clinical outcome in comparison with bare metal stent in chronic total occlusions (CTOs) percutaneous revascularization, however, great concerns still remain regarding the rate of restenosis and reocclusion in comparison with nonocclusive lesions. To evaluate angiographic and clinical outcomes after sirolimus-eluting stent (SES) implantation in the setting of a "real world" series of complex CTOs. From January 2006 to December 2008, 172 consecutive patients with 179 CTO lesions were enrolled into registry. Among these, successful recanalization was obtained in 144 lesions (80.4%) with exclusive SES implantation in 104 lesions. The 9-12 months angiographic follow-up was executed in 85.5% of lesions with evidence of angiographic binary restenosis in 16.8% of lesions. Total stent length and number of stent implanted were recognized as independent predictors of restenosis (odds ratio [OR] 4.7, 95% confidence interval [CI] 1.28-107.09, P = 0.02) and (OR 5.8, 95% CI 1.39-23.55, P = 0.01), respectively.The 2-year clinical follow-up showed rates of target lesion revascularization, non-Q wave myocardial infarction, and total major adverse cardiovascular events (MACEs) of 11.1%, 2%, and 13.1%, respectively. Cox proportional-hazard analysis showed diabetes as independent predictor of MACEs (hazard ratio [HR] 4.832; 95% CI, 0.730-0.861; P = 0.028). Data from this registry demonstrate the long-term efficacy and safety of SES implantation after complex CTOs recanalization. ©2011, Wiley Periodicals, Inc.

Outflow occlusion for circulatory arrest in dogs "Outfow occlusion" para parada circulatória em cães

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James N.B.M. de Andrade

2009-02-01

Full Text Available The purpose of this study was to evaluate the possibility of producing circulatory arrest by occlusion of the pulmonary trunk as an alternative to the venous inflow occlusion through the left hemithorax. Eight healthy mongrel dogs were divided in two groups. Group I underwent 4 minutes of outflow occlusion and Group II was submitted to 8 minutes of circulatory arrest. Outflow occlusion was performed through left thoracotomy and pericardiotomy by passing a Rumel tourniquet around the pulmonary trunk. Physical examination, electrocardiography, echocardiography, blood gas analyses, hemodynamic, and oxygen transport variables were obtained before and after the procedure. The dogs from Group I did not have any clinical, electrocardiographic, echocardiographic, or hemo-dynamic abnormalities after anesthetic recover. In the Group II, only one dog survived, which had no clinical, electrocardiographic, or echocardiographic abnormalities. In this last dog, just after releasing the occlusion, it was detected increases in the following parameters: heart rate (HR, systolic, diastolic and mean arterial blood pressure (SAP; DAP; MAP, pulmonary artery pressure (PAP, pulmonary wedge pressure (PWP, central venous pressure (CVP, cardiac output (CO, systolic index (SI, cardiac index (CI, left and right ventricular stroke work (LVSW; RVSW, oxygen delivery index (DO2, oxygen consumption index (VO2, and oxygen extraction (O2 ext. Moreover, the oxygen content of arterial and mixed venous blood (CaO2; CvO2, and the arterial and mixed venous partial pressure of oxygen (PaO2; PvO2 were decreased 5 minutes after circulatory arrest. Outflow occlusion is a feasible surgical procedure for period of 4 minutes of circulatory arrest.O objetivo deste estudo foi avaliar a possibilidade de se produzir uma parada circulatória pela oclusão do tronco pulmonar, como alternativa ao "inflow occlusion", pelo hemitórax esquerdo. Oito cães sem raça definida foram divididos em dois

Successful penetration and bougie dilatation with Brockenbrough needle for severely calcified occlusion in superficial femoral artery.

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Makita, Toshio; Suzuki, Kenji; Takizawa, Kaname; Ootomo, Tatsushi; Inoue, Naoto; Meguro, Taiichirou

2014-04-01

A 75-year-old hemodialysis patient with right critical limb ischemia received endovascular therapy for a chronic total occlusion (CTO) in a diffusely calcified superficial femoral artery (SFA). During a retrograde approach, a Brockenbrough needle (BN) was able to penetrate the calcified hard plaque formed in the middle segment of the CTO. Moreover, bougie dilatation with the BN allowed balloon crossing and stent deployment, even after failure to pass a 2.0-mm monorail balloon across the plaque. These results suggest that the BN offers a new therapeutic option in the penetration and modification of severely calcified CTO in SFA.

Early endovascular treatment of superior mesenteric occlusion secondary to thromboemboli.

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Jia, Z; Jiang, G; Tian, F; Zhao, J; Li, S; Wang, K; Wang, Y; Jiang, L; Wang, W

2014-02-01

To evaluate our early experience with endovascular revascularization in patients with acute thromboembolic occlusion of the superior mesenteric artery (SMA). A retrospective review was conducted of all patients who underwent endovascular revascularization for acute thromboembolic SMA occlusion from May 2005 to May 2012. Endovascular revascularization was performed using aspiration, intra-arterial thrombolysis, and adjunctive stent-placement techniques. Laparotomy was performed if the patient developed clinical signs of advanced bowel ischemia after endovascular procedure. Twenty-one patients underwent endovascular revascularization for acute thromboembolic SMA occlusion. All presented with acute-onset abdominal pain. Three patients had rebound tenderness before the procedure. Computed tomography angiography revealed complete occlusion in seven cases and incomplete occlusion in 14 cases, with no evidence of free gas or bowel necrosis. The median duration from onset of symptoms to revascularization was 8.7 ± 4.1 hours (range, 2-18 hours). Completely successful endovascular revascularization occurred in six cases (aspiration alone, 3 cases; combined aspiration and urokinase, 3 cases); partial success was achieved in 15 cases (aspiration alone, 4 cases; combined aspiration and urokinase, 10 cases; and combined aspiration, urokinase, and stent placement, 1 case). Laparotomy was required in five patients, all of whom had SMA main trunk complete occlusion and required small bowel resection. The 30-day mortality for all patients was 9.5%. During a median follow-up of 26 months, 15 patients remained asymptomatic, three patients reported occasional abdominal pain, and one patient had temporary short-bowel syndrome. Percutaneous revascularization is a promising alternative to surgery for acute SMA occlusion in selected patients who have no signs of advanced bowel ischemia. Early diagnosis followed by prompt endovascular intervention with close postprocedural monitoring is

Interventional treatment for the occlusive hepatic veins in Budd-Chiari syndrome

International Nuclear Information System (INIS)

Zhang Xitong; Xu Ke; Feng Bo; Su Hongying; Li Hong; Zu Maoheng; Cui Jingguo; Yang Xueliang; Zhao Jinxu; Chen Kai

2003-01-01

Objective: To evaluate the interventional methods for occlusive hepatic veins in Budd-Chiari syndrome and its mid and long-term effects. Methods: Forty-two patients (male 17 cases and female 25 cases) aged from 18 to 57 years old (mean 34.5 years) were studied. The liver functions were Child A in 23 cases, Child B in 6 cases, and Child C in 13 cases, respectively. A total of 92 hepatic veins were occluded. Among them, 29 left hepatic veins, 24 middle hepatic veins, 36 right hepatic veins, and 3 accessory hepatic veins were occluded. Thirty-four patients were accompanied with the stenotic or occlusive inferior vena cave (IVC) . The interventional methods included: (1) recanalization of occlusive hepatic veins (by transjugular, transfemoral, and percutaneous transhepatic route, or the combination of above three methods); (2) percutaneous transluminal angioplasty; (3) self-expanding stent implantation. The occlusive IVC in 32 patients also accepted PTA and/or stent implantation. Results: The successful recanalization was carried out in forty hepatic veins in 40 patients. PTA of occlusive veins was followed by stent implantation in 8 patients. The pressure of hepatic veins dropped from 34.5 cm H 2 O (25.0-48.0 cm H 2 O) to 22.0 cm H 2 O (12.0-35.0 cm H 2 O) after intervention (T=11.50, P < 0.01). The symptoms and pathological signs improved obviously in 32 cases and improved partly in 8 cases. During the follow-up period from 1 month to 54 months (mean 27.5 months), one cases died of liver function failure at one month after intervention. The re-intervention of occlusive veins in two cases were performed and the better results were acquired again. Five cases didn't accept re-intervention. Neither recurrence of symptoms nor re-occlusion of hepatic veins was found in the other 32 patients. Conclusion: (1) Multiple and synthetical interventional methods for the occlusive hepatic veins in Budd-Chiari syndrome can be utilized. (2) The intervention of hepatic vein is mini

Clinical Decision Support Model to Predict Occlusal Force in Bruxism Patients.

Science.gov (United States)

Thanathornwong, Bhornsawan; Suebnukarn, Siriwan

2017-10-01

The aim of this study was to develop a decision support model for the prediction of occlusal force from the size and color of articulating paper markings in bruxism patients. We used the information from the datasets of 30 bruxism patients in which digital measurements of the size and color of articulating paper markings (12-µm Hanel; Coltene/Whaledent GmbH, Langenau, Germany) on canine protected hard stabilization splints were measured in pixels (P) and in red (R), green (G), and blue (B) values using Adobe Photoshop software (Adobe Systems, San Jose, CA, USA). The occlusal force (F) was measured using T-Scan III (Tekscan Inc., South Boston, MA, USA). The multiple regression equation was applied to predict F from the P and RGB. Model evaluation was performed using the datasets from 10 new patients. The patient's occlusal force measured by T-Scan III was used as a 'gold standard' to compare with the occlusal force predicted by the multiple regression model. The results demonstrate that the correlation between the occlusal force and the pixels and RGB of the articulating paper markings was positive (F = 1.62×P + 0.07×R -0.08×G + 0.08×B + 4.74; R 2 = 0.34). There was a high degree of agreement between the occlusal force of the patient measured using T-Scan III and the occlusal force predicted by the model (kappa value = 0.82). The results obtained demonstrate that the multiple regression model can predict the occlusal force using the digital values for the size and color of the articulating paper markings in bruxism patients.

Clinical Decision Support Model to Predict Occlusal Force in Bruxism Patients

Science.gov (United States)

Thanathornwong, Bhornsawan

2017-01-01

Objectives The aim of this study was to develop a decision support model for the prediction of occlusal force from the size and color of articulating paper markings in bruxism patients. Methods We used the information from the datasets of 30 bruxism patients in which digital measurements of the size and color of articulating paper markings (12-µm Hanel; Coltene/Whaledent GmbH, Langenau, Germany) on canine protected hard stabilization splints were measured in pixels (P) and in red (R), green (G), and blue (B) values using Adobe Photoshop software (Adobe Systems, San Jose, CA, USA). The occlusal force (F) was measured using T-Scan III (Tekscan Inc., South Boston, MA, USA). The multiple regression equation was applied to predict F from the P and RGB. Model evaluation was performed using the datasets from 10 new patients. The patient's occlusal force measured by T-Scan III was used as a ‘gold standard’ to compare with the occlusal force predicted by the multiple regression model. Results The results demonstrate that the correlation between the occlusal force and the pixels and RGB of the articulating paper markings was positive (F = 1.62×P + 0.07×R –0.08×G + 0.08×B + 4.74; R2 = 0.34). There was a high degree of agreement between the occlusal force of the patient measured using T-Scan III and the occlusal force predicted by the model (kappa value = 0.82). Conclusions The results obtained demonstrate that the multiple regression model can predict the occlusal force using the digital values for the size and color of the articulating paper markings in bruxism patients. PMID:29181234

Occlusion detection via structured sparse learning for robust object tracking

KAUST Repository

Zhang, Tianzhu; Ghanem, Bernard; Xu, Changsheng; Ahuja, Narendra

2014-01-01

occlusion through structured sparse learning. We test our tracker on challenging benchmark sequences, such as sports videos, which involve heavy occlusion, drastic illumination changes, and large pose variations. Extensive experimental results show that our

Effect of occlusal contact stability on the jaw closing point during tapping movements.

Science.gov (United States)

Nishigawa, Keisuke; Suzuki, Yoshitake; Ishikawa, Teruaki; Bando, Eiichi

2012-04-01

We studied the relationship between tapping point reproducibility and stability of occlusal contacts at maximum intercuspation. Tapping movements of 12 adult volunteers who had dentition with natural teeth were recorded, and distances between the tapping point (TP) and the intercuspal position (ICP) at the incisal point were calculated. Occlusal contacts at the ICP of individual subjects were also evaluated with black-colored silicone impression material. The correlation between TP-ICP distance and occlusal contact stability was studied. TP-ICP distance exhibited negative correlations with the total number of teeth showing occlusal contact at the ICP. Standard deviations of TP-ICP distance also negatively correlated with the extension of occlusal contact area over dentition. This finding indicates that occlusal contacts at the ICP affect the kinematic behavior of tapping movements. The results of this study also suggest that jaw movement data may provide useful clinical information for the evaluation of occlusal contact at ICP. Copyright © 2011 Japan Prosthodontic Society. Published by Elsevier Ltd. All rights reserved.

STUDY OF THE DISTANCE BETWEEN LINGULA AND MANDIBULAR OCCLUSAL PLANE IN IRANIAN MALES WITH NORMAL OCCLUSION

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M GHOREYSHIAN

2002-09-01

Full Text Available Introduction. Pain and the need for controlling it is a determinant factor in dental treatment procedures. One of the most common methods of local anesthesia in mandibular area is infra alveolar nerve block which has failure rate of 5% to 15%. The purpose of this study was to locate the optimal needle entrance point in order to achieve a fast, deep and durable anesthesia with minimal anesthetic consumption. Methods. This cross-sectional study has been performed on 38 cadavers of Iranian males with approximate age of more than 17 years. old. They had normal occlusion and at least 2 molars in each quadrant of the mandible if a sample was edentulous in one quadrant of the mandible or in the opposite jaw; or when a severe tilt in mandi bular dentition was present and in the case of mandibular or condylar fracture, the sample was excluded from the study. Distance between lingual and occlusal plane was measured by a device with two parallel plates. The precision of the measurment was 1mm. Data was analysed by the use of SPSS software. Results. On the right side, the average distance between lingual and occlusal plane was 2.4 ± 4.4 (Mean ± SD and on the left side, was 2:r.4.4 which there was no significant difference between right and left sides (P value=0.9. Discussion. In this study the human body is used and the best point for entrance of the needle for inferior alveolar nerve block technique is located at 8mm above the occlusal plane. At this point the anesthetic solution will be evacuated in the nearest position to the inferior alveolar never.

Reconstruction-based Digital Dental Occlusion of the Partially Edentulous Dentition

Science.gov (United States)

Zhang, Jian; Xia, James J.; Li, Jianfu; Zhou, Xiaobo

2016-01-01

Partially edentulous dentition presents a challenging problem for the surgical planning of digital dental occlusion in the field of craniomaxillofacial surgery because of the incorrect maxillomandibular distance caused by missing teeth. We propose an innovative approach called Dental Reconstruction with Symmetrical Teeth (DRST) to achieve accurate dental occlusion for the partially edentulous cases. In this DRST approach, the rigid transformation between two symmetrical teeth existing on the left and right dental model is estimated through probabilistic point registration by matching the two shapes. With the estimated transformation, the partially edentulous space can be virtually filled with the teeth in its symmetrical position. Dental alignment is performed by digital dental occlusion reestablishment algorithm with the reconstructed complete dental model. Satisfactory reconstruction and occlusion results are demonstrated with the synthetic and real partially edentulous models. PMID:26584502

Veno-occlusive disease of the colon - CT findings

International Nuclear Information System (INIS)

Rademaker, J.

1998-01-01

Venous occlusion is a rare cause of ischemic bowel disease and is usually brought about by thrombosis that may occur as a complication of systemic disorders like systemic lupus erythematosus, Behcet disease or Churg-Strauss syndrome. This report describes a patient with veno-occlusive disease of the colon caused by lymphocytic phlebitis. Typical CT findings included homogeneous bowel wall thickening and vascular engorgement. (orig.) (orig.)

Bilateral Internal Carotid Artery Occlusion Associated with the Antiphospholipid Antibody Syndrome

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Pria Anand

2014-03-01

Full Text Available A 39-year-old woman presented with a right-hemispheric stroke 1 year after she had suffered a left-hemispheric stroke. Her diagnostic workup was notable for bilateral occlusions of the internal carotid arteries at their origins and a positive lupus anticoagulant antibody test. There was no evidence of carotid dissection or another identifiable cause for her carotid occlusions. These findings suggest that the antiphospholipid antibody syndrome may be implicated in the pathological changes that resulted in occlusions of the extracranial internal carotid arteries. Young stroke patients who present with unexplained internal carotid artery occlusions may benefit from testing for the presence of antiphospholipid antibodies.

Endovascular Treatment of Chronic Mesenteric Ischemia by Crossing of Two Stents in a Patient with Celiacomesenteric Trunk

International Nuclear Information System (INIS)

Khil, Eun Kyung; Lee, Jae Myeong

2013-01-01

A 73-year-old woman was presented with a 3-month history of postprandial abdominal pain and weight loss. The patient had an anatomic variant of celiacomesenteric trunk (CMT), with complete occlusion of the superior mesenteric artery (SMA) and significant stenosis of the CMT ostium, resulting in chronic mesenteric ischemia. After several unsuccessful attempts at revascularization of the SMA, celiac artery stenting was performed, followed by SMA stent placement through the previously placed stent mesh into the occlusion site. The patient's symptoms completely resolved after treatment.

Sequential gadolinium-enhanced magnetic resonance angiography of the aortoiliac and the femoropopliteal arteries with repetitive administration of low-dose contrast agent

International Nuclear Information System (INIS)

Ito, Koichiro; Kumazaki, Tatsuo

2000-01-01

To obtain a wide-range contrast MR angiography in a single examination, we performed two sequential administrations of low-dose (0.08 mmol/kg) gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) with three dimensional inversion recovery prepared fast spoiled gradient recalled acquisition in the steady-state (3D IR-fast SPGR) sequence. Signal characteristics of the sequence were estimated by computed simulations and an in vitro study. A clinical study of 19 examinations was done with sequential MR angiography of the aortoiliac and femoropopliteal arteries. Great signal differences were observed between the high and low Gd concentrations. Higher Gd concentrations generated significantly stronger signals. Greater signals were produced at TIs of longer than 150 msec than at shorter than 100 msec. In the clinical study, the arteries were visualized with sufficient signals even with a small amount of contrast agent. Contrast-to-noise ratios between the arteries and surrounding skeletal muscles or fat tissues ranged from 10.5±9.6 to 4.7±2.2 and 6.6±2.8 to -3.1±11.2, respectively. No venous enhancement was found with diluted contrast agent on the second MR angiography. Two consecutive contrast MR angiographies can be obtained with repetitive administration of low-dose contrast agent. (author)

Sequential gadolinium-enhanced magnetic resonance angiography of the aortoiliac and the femoropopliteal arteries with repetitive administration of low-dose contrast agent

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Ito, Koichiro [Nippon Medical School, Inba, Chiba (Japan). Chiba Hokusoh Hospital; Kumazaki, Tatsuo

2000-12-01

To obtain a wide-range contrast MR angiography in a single examination, we performed two sequential administrations of low-dose (0.08 mmol/kg) gadolinium diethylenetriaminepentaacetic acid (Gd-DTPA) with three dimensional inversion recovery prepared fast spoiled gradient recalled acquisition in the steady-state (3D IR-fast SPGR) sequence. Signal characteristics of the sequence were estimated by computed simulations and an in vitro study. A clinical study of 19 examinations was done with sequential MR angiography of the aortoiliac and femoropopliteal arteries. Great signal differences were observed between the high and low Gd concentrations. Higher Gd concentrations generated significantly stronger signals. Greater signals were produced at TIs of longer than 150 msec than at shorter than 100 msec. In the clinical study, the arteries were visualized with sufficient signals even with a small amount of contrast agent. Contrast-to-noise ratios between the arteries and surrounding skeletal muscles or fat tissues ranged from 10.5{+-}9.6 to 4.7{+-}2.2 and 6.6{+-}2.8 to -3.1{+-}11.2, respectively. No venous enhancement was found with diluted contrast agent on the second MR angiography. Two consecutive contrast MR angiographies can be obtained with repetitive administration of low-dose contrast agent. (author)

Does Maturity Affect Cephalic Perfusion and T/QRS Ratio during Prolonged Umbilical Cord Occlusion in Fetal Sheep?

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Guido Wassink

2014-01-01

Full Text Available T/QRS ratio monitoring is used to help identify fetal asphyxia. However, immature animals have greater capacity to maintain blood pressure during severe asphyxia, raising the possibility that they may show an attenuated T/QRS increase during asphyxia. Chronically instrumented fetal sheep at 0.6 of gestation (0.6 GA; n = 12, 0.7 GA (n = 12, and 0.8 GA (n = 8 underwent complete umbilical cord occlusion for 30 min, 25 min, or 15 min, respectively. Cord occlusion was associated with progressive metabolic acidosis and initial hypertension followed by severe hypotension, with a more rapid fall in mean arterial blood pressure (MAP and carotid blood flow (CaBF with advancing gestation. T/QRS ratio rose after occlusion more rapidly at 0.8 GA than in immature fetuses, to a similar final peak at all ages, followed by a progressive fall that was slower at 0.8 GA than in the immature fetuses. The increase in T/QRS ratio correlated with initial hypertension at 0.8 GA (P<0.05, R2 = 0.38, and conversely, its fall correlated closely with falling MAP in all gestational groups (P<0.01, R2 = 0.67. In conclusion, elevation of the T/QRS ratio is an index of onset of severe asphyxia in the last third of gestation, but not of fetal compromise.

Induction of intestinal ischemia reperfusion injury by portal vein outflow occlusion in rats

International Nuclear Information System (INIS)

Vincenti, M.; Behrends, M.; Hirose, Ryutaro; Liu, T.; Niemann, C.U.; Dang, K.; Park, Y.H.; Blasi-Ibanez, A.; Serkova, N.J.

2010-01-01

Intestinal ischemia can occur from mesenteric artery (MA) occlusion and portal vein (PV) occlusion. The degree and mechanisms of ischemia/reperfusion (I/R) injury in these conditions may differ. Metabolic changes are seen early in I/R. This study compares tissue histology, inflammation, and metabolic response during small bowel I/R due to superior MA or PV occlusion. Anesthetized male Wistar rats (250-300 g) underwent laparotomy followed by MA or PV occlusion for 40 min. After 120 min of reperfusion, small bowel tissue was collected. The expression of heat shock protein (HSP)-32 and HSP70 was evaluated to compare physiological stress responses between groups. Metabolic profiles were obtained using 1 H-nuclear magnetic resonance spectroscopy (NMR)-based quantitative metabolomics. Histological injury of small bowel was graded from 0 (normal) to 4 (extensive ischemic damage). Protein expression of HSP32 and HSP70 increased when compared to sham but was not different in the MA I/R and PV I/R groups. Metabolic profiles demonstrated decreased glucose levels and highly elevated tissue lactate and amino acids and fatty acids following I/R, with more pronounced changes with PV occlusion. Lipid peroxidation was equally increased in both groups, while depletion of reduced glutathione (GSH) was more severe with MA occlusion. The epithelial necrosis score was higher with MA (3.5±0.6) than with PV occlusion (2.3±0.8). Histological injury of the intestine is less pronounced following PV occlusion, most likely due to higher oxygen and substrate availability during I/R by PV occlusion. This conclusion is supported by a more pronounced metabolic synthetic response (increased glycolysis and fatty acid and amino acid accumulation) with PV occlusion, while oxidative stress was higher with MA occlusion. The inflammatory response showed little difference between the groups. (author)

String-like lumen in below-the-knee chronic total occlusions on contrast-enhanced magnetic resonance angiography predicts intraluminal recanalization and better blood flow restoration

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Zhu, Yue-Qi; Lu, Hai-Tao; Wei, Li-Ming; Cheng, Ying-Sheng; Wang, Jian-Bo; Zhao, Jun-Gong [Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, Department of Diagnostic and Interventional Radiology, Shanghai (China); Liu, Fang [Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, Department of Endocrinology, Shanghai (China)

2017-07-15

To determine whether string-like lumina (SLs) on contrast-enhanced magnetic resonance angiography (CE-MRA) predict better outcomes in diabetic patients with below-the-knee (BTK) chronic total occlusions (CTOs). This study involved 317 long-segment (>5 cm) BTK CTOs of 245 patients that were examined using CE-MRA and treated using endovascular angioplasty. An SL with a CTO was slowly filled with blood on conventional CE-MRA. Univariate and multivariate analyses were performed to identify predictors of procedural success, recanalisation method and immediate blood flow restoration. The target-lesion patency and limb-salvage rates were assessed. SL-positive CTOs (n = 60) achieved a higher technique success rate, preferred intraluminal angioplasty and better blood flow restoration than SL-negative CTOs (n = 257, P < 0.05). Multivariate analyses revealed that lesion length was the independent predictor of procedural success (P = 0.028). SL was a predictor of intraluminal angioplasty (P < 0.001) and good blood-flow restoration (P = 0.004). Kaplan-Meier analyses at 12 months revealed a higher target lesion patency rate (P = 0.04) and limb-salvage rate (P = 0.35) in SL-positive CTOs. In patients with BTK CTOs, SL predicted intraluminal angioplasty and good blood-flow restoration for BTK CTOs. (orig.)

Occlusal Grinding Pattern during Sleep Bruxism and Temporomandibular Disorder

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Yeni Wijaya

2013-09-01

Full Text Available Sleep Bruxism is a significant etiology of temporomandibular disorder (TMD and causes many dental or oral problems such as tooth wear or facet. There is no study analyzing the relationship between sleep bruxism and TMD. Objective: To investigate any relationship between occlusal grinding pattern during sleep bruxism and temporomandibular disorder. Methods: A cross-sectional study involving 30 sleep bruxism patients attended the Faculty Dentistry Universitas Indonesia Teaching Hospital (RSGMP FKG UI. Completion of 2 forms of ID-TMD index and questionnaire from American Academy of Sleep Medicine were done. BruxChecker was fabricated and used for two nights to record the occlusal grinding pattern. The occlusal grinding pattern was categorized into laterotrusive grinding (LG and mediotrusive side. Further divisons of LG were: incisor-canine (IC, incisor-caninepremolar (ICP and incisor-canine-premolar-molar (ICPM. Mediotrusive side was classified as mediotrusive contact (MC and mediotrusive grinding (MG. Results: It was found that occlusal grinding pattern in non-TMD subjects were IC+MC, in subjects with mild TMD were ICP+MG and in subjects with moderate TMD were ICP+MG and ICPM+MG. TMJ was more significantly affected by ICP and ICPM grinding pattern than that of IC. Conclusion: There was a significant relationship between occlusal grinding pattern during sleep bruxism and TMD.DOI: 10.14693/jdi.v20i2.149

Stability of anterior open-bite treatment with occlusal adjustment.

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Janson, Guilherme; Crepaldi, Marcus Vinicius; Freitas, Karina Maria Salvatore; de Freitas, Marcos Roberto; Janson, Waldyr

2010-07-01

In this study, we aimed to evaluate the long-term stability of anterior open-bite treatment with occlusal adjustment and the dentinal sensitivity caused by this procedure in the long term. The sample comprised 17 open-bite patients who experienced relapse of the negative vertical overbite after orthodontic treatment and were retreated with occlusal adjustment. The cephalometric changes were evaluated on lateral cephalograms obtained before and after the occlusal adjustment and in the long term (mean, 3.4 years after occlusal adjustment). Dentinal sensitivity was also evaluated before the occlusal adjustment, and 1.35 months, 4.61 months, and 3.4 years later. The cephalometric statuses between the 3 evaluations were compared with analysis of variance (ANOVA) and Tukey tests. The percentages of clinically significant relapse were calculated. To compare dentinal sensitivity at the several stages, nonparametric Friedman and Wilcoxon tests were performed. Statistically significant relapse of anterior open bite occurred in 33.3% of the patients. Those who had the procedure before 21 years of age were most likely to experience relapse. Dentinal sensitivity remained within the normal range in the long term. Despite the statistically significant relapse of anterior open bite, clinically significant stability was found in 66.7% of the patients. Copyright (c) 2010 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

[Single- and multi-unit fixed dental prostheses in relation to the occlusal system

NARCIS (Netherlands)

Witter, D.J.; Gerritsen, A.E.; Spijker, A. van 't; Creugers, N.H.J.

2013-01-01

Occlusion concepts based on functional aspects offer more solid ground in the diagnostic process and in the treatment of (reduced) dentitions than morphologically and mechanically oriented occlusion concepts. Nevertheless, for occlusal reconstruction morphologically oriented guidelines are

A novel method to determine perineal artery occlusion among male bicyclists

OpenAIRE

Parthiban, Sujeeth; Hotaling, James M.; Kathrins, Martin; Baftiri, Amit P.; Freels, Sally; Niederberger, Craig S.

2015-01-01

Background. Perineal pressure due to bicycle riding has been associated with erectile dysfunction. We developed a novel method to measure the occlusive force exerted over the perineal arteries and determined perineal artery occlusion by a variety of seat designs. Methods. Doppler ultrasonography facilitated perineal artery localization and determination of the force required for perineal artery occlusion in 20 healthy men. Flexiforce? sensors were affixed over the proximal and distal aspects ...

Psychosocial distress of part-time occlusion in children with intermittent exotropia.

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Kim, Ungsoo Samuel; Park, Subin; Yoo, Hee Jeong; Hwang, Jeong-Min

2013-01-01

To evaluate the psychosocial distress of part-time occlusion therapy in intermittent exotropia. A total of 25 children (15 males and 10 females, aged 3 to 7 years, mean age 4.7 years) with intermittent exotropia were enrolled. Behavioral and psychosocial problems were assessed by the Korean Child Behavior Checklist (K-CBCL), which consists of eight categories of withdrawal, somatic problems, depression/anxiety, social problems, thought problems, attention problems, delinquent behavior, and aggressive behavior, and the Amblyopia Treatment Index (ATI). The ATI was designed to evaluate the three factors of compliance, adverse effect, and social stigma. The Parenting Stress Index (PSI) is a parent self-report designed to identify potentially dysfunctional parent-child systems. The K-CBCL was obtained before and after occlusion therapy, and the ATI and PSI were taken from parents only after occlusion therapy. We evaluated the change on the K-CBCL and the correlation between the K-CBCL and ATI. The attention problem assessed by the K-CBCL significantly decreased after occlusion therapy. On the ATI, the social stigma was relatively lower than compliance and adverse effect factors (Likert scale 2.64, 3.11, and 3.11, respectively). The somatic problem assessed by the K-CBCL and compliance on the ATI were significantly correlated (p = 0.014). There was no significant change in percentile scores of each subscale (parental dominant scale and child dominant scale) of the PSI. Total stress index before and after occlusion therapy was 97.16 ± 8.38 and 97.00 ± 8.16 respectively (p = 0.382). Occlusion therapy may influence the psychosocial impact on intermittent exotropia patients. Part-time occlusion significantly decreased the attention problem in children with intermittent strabismus. Children with a high somatic problem score on the KCBCL showed poor compliance to the part-time occlusion.

Minimally invasive lung volume reduction treated with bronchi occlusion emphysema model

International Nuclear Information System (INIS)

Zhou Dayong; Shen Liming; Shen Junkang; Jin Yiqi; Chen Lei; Huang Xianchen

2007-01-01

Objective: To evaluate the efficacy and feasibility of the coil-and-glue method for the reduction of lung volume in rabbit emphysema model. Methods: Sixteen rabbits of emphysema model were divided into the occlusion group(n=10), in which both anterior bronchi were occluded using the coil-and- glue method, and the control group (n=6). The maximal static pressure of airway (P max ), peak expiratory flow (PEF), end-expiratory volume (EEV) and pressure of oxygen (PO 2 ) were measured at ante- emphysema, post-emphysema, 1 week and 4 week after occlusion respectively. The expectoration (or migration) of coil and collapse of lung were also investigated. Results: P max was (20.0±1.3) and (17.1± 1.4) cm H 2 O (1 cm H 2 O=0.098 kPa) in the occlusion group at ante-emphysema and post-emphysema respectively. P max was (19.2±1.4) cm H 2 O in the occlusion group in the 1 week after the occlusion, while (17.1±1.5)cm H 2 O in the control group (F=6.68, P max was (19.2±1.4) cm H 2 O in the occlusion group, while (16.6±1.2) cm H 2 O in the control group (F=12.10, P max , in the 1 week and 4 week after occlusion were higher than those at post-emphysema (P<0.01, respectively); EEV at post-emphysema was higher than that at ante-emphysema (P<0.01). Conclusion: Coil-and-glue occlusion method for lung volume reduction in rabbit emphysema model can improve the pulmonary function, which can be relatively long lasting. (authors)

Veno-occlusive disease of the colon - CT findings

Energy Technology Data Exchange (ETDEWEB)

Rademaker, J [Department of Radiology I, Medical School Hannover (Germany)

1998-10-01

Venous occlusion is a rare cause of ischemic bowel disease and is usually brought about by thrombosis that may occur as a complication of systemic disorders like systemic lupus erythematosus, Behcet disease or Churg-Strauss syndrome. This report describes a patient with veno-occlusive disease of the colon caused by lymphocytic phlebitis. Typical CT findings included homogeneous bowel wall thickening and vascular engorgement. (orig.) (orig.) With 1 fig., 4 refs.

A study of parallelism of the occlusal plane and ala-tragus line.

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Sadr, Katayoun; Sadr, Makan

2009-01-01

Orientation of the occlusal plane is one of the most important clinical procedures in prostho-dontic rehabilitation of edentulous patients. The aim of this study was to define the best posterior reference point of ala-tragus line for orientation of occlusal plane for complete denture fabrication. Fifty-three dental students (27 females and 26 males) with complete natural dentition and Angel's Class I occlusal relationship were selected. The subjects were photographed in natural head position while clenching on a Fox plane. After tracing the photographs, the angles between the following lines were measured: the occlusal plane (Fox plane) and the superior border of ala-tragus, the occlusal plane (Fox plane) and the middle of ala-tragus as well as the occlusal plane (Fox plane) and the inferior border of ala-tragus. Descriptive statistics, one sample t-test and independent t-test were used. P value less than 0.05 was considered significant. There was no parallelism between the occlusal plane and ala-tragus line with three different posterior ends and one sample t-test showed that the angles between them were significantly different from zero (pplane. The superior border of the tragus is suggested as the posterior reference for ala-tragus line.

Retinal artery occlusion during carotid artery stenting with distal embolic protection device.

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Kohara, Kotaro; Ishikawa, Tatsuya; Kobayashi, Tomonori; Kawamata, Takakazu

2018-01-01

Retinal artery occlusion associated with carotid artery stenosis is well known. Although it can also occur at the time of carotid artery stenting, retinal artery occlusion via the collateral circulation of the external carotid artery is rare. We encountered two cases of retinal artery occlusion that were thought to be caused by an embolus from the external carotid artery during carotid artery stenting with a distal embolic protection device for the internal carotid artery. A 71-year-old man presented with central retinal artery occlusion after carotid artery stenting using the Carotid Guardwire PS and a 77-year-old man presented with branch retinal artery occlusion after carotid artery stenting using the FilterWire EZ. Because additional new cerebral ischaemic lesions were not detected in either case by postoperative diffusion-weighted magnetic resonance imaging, it was highly likely that the debris that caused retinal artery occlusion passed through not the internal carotid artery but collaterals to retinal arteries from the external carotid artery, which was not protected by a distal embolic protection device. It is suggested that a distal protection device for the internal carotid artery alone cannot prevent retinal artery embolisation during carotid artery stenting and protection of the external carotid artery is important to avoid retinal artery occlusion.

Influence of occlusal loading on peri-implant clinical parameters. A pilot study.

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Pellicer-Chover, Hilario; Viña-Almunia, José; Romero-Millán, Javier; Peñarrocha-Oltra, David; García-Mira, Berta; Peñarrocha-Diago, María

2014-05-01

To investigate the relation between occlusal loading and peri-implant clinical parameters (probing depth, bleeding on probing, gingival retraction, width of keratinized mucosa, and crevicular fluid volume) in patients with implant-supported complete fixed prostheses in both arches. This clinical study took place at the University of Valencia (Spain) dental clinic. It included patients attending the clinic for regular check-ups during at least 12 months after rehabilitation of both arches with implant-supported complete fixed ceramo-metallic prostheses. One study implant and one control implant were established for each patient using the T-Scan®III computerized system (Tesco, South Boston, USA). The maxillary implant closest to the point of maximum occlusal loading was taken as the study implant and the farthest (with least loading) as the control. Occlusal forces were registered with the T-Scan® III and then occlusal adjustment was performed to distribute occlusal forces correctly. Peri-implant clinical parameters were analyzed in both implants before and two and twelve months after occlusal adjustment. Before occlusal adjustment, study group implants presented a higher mean volume of crevicular fluid (51.3 ± 7.4 UP) than the control group (25.8 ± 5.5 UP), with statistically significant difference. Two months after occlusal adjustment, there were no significant differences between groups (24.6 ± 3.8 UP and 26 ± 4.5 UP respectively) (p=0.977). After twelve months, no significant differences were found between groups (24.4 ± 11.1 UP and 22.5 ± 8.9 UP respectively) (p=0.323). For the other clinical parameters, no significant differences were identified between study and control implants at any of the study times (p>0.05). Study group implants receiving higher occlusal loading presented significantly higher volumes of crevicular fluid than control implants. Crevicular fluid volumes were similar in both groups two and twelve months after occlusal adjustment.

Visual Acuity Improvement in Continuous vs Divided Occlusion in Anisometropic Amblyopia.

Science.gov (United States)

Irfani, Irawati; Feriyanto, Feri; Oktarima, Primawita; Kartasasmita, Arief

2018-01-01

To compare visual acuity improvement between continuous and split part-time occlusion for the treatment of moderate and severe anisometropic amblyopia. Randomised clinical trials in 6 - 13 y.o children with moderate and severe anisometropic amblyopia. Each patient was consecutively selected with continuous or split part-time occlusion. Best corrected visual acuity's improvement was followed up to six weeks and statistical data were analyzed using chi square and unpaired t-test. Best corrected visual acuity's improvement was comparable between continuous and split part-time occlusion (0.20±0.27 vs 0.21±0.25; p = 0.79). Split part-time occlusion may be considered as an alternative treatment for moderate and severe anisometropic amblyopia treatment.

Advanced Oxidation Protein Products and Carbonylated Proteins as Biomarkers of Oxidative Stress in Selected Atherosclerosis-Mediated Diseases

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Bogna Gryszczyńska

2017-01-01

Full Text Available Objectives. The main question of this study was to evaluate the intensity of oxidative protein modification shown as advanced oxidation protein products (AOPP and carbonylated proteins, expressed as protein carbonyl content (C=O in abdominal aortic aneurysms (AAA, aortoiliac occlusive disease (AIOD, and chronic kidney disease (CKD. Design and Methods. The study was carried out in a group of 35 AAA patients and 13 AIOD patients. However, CKD patients were divided into two groups: predialysis (PRE included 50 patients or hemodialysis (HD consisted of 34 patients. AOPP and C=O were measured using colorimetric assay kit, while C-reactive protein concentration was measured by high-sensitivity assay (hsCRP. Results. The concentration of AOPP in both AAA and AIOD groups was higher than in PRE and HD groups according to descending order: AAA~AIOD > HD > PRE. The content of C=O was higher in the PRE group in comparison to AIOD and AAA according to the descending order: PRE~HD > AAA~AIOD. Conclusions. AAA, AIOD, and CKD-related atherosclerosis (PRE and HD contribute to the changes in the formation of AOPP and C=O. They may promote modification of proteins in a different way, probably due to the various factors that influence oxidative stress here.

Valve-Like and Protruding Calcified Intimal Flap Complicating Common Iliac Arteries Kissing Stenting

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George S. Georgiadis

2015-01-01

Full Text Available Endovascular therapy for iliac artery chronic total occlusions is nowadays associated with low rates of procedure-related complications and improved clinical outcomes, and it is predominantly used as first-line therapy prior to aortobifemoral bypass grafting. Herein, we describe the case of a patient presenting with an ischemic left foot digit ulcer and suffering complex aortoiliac lesions, who received common iliac arteries kissing stents, illustrating at final antegrade and retrograde angiograms the early recognition of a blood flow obstructing valve-like calcified intimal flap protruding through the stent struts, which was obstructing antegrade but not retrograde unilateral iliac arterial axis blood flow. The problem was resolved by reconstructing the aortic bifurcation at a more proximal level. Completion angiogram verified normal patency of aorta and iliac vessels. Additionally, a severe left femoral bifurcation stenosis was also corrected by endarterectomy-arterioplasty with a bovine patch. Postintervention ankle brachial pressure indices were significantly improved. At the 6-month and 2-year follow-up, normal peripheral pulses were still reported without intermittent claudication suggesting the durability of the procedure. Through stent-protruding calcified intimal flap, is a very rare, but existing source of antegrade blood flow obstruction after common iliac arteries kissing stents.

A cephalometric study to determine the plane of occlusion in completely edentulous patients.

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Hindocha, Amit D; Vartak, Vikas N; Bhandari, Aruna J; Dudani, Mohit T

2013-01-01

Determination of the plane of occlusion in completely edentulous patients with the help of the ala-tragus line (Camper's plane) may be questioned. An attempt to devise an alternative method to determine the orientation of the plane of occlusion was made. Cephalometric analysis was used to identify whether a correlation exists between the plane of occlusion of dentulous Indian individuals and other stable cranial landmarks. A negative correlation was found to exist between the occlusal Plane-FH plane angle and the porion-nasion-anterior nasal spine (PoNANS) angle. From the derived mathematical correlation, it was concluded that the angulation of the occlusal plane in completely edentulous subjects may be determined by taking a cephalogram at the diagnostic stage. Further, the clinical applicability of the derived mathematical formula (while determining the plane of occlusion) was tested on completely edentulous patients.

An Automatic Occlusion Device for Remote Control of Tumor Tissue Ischemia

Science.gov (United States)

El-Dahdah, Hamid; Wang, Bei; He, Guanglong; Xu, Ronald X.

2015-01-01

We developed an automatic occlusion device for remote control of tumor tissue ischemia. The device consists of a flexible cannula encasing a shape memory alloy wire with its distal end connected to surgical suture. Regional tissue occlusion was tested on both the benchtop and the animal models. In the benchtop test, the occlusion device introduced quantitative and reproducible changes of blood flow in a tissue simulating phantom embedding a vessel simulator. In the animal test, the device generated a cyclic pattern of reversible ischemia in the right hinder leg tissue of a black male C57BL/6 mouse. We also developed a multimodal detector that integrates near infrared spectroscopy and electron paramagnetic resonance spectroscopy for continuous monitoring of tumor tissue oxygenation, blood content, and oxygen tension changes. The multimodal detector was tested on a cancer xenograft nude mouse undergoing reversible tumor ischemia. The automatic occlusion device and the multi-modal detector can be potentially integrated for closed-loop feedback control of tumor tissue ischemia. Such an integrated occlusion device may be used in multiple clinical applications such as regional hypoperfusion control in tumor resection surgeries and thermal ablation processes. In addition, the proposed occlusion device can also be used as a research tool to understand tumor oxygen transport and hemodynamic characteristics. PMID:20082532

The effect of experimental stress and experimental occlusal interference on masseteric EMG activity.

Science.gov (United States)

McGlynn, F D; Bichajian, C; Tira, D E; Lundeen, H C; Mahan, P E; Nicholas, B V

1989-01-01

This experiment attempted to study the separate and combined effects of occlusal interference and transient stress on masseteric activity among eight nonclinical human subjects. Before each of two sessions, subjects were fitted with an occlusal interference or an occlusally inert (control) molar clasp. During each session they viewed horrific and idyllic videotapes while masseter EMG was recorded bilaterally. Electrodermal measures validated that the horrific videotapes were stressful. Studies showed that the occlusal variable worked less well. The EMG was elevated contralateral to both clasps and during videotape viewing. The EMG effects from videotape viewing were relatively pronounced without the occlusal interference. Research implications are discussed.

Comparison of Radiofrequency Ablation with Saturated Saline Preinjection and Renal Artery Occlusion: In Vivo Study in Canine Kidneys Preinjection and Renal Artery Occlusion: In Vivo Study in Canine Kidneys

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Shin, Byung Seok; Ahn, Moon Sang [Chungnam National University Hospital, Daejeon (Korea, Republic of); Park, Mi Hyun [Dept. of Radiology, Dankook University Hospital, Cheonan (Korea, Republic of); Jeon, Gyeong Sik [Dept. of Radiology, CHA Bundang Medical Center, CHA University College of Medicine, Seongnam (Korea, Republic of); Lee, Byung Mo [Dept. of Surgery, Paik Hospital, Inje University College of Medicine, Seoul (Korea, Republic of); Lee, Ki Chang [Dept. of Veterinary Radiology, Chonbuk National University College of VeterinaryMedicine, Seoul (Korea, Republic of); Kim, Ho Jun [Dept. of Radiology, Konyang University Hospital, Daejeon (Korea, Republic of); Ohm, Joon Young [Dept. of Radiology, Bucheon St. Mary Hospital, The Catholic University of Korea College of Medicine, Bucheon (Korea, Republic of)

2012-04-15

To compare the ablation zone after radiofrequency ablation (RFA) with saturated saline preinjection and renal artery occlusion in canine kidneys. RFA was induced in the kidneys of six mongrel dogs. A total of 24 ablation zones were induced using a 1-cm tip internally cooled needle electrode in three groups: RFA (Control group), RFA with 0.5 mL saturated saline preinjection (SS group), and RFA with renal artery occlusion by atraumatic vascular clamp (Occlusion group). Ablation zone diameters were measured along transverse and longitudinal sections of the needle axis, and volumes were calculated. Temperature, applied voltage, current, and impedance during RFA were recorded automatically. The RFA zone volume was the largest in the SS group (1.33 {+-} 0.34 cm{sup 3}), followed by the Occlusion group (1.07 {+-} 0.38 cm{sup 3}) and then the Control group (0.62 {+-} 0.09 cm{sup 3}). Volumes for the SS and Occlusion groups were significantly larger than those for the Control group (p = 0.001, p = 0.012). There was no significant difference in volumes between the SS and Occlusion groups (p = 0.178). Saturated saline preinjection is as effective as renal arterial occlusion for expanding the ablation zone. RFA with saturated saline preinjection could help to treat large renal tumors.

Comparison of Radiofrequency Ablation with Saturated Saline Preinjection and Renal Artery Occlusion: In Vivo Study in Canine Kidneys Preinjection and Renal Artery Occlusion: In Vivo Study in Canine Kidneys

International Nuclear Information System (INIS)

Shin, Byung Seok; Ahn, Moon Sang; Park, Mi Hyun; Jeon, Gyeong Sik; Lee, Byung Mo; Lee, Ki Chang; Kim, Ho Jun; Ohm, Joon Young

2012-01-01

To compare the ablation zone after radiofrequency ablation (RFA) with saturated saline preinjection and renal artery occlusion in canine kidneys. RFA was induced in the kidneys of six mongrel dogs. A total of 24 ablation zones were induced using a 1-cm tip internally cooled needle electrode in three groups: RFA (Control group), RFA with 0.5 mL saturated saline preinjection (SS group), and RFA with renal artery occlusion by atraumatic vascular clamp (Occlusion group). Ablation zone diameters were measured along transverse and longitudinal sections of the needle axis, and volumes were calculated. Temperature, applied voltage, current, and impedance during RFA were recorded automatically. The RFA zone volume was the largest in the SS group (1.33 ± 0.34 cm 3 ), followed by the Occlusion group (1.07 ± 0.38 cm 3 ) and then the Control group (0.62 ± 0.09 cm 3 ). Volumes for the SS and Occlusion groups were significantly larger than those for the Control group (p = 0.001, p = 0.012). There was no significant difference in volumes between the SS and Occlusion groups (p = 0.178). Saturated saline preinjection is as effective as renal arterial occlusion for expanding the ablation zone. RFA with saturated saline preinjection could help to treat large renal tumors.

Retrograde approach for the recanalization of coronary chronic total occlusion: collateral selection and collateral related complication.

Science.gov (United States)

Ma, Jian-Ying; Qian, Ju-Ying; Ge, Lei; Fan, Bing; Wang, Qi-Bing; Yan, Yan; Zhang, Feng; Yao, Kang; Huang, Dong; Ge, Jun-Bo

2013-03-01

The retrograde approach through collaterals has been applied in the treatment of chronic total occlusion (CTO) lesions during percutaneous recanalization of coronary arteries. This study was to investigate the success rate of recanalization and collateral related complications in patients when using the retrograde approach. Eighty-four cases subjected to retrograde approach identified from July 2005 to July 2012 were included in this study. Patient characteristics, procedural outcomes and in-hospital clinical events were evaluated. Mean age of the patient was (59.6 ± 11.2) years old and 91.7% were men. The target CTO lesions were distributed among the left anterior descending artery in 45 cases (53.5%), left circumflex artery in one case (1.2%), right coronary artery in 34 cases (40.5%), and left main in four cases (4.8%). The overall success rate of recanalization was 79.8%. The septal collateral was three times more frequently used for retrograde access than the epicardial collateral, 68/84 (81%) vs. 16/84 (19%). Successful wire passage through the collateral channel was achieved in 58 (72.6%) patients. The success rate of recanalization was 93.1% (54/58) in patients with and 50% (13/26) in patients without successful retrograde wire passage of the collateral channel (P collaterals was achieved in 49 of 68 septal collaterals (72.1%) and in 9 of 16 epicardial collaterals (56.3%) (P = NS). There was no significant difference between the septal collateral group and the epicardial group in the success rate of recanalization after retrograde wire crossing the collaterals (91.8% vs. 100%, P > 0.05). CART or reverse CART technique was used in 15 patients, and 14 patients (93.3%) were recanalized successfully. Collateral related perforation occurred in three (18.8%) cases with the epicardial collateral as the first choice (compared with the septal collateral group (0), P collaterals. The retrograde approach is an effective technique to recanalize CTO lesions, the septal

Interdisciplinary treatment of bruxism with an occlusal splint and cognitive behavioral therapy.

Science.gov (United States)

Trindade, Marilene; Orestes-Cardoso, Silvana; de Siqueira, Teresa Cristina

2015-01-01

The etiology of bruxism is associated with exogenous factors, such as occlusal interference, stress, and anxiety, as well as endogenous factors involving neurotransmitters of the basal ganglia. Due to the multifactorial etiology of bruxism, interdisciplinary treatment involving professionals from different healthcare fields has been proposed. The aim of the present study was to compare 2 groups of patients with bruxism (11 in each group) treated with either an occlusal splint combined with cognitive behavioral therapy or an occlusal splint alone. Surface electromyography of the masseter and anterior temporal muscles at rest was performed before and after treatment. The mean amplitude of activity of all muscles was lower after treatment, except for the right anterior temporal muscle in the group treated with an occlusal splint alone. Mean amplitudes were greater in the anterior temporal muscles than in the masseter muscles. Significantly greater improvement was found in the group exposed to cognitive behavioral therapy (P < 0.05; analysis of variance and Student t tests). Therefore, the combination of occlusal splint and psychological therapy was more effective at achieving muscle relaxation than occlusal splint use alone.

Acute internal carotid artery occlusion after carotid endarterectomy

Directory of Open Access Journals (Sweden)

Masatoshi Yunoki

2016-09-01

Full Text Available We report two cases of acute carotid artery (CA occlusion following carotid endarterectomy (CEA. Case 1: a 58-year-old man was admitted with transient right-sided hemiparesis. Magnetic resonance imaging (MRI and MR angiography (MRA revealed cerebral infarction in the left cerebral hemisphere and left CA stenosis. Ten days after admission, he underwent CEA. 24 h after surgery, he developed right hemiplegia. MRI and MRA demonstrated a slightly enlarged infarction and left internal carotid artery (ICA occlusion. Emergency reoperation was performed and complete recanalization achieved. The patient made a clinically significant recovery. Case 2: a 65 year-old man underwent a right-sided CEA for an asymptomatic 80% CA stenosis. 48 h after surgery, his family noticed he was slightly disorientated. MRI and MRA revealed multiple infarctions and right ICA occlusion. He was treated with antiplatelet therapy without reoperation because sufficient cross-flow from the left ICA through the anterior communicating artery was demonstrated by angiography, and his neurological symptoms were mild. His symptoms gradually alleviated and he was discharged 14 days after surgery. With ICA occlusion after CEA, immediate re-operation is mandatory with severe neurological symptoms, whereas individualized judgement is needed when the symptoms are mild.

Cerebral blood flow measurement in cerebrovascular occlusive diseases

International Nuclear Information System (INIS)

Yanagihara, T.; Wahner, H.W.

1984-01-01

In order to evaluate cerebral blood flow (CBF) patterns among individual patients with increased statistical confidence, CBF measurements were carried out using the 133Xe-inhalation method and external head detectors. F1 values representing gray matter flow from 3 to 6 head detectors were averaged to form 16 different regions for each cerebral hemisphere. Normative values were obtained from 46 healthy volunteers, and data from individual regions were analyzed for absolute blood flow rates (ml/100g/min), for concordance between right and left hemispheres and as percent of mean hemispheric flow. CBF measurements were then carried out among 37 patients with cerebrovascular occlusive diseases, and results were compared with normative values. A high incidence of abnormal flows were detected among symptomatic patients with intracranial arterial stenosis or occlusion and those with extracranial internal carotid artery occlusion. By using the above method for data analysis, it was possible to delineate hypoperfused areas among these patients. Even though the 133Xe-inhalation method has inherent limitations, this is a practical and safe method for measurement of CBF which can provide reliable information useful for management of patients with cerebrovascular occlusive diseases, particularly when the results are presented with statistical confidence

Endovascular Treatment of Chronic Mesenteric Ischemia by Crossing of Two Stents in a Patient with Celiacomesenteric Trunk

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Khil, Eun Kyung; Lee, Jae Myeong [Dept. of Radiology, Soonchunhyang University College of Medicine, Bucheon Hospital, Bucheon (Korea, Republic of)

2013-06-15

A 73-year-old woman was presented with a 3-month history of postprandial abdominal pain and weight loss. The patient had an anatomic variant of celiacomesenteric trunk (CMT), with complete occlusion of the superior mesenteric artery (SMA) and significant stenosis of the CMT ostium, resulting in chronic mesenteric ischemia. After several unsuccessful attempts at revascularization of the SMA, celiac artery stenting was performed, followed by SMA stent placement through the previously placed stent mesh into the occlusion site. The patient's symptoms completely resolved after treatment.

Aneurysm occlusion in elderly patients with aneurysmal subarachnoid haemorrhage : a cost-utility analysis

NARCIS (Netherlands)

Koffijberg, H.; Buskens, E.; Rinkel, G. J. E.

Background Aneurysm occlusion after subarachnoid haemorrhage (SAH) aims to improve outcome by reducing the rebleeding risk. With increasing age, overall prognosis decreases, and the complications of aneurysm occlusion increase. The balance of risks for aneurysm occlusion in elderly SAH patients in

Implications of natural occlusion of ventilated racks on ammonia and sanitation practices.

Science.gov (United States)

Creamer, Michelle A; Petty, Joann; Martin, Tara; Bergdall, Valerie; Hickman-Davis, Judy M

2014-03-01

Examination of ventilated rat racks prior to semiannual sanitation revealed silicone nozzles and ventilation ports that were partially or completely occluded with granular debris. We subsequently sought to document performance standards for rack sanitation and investigate the effect of ventilation port occlusion on rack function and animal husbandry practices. We hypothesized that individually ventilated cages with occluded airflow would require more frequent cage changes, comparable to those for static cages (that is, every 3 to 4 d). Sprague-Dawley rats were housed under one of 4 conditions: no airflow occlusion, occluded air-supply inlet, occluded air-exhaust outlet, and occlusion of both inlet and outlet. Cages were changed when daily ammonia concentration exceeded 20 ppm or after 14 d had elapsed. Most cages with unoccluded or partial airflow occlusion remained below the 20 ppm limit until day 12 or 13. Cages with occlusion of both inlet and outlet exceeded 20 ppm ammonia by as early as day 5. Airflow was significantly lower in cages with occlusion of both inlet and outlet airflow. Weekly inspection revealed that occlusion of ventilation ports was detectable by 3 mo after semiannual sanitation. This study demonstrates that silicone nozzles should be removed prior to rack sanitation to improve the effectiveness of cleaning ventilation ports and nozzles. While the rack is in use, silicone nozzles and ventilation ports should be inspected regularly to identify occlusion that is likely to diminish environmental quality in the cage. Intracage ammonia levels are significantly higher when both inlet and outlet airflow are occluded.

Intravascular stenting in the superior mesenteric artery for chronic abdominal angina.

Science.gov (United States)

Busquet, J

1997-11-01

Abdominal angina is an early clinical expression of occlusive mesenteric arterial insufficiency, a condition that requires aggressive treatment to prevent intestinal infarction. We report a case of chronic mesenteric ischemia in a young polyvascular man who had symptoms of abdominal angina. An aortic angiogram revealed a significant ostial stenosis of the superior mesenteric artery (SMA) associated with an occlusion of the inferior mesenteric artery. After predilation of the ostial portion of the SMA, significant residual stenosis remained. A balloon-expandable Palmaz P154 stent was deployed, restoring adequate luminal dimensions and blood flow. The patient was discharged after 2 days and remains asymptomatic at 5 months. Intraluminal stenting for treatment of mesenteric ischemia represents a viable alternative to surgical revascularization in selected cases.

Laser photocoagulation for retinal vein occlusion

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K. A. Mirzabekova

2015-03-01

Full Text Available Retinal vein occlusion (RVO is one of the leading causes of permanent vision loss. In adults, central retinal vein occlusion (CRVO occurs in 1.8% while branch retinal vein occlusion (BRVO occurs in 0.2%. Treatment strategy and disease prognosis are determined by RVO type (ischemic/non-ischemic. Despite numerous studies and many current CRVO and BRVO treatment approaches, the management of these patients is still being debated. Intravitreal injections of steroids (triamcinolone acetate, dexamethasone and vascular endothelial growth factor (VEGF inhibitors (bevacizumab, ranibizumab were shown to be fairly effective. However, it is unclear whether anti-VEGF agents are reasonable in ischemic RVOs. Laser photocoagulation remains the only effective treatment of optic nerve head and/or retinal neovascularization. Laser photocoagulation is also indicated for the treatment of macular edema. Both threshold and sub-threshold photocoagulation may be performed. Photocoagulation performed with argon (514 nm, krypton (647 nm, or diode (810 nm laser for macular edema provides similar results (no significant differences. The treatment may be complex and include medication therapy and/or surgery. Medication therapy includes anti-aggregant agents and antioxidants, i.e., emoxypine which may be used in acute RVO as well as in post-thrombotic retinopathy. 

Laser photocoagulation for retinal vein occlusion

Directory of Open Access Journals (Sweden)

K. A. Mirzabekova

2015-01-01

Full Text Available Retinal vein occlusion (RVO is one of the leading causes of permanent vision loss. In adults, central retinal vein occlusion (CRVO occurs in 1.8% while branch retinal vein occlusion (BRVO occurs in 0.2%. Treatment strategy and disease prognosis are determined by RVO type (ischemic/non-ischemic. Despite numerous studies and many current CRVO and BRVO treatment approaches, the management of these patients is still being debated. Intravitreal injections of steroids (triamcinolone acetate, dexamethasone and vascular endothelial growth factor (VEGF inhibitors (bevacizumab, ranibizumab were shown to be fairly effective. However, it is unclear whether anti-VEGF agents are reasonable in ischemic RVOs. Laser photocoagulation remains the only effective treatment of optic nerve head and/or retinal neovascularization. Laser photocoagulation is also indicated for the treatment of macular edema. Both threshold and sub-threshold photocoagulation may be performed. Photocoagulation performed with argon (514 nm, krypton (647 nm, or diode (810 nm laser for macular edema provides similar results (no significant differences. The treatment may be complex and include medication therapy and/or surgery. Medication therapy includes anti-aggregant agents and antioxidants, i.e., emoxypine which may be used in acute RVO as well as in post-thrombotic retinopathy. 

Occlus-o-Guide® versus Andresen activator appliance: neuromuscular evaluation.

Science.gov (United States)

Farronato, Giampietro; Giannini, Lucia; Galbiati, Guido; Grillo, Elena; Maspero, Cinzia

2013-05-20

The aim of the present study was to assess the muscular variations at the electromyography (EMG) level for the anterior temporalis muscles and masseter muscles during treatment with Occlus-o-Guide® and Andresen activator appliances. Eighty-two patients (35 males and 47 females) aged between 8 and 12 years (mean age, 10.5±0.8 years) participated in the study. Fifty patients underwent treatment with an Occlus-o-Guide® and 32 patients with an Andresen activator. All patients underwent EMG examination using a Freely EMG (De Gotzen, Legnano, Italy) and surface bipolar electrodes when the appliances were worn for the first time (T0), and after 6 months (T1) and after 12 months (T2) of appliance use. Statistical analysis showed that both at T0 and T2, the percent overlapping coefficient (POC) of the anterior temporalis muscles was not statistically different between the appliance groups. At T0, the POC of the masseter muscles was significantly lower for the Andresen appliance as compared to the Occlus-o-Guide® (p=0.02), while at T2 this significance was lost. At insertion of an appliance, all patients show neuromuscular balance that does not correspond to orthognathic occlusion. Both appliances work by creating muscular imbalance. With the appliances in situ, EMG responses were generally analogous for the Occlus-o-Guide® and the Andresen activator; however, the imbalance was greater and the recovery of the orthological muscular balance was slower in patients under treatment with the Andresen activator as compared to those with the Occlus-o-Guide®.

Chronic intestinal pseudoobstruction syndrome

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Yeon, Kyung Mo; Seo, Jeong Kee; Lee, Yong Seok [Seoul National University Children' s Hospital, Seoul (Korea, Republic of)

1992-03-15

Chronic intestinal pseudoobstruction syndrome is a rare clinical condition in which impaired intestinal peristalsis causes recurrent symptoms of bowel obstruction in the absence of a mechanical occlusion. This syndrome may involve variable segments of small or large bowel, and may be associated with urinary bladder retention. This study included 6 children(3 boys and 3 girls) of chronic intestinal obstruction. Four were symptomatic at birth and two were of the ages of one month and one year. All had abdominal distension and deflection difficulty. Five had urinary bladder distension. Despite parenteral nutrition and surgical intervention(ileostomy or colostomy), bowel obstruction persisted and four patients expired from sepses within one year. All had gaseous distension of small and large bowel on abdominal films. In small bowel series, consistent findings were variable degree of dilatation, decreased peristalsis(prolonged transit time) and microcolon or microrectum. This disease entity must be differentiated from congenital megacolon, ileal atresia and megacystis syndrome.

Experimental animal study of a novel radiofrequency endovascular occlusion device.

Science.gov (United States)

Zacharoulis, Dimitris; Lazoura, Olga; Rountas, Christos; Katsimboulas, Michael; Mantzianas, George; Tzovaras, George; Habib, Nagy

2011-07-01

The purpose of this study was to present a radiofrequency (RF) endovascular occlusion device (ie, Habib VesCoag Catheter; EMcision Ltd, London, UK) and to evaluate safety and efficacy of the device for complete occlusion of normal porcine vessels. The study included 20 pigs. In each pig, a segmental branch of the right hepatic artery, a branch of the splenic artery, and a branch of one of the renal arteries were catheterized. A single or multiple applications of RF energy were performed until vessel occlusion was achieved. Fifteen days later, angiography was repeated to assess vessel patency. The vessels were then excised for pathological analysis. Vessels 2.5 to 6 mm in diameter were treated. Complete occlusion with a single attempt was achieved using a mean amount of energy of 110.67 J in vessels 2.5 to 3 mm, 111.67 J in vessels 3.5 to 4 mm, and 116.63 J in vessels 5 to 6 mm in diameter and was confirmed by angiography at the 15-day follow-up. Vascular occlusion can be effectively and safely achieved by endovascular application of RF energy to normal porcine arteries using the Habib VesCoag catheter. Copyright © 2011 Elsevier Inc. All rights reserved.

Occlusion and Temporomandibular Function among Subjects with Mandibular Distal Extension Removable Partial Dentures

Science.gov (United States)

Creugers, N. H. J.; Witter, D. J.; Van 't Spijker, A.; Gerritsen, A. E.; Kreulen, C. M.

2010-01-01

Objective. To quantify effects on occlusion and temporomandibular function of mandibular distal extension removable partial dentures in shortened dental arches. Methods. Subjects wearing mandibular extension removable partial dentures (n = 25) were compared with subjects with shortened dental arches without extension (n = 74) and with subjects who had worn a mandibular extension removable partial denture in the past (n = 19). Subjects with complete dentitions (n = 72) were controls. Data were collected at baseline and at 3-, 6-, and 9-year observations. Results. Occlusal activity in terms of reported awareness of bruxism and occlusal tooth wear of lower anterior teeth did not differ significantly between the groups. In contrast, occlusal tooth wear of premolars in shortened dental arches with or without extension dentures was significantly higher than in the controls. Differences amongst groups with respect to signs and symptoms related to temporomandibular disorders were not found. Occlusal support of the dentures did not influence anterior spatial relationship. Occlusal contacts of the denture teeth decreased from 70% for second premolars via 50% for first molars, to 30% for second molars. Conclusions. Mandibular distal extension removable partial dentures in moderate shortened dental arches had no effects on occlusion and temporomandibular function. PMID:20671961

Biphasic functional regulation in hippocampus of rat with chronic cerebral hypoperfusion induced by permanent occlusion of bilateral common carotid artery.

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Jihye Bang

Full Text Available BACKGROUND: Chronic cerebral hypoperfusion induced by permanent occlusion of the bilateral common carotid artery (BCCAO in rats has been commonly used for the study of Alzheimer's disease and vascular dementia. Despite the apparent cognitive dysfunction in rats with BCCAO, the molecular markers or pathways involved in the pathological alternation have not been clearly identified. METHODS: Temporal changes (sham, 21, 35, 45, 55 and 70 days in gene expression in the hippocampus of rats after BCCAO were measured using time-course microarray analysis. Gene Ontology (GO and pathway analyses were performed to identify the functional involvement of temporally regulated genes in BCCAO. RESULTS: Two major gene expression patterns were observed in the hippocampus of rats after BCCAO. One pattern, which was composed of 341 early up-regulated genes after the surgical procedure, was dominantly involved in immune-related biological functions (false discovery rate [FDR]<0.01. Another pattern composed of 182 temporally delayed down-regulated genes was involved in sensory perception such as olfactory and cognition functions (FDR<0.01. In addition to the two gene expression patterns, the temporal change of GO and the pathway activities using all differentially expressed genes also confirmed that an immune response was the main early change, whereas sensory functions were delayed responses. Moreover, we identified FADD and SOCS3 as possible core genes in the sensory function loss process using text-based mining and interaction network analysis. CONCLUSIONS: The biphasic regulatory mechanism first reported here could provide molecular evidence of BCCAO-induced impaired memory in rats as well as mechanism of the development of vascular dementia.

Occlusal enamel complexity in middle miocene to holocene equids (Equidae: Perissodactyla of North America.

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Nicholas A Famoso

Full Text Available Four groups of equids, "Anchitheriinae," Merychippine-grade Equinae, Hipparionini, and Equini, coexisted in the middle Miocene, but only the Equini remains after 16 Myr of evolution and extinction. Each group is distinct in its occlusal enamel pattern. These patterns have been compared qualitatively but rarely quantitatively. The processes influencing the evolution of these occlusal patterns have not been thoroughly investigated with respect to phylogeny, tooth position, and climate through geologic time. We investigated Occlusal Enamel Index, a quantitative method for the analysis of the complexity of occlusal patterns. We used analyses of variance and an analysis of co-variance to test whether equid teeth increase resistive cutting area for food processing during mastication, as expressed in occlusal enamel complexity, in response to increased abrasion in their diet. Results suggest that occlusal enamel complexity was influenced by climate, phylogeny, and tooth position through time. Occlusal enamel complexity in middle Miocene to Modern horses increased as the animals experienced increased tooth abrasion and a cooling climate.

Occlusal enamel complexity in middle miocene to holocene equids (Equidae: Perissodactyla) of North America.

Science.gov (United States)

Famoso, Nicholas A; Davis, Edward Byrd

2014-01-01

Four groups of equids, "Anchitheriinae," Merychippine-grade Equinae, Hipparionini, and Equini, coexisted in the middle Miocene, but only the Equini remains after 16 Myr of evolution and extinction. Each group is distinct in its occlusal enamel pattern. These patterns have been compared qualitatively but rarely quantitatively. The processes influencing the evolution of these occlusal patterns have not been thoroughly investigated with respect to phylogeny, tooth position, and climate through geologic time. We investigated Occlusal Enamel Index, a quantitative method for the analysis of the complexity of occlusal patterns. We used analyses of variance and an analysis of co-variance to test whether equid teeth increase resistive cutting area for food processing during mastication, as expressed in occlusal enamel complexity, in response to increased abrasion in their diet. Results suggest that occlusal enamel complexity was influenced by climate, phylogeny, and tooth position through time. Occlusal enamel complexity in middle Miocene to Modern horses increased as the animals experienced increased tooth abrasion and a cooling climate.

Reduction of deviation angle during occlusion therapy: in partially accommodative esotropia with moderate amblyopia.

Science.gov (United States)

Chun, Bo Young; Kwon, Soon Jae; Chae, Sun Hwa; Kwon, Jung Yoon

2007-09-01

To evaluate changes in ocular alignment in partially accommodative esotropic children age ranged from 3 to 8 years during occlusion therapy for amblyopia. Angle measurements of twenty-two partially accommodative esotropic patients with moderate amblyopia were evaluated before and at 2 years after occlusion therapy. Mean deviation angle with glasses at the start of occlusion treatment was 19.45+/-5.97 PD and decreased to 12.14+/-12.96 PD at 2 years after occlusion therapy (pocclusion therapy, 9 (41%) cases were indications of surgery for residual deviation but if we had planned surgery before occlusion treatment, 18 (82%) of patients would have had surgery. There was a statistical relationship between increase of visual acuity ratio and decrease of deviation angle (r=-0.479, p=0.024). There was a significant reduction of deviation angle of partially accommodative esotropic patients at 2 years after occlusion therapy. Our results suggest that occlusion therapy has an influence on ocular alignment in partially accommodative esotropic patients with amblyopia.

The dental literature on occlusion and myogenous orofacial pain: application of critical thinking.

Science.gov (United States)

Solow, Roger Alan

2016-09-01

To enhance the reader's critical thinking when reading the dental literature on the relationship of occlusion and myogenous orofacial pain (MOP). Representative journal articles and systematic reviews from the dental literature confirming and denying a relationship of occlusion to MOP were analyzed and reviewed. Studies using computerized occlusal analysis (COA) consistently find a relationship of the occlusion to MOP. Studies that do not confirm this relationship have problems with invalid primary source conclusions, unstated assumptions, bias, and errors in logic that disqualify their conclusion. This review explains four categories of problems with the dental literature that denies occlusion has a relationship with MOP. When the reader understands these examples of flaws in this literature, they can apply this critical thinking to future studies. Correct interpretation of the literature on occlusion and MOP requires a foundation of basic and clinical scientific knowledge as well as an understanding of the details of the primary source articles.

Ambient Occlusion Effects for Combined Volumes and Tubular Geometry

KAUST Repository

Schott, M.; Martin, T.; Grosset, A. V. P.; Smith, S. T.; Hansen, C. D.

2013-01-01

This paper details a method for interactive direct volume rendering that computes ambient occlusion effects for visualizations that combine both volumetric and geometric primitives, specifically tube-shaped geometric objects representing streamlines, magnetic field lines or DTI fiber tracts. The algorithm extends the recently presented the directional occlusion shading model to allow the rendering of those geometric shapes in combination with a context providing 3D volume, considering mutual occlusion between structures represented by a volume or geometry. Stream tube geometries are computed using an effective spline-based interpolation and approximation scheme that avoids self-intersection and maintains coherent orientation of the stream tube segments to avoid surface deforming twists. Furthermore, strategies to reduce the geometric and specular aliasing of the stream tubes are discussed.

Ambient Occlusion Effects for Combined Volumes and Tubular Geometry

KAUST Repository

Schott, M.

2013-06-01

This paper details a method for interactive direct volume rendering that computes ambient occlusion effects for visualizations that combine both volumetric and geometric primitives, specifically tube-shaped geometric objects representing streamlines, magnetic field lines or DTI fiber tracts. The algorithm extends the recently presented the directional occlusion shading model to allow the rendering of those geometric shapes in combination with a context providing 3D volume, considering mutual occlusion between structures represented by a volume or geometry. Stream tube geometries are computed using an effective spline-based interpolation and approximation scheme that avoids self-intersection and maintains coherent orientation of the stream tube segments to avoid surface deforming twists. Furthermore, strategies to reduce the geometric and specular aliasing of the stream tubes are discussed.

Islet neogenesis is stimulated by brief occlusion of the main ...

African Journals Online (AJOL)

Islet neogenesis is stimulated by brief occlusion of the main pancreatic duct. ... South African Medical Journal ... where the initial events that culminate in increased pancreatic endocrine mass caube studied. ... The animals were killed 56 days post .occlusion, and the pancreata excised and fiXed tor histological analysis.

Vascular endoprostheses for femoro-popliteal occlusive disease

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Triller, J; Mahler, F; Do, D; Thalmann, R

1989-03-01

A self-expanding vascular endoprothesis (wall stent) was implanted in 26 patients with femoro-popliteal occlusive disease following recurrent stenosis or occlusion after percutaneous angioplasty. Implantation was successful in all cases and there were no complications. Five of the 26 patients developped a thrombosis in the first nine days; in four of these, thrombolysis was successful. Patency rate after one month was 96%, after three months 95%, after six months 85% and after nine months 87%. In order to prevent thrombosis after implantation, anticoagulant therapy is indicated. Poor distal flow encourages intimal hyperplasia and therefore recurrences.

Vascular endoprostheses for femoro-popliteal occlusive disease

International Nuclear Information System (INIS)

Triller, J.; Mahler, F.; Do, D.; Thalmann, R.

1989-01-01

A self-expanding vascular endoprothesis (wall stent) was implanted in 26 patients with femoro-popliteal occlusive disease following recurrent stenosis or occlusion after percutaneous angioplasty. Implantation was successful in all cases and there were no complications. Five of the 26 patients developped a thrombosis in the first nine days; in four of these, thrombolysis was successful. Patency rate after one month was 96%, after three months 95%, after six months 85% and after nine months 87%. In order to prevent thrombosis after implantation, anticoagulant therapy is indicated. Poor distal flow encourages intimal hyperplasia and therefore recurrences. (orig.) [de

[The influence of occlusal interferences on pulp vitality threshold in permanent dentition].

Science.gov (United States)

Hejne, Arletta Julita

2003-01-01

Examination of pulp vitality is a valuable aid in diagnosis and treatment and thus has been in use for a long time. Numerous factors influencing the pain threshold have been found including occlusal interferences. The effect of EOI (Experimental Occlusal Interferences) has been described, while the effect of primary occlusal interference awaits further investigation. The aim of this work was to evaluate the influence of malocclusion (primary occlusal interference) on pulp vitality. At first, the pattern of bite forces in normal occlusion was established. For this purpose, 20 individuals were examined. The following results were found: (a) Bite forces on the right and left side are symmetrical; (b) Total bite forces are distributed as follows: (I) upper half arch: medial incisor 6.3%, lateral incisor 2.9%, canine 3.6%, first premolar 10.4%, second premolar 11.7%, first molar 29.4%, second molar 23.8%; (II) lower half arch: medial incisor 4.1%, lateral incisor 4%, canine 4.8%, first premolar 9%, second premolar 15.1%, first molar 27.3%, second molar 29.7% (Fig. 4). Next, 83 patients with unilateral malocclusion were subjected to clinical examination (orthodontic diagnosis) and measurement of bite forces (with T-Scan system). A computer program was used to establish bite forces (in %) for each tooth. 576 teeth were divided into 9 groups in accordance with the orthodontic diagnosis as follows: class II tendency (n = 126), cross-bite (n = 50), rotated (n = 30), scissors bite (n = 23), class III tendency (n = 19), class II (n = 16), open bite (n = 15), class III (n = 9), normal occlusion (n = 288). Each tooth in malocclusion was assigned a contralateral "control" tooth (Fig. 5). Bite forces acting on teeth in malocclusion were compared with control teeth using Student's t-test (Fig. 6). There is no difference between bite forces of teeth in normal occlusion and malocclusion on the opposite side of dental arches in the same patient, the only exceptions being open and

Intraoral Digital Impressions for Virtual Occlusal Records: Section Quantity and Dimensions

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Eneko Solaberrieta

2016-01-01

Full Text Available The purpose of this study was to locate the 3D spatial position mandibular cast and determine its occlusal contacts in a novel way by using an intraoral scanner as part of the virtual occlusal record procedure. This study also analyzes the requirements in quantity and dimensions of the intraoral virtual occlusal record. The results showed that the best section combination consists of 2 lateral and frontal sections, the width of this section being that of 2 teeth (24 mm × 15 mm. This study concluded that this procedure was accurate enough to locate the mandibular cast on a virtual articulator. However, at least 2 sections of the virtual occlusal records were necessary, and the best results were obtained when the distance between these sections was maximum.

Intraoral Digital Impressions for Virtual Occlusal Records: Section Quantity and Dimensions

Science.gov (United States)

Solaberrieta, Eneko; Garmendia, Asier; Brizuela, Aritza; Otegi, Jose Ramon; Pradies, Guillermo; Szentpétery, Andras

2016-01-01

The purpose of this study was to locate the 3D spatial position mandibular cast and determine its occlusal contacts in a novel way by using an intraoral scanner as part of the virtual occlusal record procedure. This study also analyzes the requirements in quantity and dimensions of the intraoral virtual occlusal record. The results showed that the best section combination consists of 2 lateral and frontal sections, the width of this section being that of 2 teeth (24 mm × 15 mm). This study concluded that this procedure was accurate enough to locate the mandibular cast on a virtual articulator. However, at least 2 sections of the virtual occlusal records were necessary, and the best results were obtained when the distance between these sections was maximum. PMID:26881226

Occlusal consequence of using average condylar guidance settings: An in vitro study.

Science.gov (United States)

Lee, Wonsup; Lim, Young-Jun; Kim, Myung-Joo; Kwon, Ho-Beom

2017-04-01

A simplified mounting technique that adopts an average condylar guidance has been advocated. Despite this, the experimental explanation of how average settings differ from individual condylar guidance remains unclear. The purpose of this in vitro study was to examine potential occlusal error by using average condylar guidance settings during nonworking side movement of the articulator. Three-dimensional positions of the nonworking side maxillary first molar at various condylar and incisal settings were traced using a laser displacement sensor attached to the motorized stages with biaxial freedom of movement. To examine clinically relevant occlusal consequences of condylar guidance setting errors, the vertical occlusal error was defined as the vertical-axis positional difference between the average setting trace and the other condylar guidance setting trace. In addition, the respective contribution of the condylar and incisal guidance to the position of the maxillary first molar area was analyzed by multiple regression analysis using the resultant coordinate data. Alteration from individual to average settings led to a positional difference in the maxillary first molar nonworking side movement. When the individual setting was lower than average, vertical occlusal error occurred, which might cause occlusal interference. The vertical occlusal error ranged from -2964 to 1711 μm. In addition, the occlusal effect of incisal guidance was measured as a partial regression coefficient of 0.882, which exceeded the effect of condylar guidance, 0.431. Potential occlusal error as a result of adopting an average condylar guidance setting was observed. The occlusal effect of incisal guidance doubled the effect of condylar guidance. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Haemodynamic changes in hepatocellular carcinoma and liver parenchyma under balloon occlusion of the hepatic artery

Energy Technology Data Exchange (ETDEWEB)

Sugihara, Fumie; Murata, Satoru; Ueda, Tatsuo; Yasui, Daisuke; Yamaguchi, Hidenori; Miki, Izumi; Kumita, Shin-ichiro [Nippon Medical School, Department of Radiology, Center for Advanced Medical Technology, Tokyo (Japan); Kawamoto, Chiaki [Nippon Medical School, Department of Internal Medicine, Tokyo (Japan); Uchida, Eiji [Nippon Medical School, Department of Surgery, Tokyo (Japan)

2017-06-15

To investigate haemodynamic changes in hepatocellular carcinoma (HCC) and liver under hepatic artery occlusion. Thirty-eight HCC nodules in 25 patients were included. Computed tomography (CT) during hepatic arteriography (CTHA) with and without balloon occlusion of the hepatic artery was performed. CT attenuation and enhancement volume of HCC and liver with and without balloon occlusion were measured on CTHA. Influence of balloon position (segmental or subsegmental branch) was evaluated based on differences in HCC-to-liver attenuation ratio (H/L ratio) and enhancement volume of HCC and liver. In the segmental group (n = 20), H/L ratio and enhancement volume of HCC and liver were significantly lower with balloon occlusion than without balloon occlusion. However, in the subsegmental group (n = 18), H/L ratio was significantly higher and liver enhancement volume was significantly lower with balloon occlusion; HCC enhancement volume was similar with and without balloon occlusion. Rate of change in H/L ratio and enhancement volume of HCC and liver were lower in the segmental group than in the subsegmental group. There were significantly more perfusion defects in HCC in the segmental group. Hepatic artery occlusion causes haemodynamic changes in HCC and liver, especially with segmental occlusion. (orig.)

[Influence of the occlusal interference time on masticatory muscle mechanical hyperalgesia in rats].

Science.gov (United States)

Liu, Cun-rui; Xu, Xiao-xiang; Cao, Ye; Xie, Qiu-fei

2016-02-18

To investigate the relationship between the removal time of 0.2 mm occlusal interference and the recovery of masticatory muscle mechanical hyperalgesia in rats. Forty male Sprague-Dawley rats (200-220 g) were randomly assigned to eight groups, with five rats in each group: (1) naive group: these rats were anesthetized and their mouths were forced open for about 5 min (the same duration as the other groups), but restorations were not applied; (2) sham-occlusal interference control group: bands were bonded to the right maxillary first molars which did not interfere with occlusion; (3)occlusal interference group: 0.2 mm thick crowns were bonded to the right maxillary first molars; (4) 2, 3, 4, 5, and 6 d removal of occlusal interference groups: 0.2 mm thick crowns were bonded to the right maxillary first molars and removed on days 2, 3, 4, 5, and 6. The naive group and sham-occlusal interference control group were control groups. The other groups were experimental groups. Bilateral masticatory muscle mechanical withdrawal thresholds were tested on pre-application days 1, 2, and 3, and on post-application days 1, 3, 5, 7, 10, 14, 21 and 28. The rats were weighed on pre-application day 1 and on post-application days 1, 2, 3, 4, 5, 6, and 7. Between the naive group and the sham-occlusal interference control group, there was no significant difference in the masticatory muscle mechanical withdrawal threshold of bilateral temporalis and masseters at each time point. No significant difference was detected between the contralateral side and ipsilateral side in experimental groups (P>0.05). In the 2, 3, 4, and 5 d removal of occlusal interference groups, the masticatory muscle mechanical withdrawal thresholds decreased after occlusal interference and increased after removal of the crowns and recovered to the baseline on days 7, 10, 14, and 14, respectively [the masticatory muscle mechanical withdrawal thresholds of right masseter muscle were (137.46 ± 2.08) g, (139.02 ± 2

Mesiodistal angulation of the lateral teeth to the functional occlusal plane in normal occlusions

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Hiroshi Ueda

2016-01-01

Full Text Available Introduction: Crowding is a malocclusion with irregularly positioned teeth caused by arch length discrepancy (ALD. Its incidence is high compared with the various malocclusions. In a previous study the crowns of the maxillary lateral teeth had erupted mesially in relation to the functional occlusal plane (FOP in patients with Angle Class I malocclusion and highly erupted canines, which had been uprighted by non-extraction orthodontic treatment, yet these results were based on only two cases evaluated by using plaster models. Therefore, the aim of this study was to assess the mesiodistal angulations of both maxillary and mandibular teeth relative to the FOP in normal occlusion by means of cephalograms and identifying the teeth axial factors contributing to the normal dentitions with the least ALD. Materials and Methods: Thirty Japanese young adult patients (6 males, 24 females with normal occlusion were selected to participate in this study; cephalograms were procured from each and the FOP was used as a reference plane for measuring the changes in the axial angulation along with other indicators of vertical growth. Results: Progressive mesial tipping of the maxillary lateral teeth was observed. First premolars tended to express this more than the second premolars but the tipping values were roughly 90° relative to the FOP on the first molars. Conclusion: The maxillary lateral teeth are more mesially angulated compared to the mandibular ones relative to the FOP. Furthermore, progressive mesial tipping of the maxillary lateral teeth was detected, of which axial angulations were significantly correlated to each other, in spite the mandibular premolars and molars being angulated in a similar fashion.

RTSAH Traversal Order for Occlusion Rays

KAUST Repository

Ize, Thiago

2011-04-01

We accelerate the finding of occluders in tree based acceleration structures, such as a packetized BVH and a single ray kd-tree, by deriving the ray termination surface area heuristic (RTSAH) cost model for traversing an occlusion ray through a tree and then using the RTSAH to determine which child node a ray should traverse first instead of the traditional choice of traversing the near node before the far node. We further extend RTSAH to handle materials that attenuate light instead of fully occluding it, so that we can avoid superfluous intersections with partially transparent objects. For scenes with high occlusion, we substantially lower the number of traversal steps and intersection tests and achieve up to 2× speedups. © 2010 The Author(s).

RTSAH Traversal Order for Occlusion Rays

KAUST Repository

Ize, Thiago; Hansen, Charles

2011-01-01

We accelerate the finding of occluders in tree based acceleration structures, such as a packetized BVH and a single ray kd-tree, by deriving the ray termination surface area heuristic (RTSAH) cost model for traversing an occlusion ray through a tree and then using the RTSAH to determine which child node a ray should traverse first instead of the traditional choice of traversing the near node before the far node. We further extend RTSAH to handle materials that attenuate light instead of fully occluding it, so that we can avoid superfluous intersections with partially transparent objects. For scenes with high occlusion, we substantially lower the number of traversal steps and intersection tests and achieve up to 2× speedups. © 2010 The Author(s).

Comparison of occlusion break responses and vacuum rise times of phacoemulsification systems.

Science.gov (United States)

Sharif-Kashani, Pooria; Fanney, Douglas; Injev, Val

2014-07-30

Occlusion break surge during phacoemulsification cataract surgery can lead to potential surgical complications. The purpose of this study was to quantify occlusion break surge and vacuum rise time of current phacoemulsification systems used in cataract surgery. Occlusion break surge at vacuum pressures between 200 and 600 mmHg was assessed with the Infiniti® Vision System, the WhiteStar Signature® Phacoemulsification System, and the Centurion® Vision System using gravity-fed fluidics. Centurion Active FluidicsTM were also tested at multiple intraoperative pressure target settings. Vacuum rise time was evaluated for Infiniti, WhiteStar Signature, Centurion, and Stellaris® Vision Enhancement systems. Rise time to vacuum limits of 400 and 600 mmHg was assessed at flow rates of 30 and 60 cc/minute. Occlusion break surge was analyzed by 2-way analysis of variance. The Centurion system exhibited substantially less occlusion break surge than the other systems tested. Surge area with Centurion Active Fluidics was similar to gravity fluidics at an equivalent bottle height. At all Centurion Active Fluidics intraoperative pressure target settings tested, surge was smaller than with Infiniti and WhiteStar Signature. Infiniti had the fastest vacuum rise time and Stellaris had the slowest. No system tested reached the 600-mmHg vacuum limit. In this laboratory study, Centurion had the least occlusion break surge and similar vacuum rise times compared with the other systems tested. Reducing occlusion break surge may increase safety of phacoemulsification cataract surgery.

Branch retinal vein occlusion associated with quetiapine fumarate

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Siang Lim

2011-08-01

Full Text Available Abstract Background To report a case of branch retinal vein occlusion in a young adult with bipolar mood disorder treated with quetiapine fumarate. Case Presentation A 29 years old gentleman who was taking quetiapine fumarate for 3 years for bipolar mood disorder, presented with sudden vision loss. He was found to have a superior temporal branch retinal vein occlusion associated with hypercholesterolemia. Conclusion Atypical antipsychotic drugs have metabolic side effects which require regular monitoring and prompt treatment.

Localized arterial occlusion following irradiation

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Kikuchi, S; Hasue, M [Japan Red Cross Medical Center, Tokyo; Fujiwara, M

1982-04-01

Occlusion of the major artery (the iliac artery in 2 cases and subclavicular artery in one) was reported, which occurred in association with bone necrosis 5 - 21 years after postoperative radiotherapy for malignant tumors (uterine cancer in 2 cases and mammary cancer in one).

Occlusion and Temporomandibular Function among Subjects with Mandibular Distal Extension Removable Partial Dentures

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N. H. J. Creugers

2010-01-01

Full Text Available Objective. To quantify effects on occlusion and temporomandibular function of mandibular distal extension removable partial dentures in shortened dental arches. Methods. Subjects wearing mandibular extension removable partial dentures (n=25 were compared with subjects with shortened dental arches without extension (n=74 and with subjects who had worn a mandibular extension removable partial denture in the past (n=19. Subjects with complete dentitions (n=72 were controls. Data were collected at baseline and at 3-, 6-, and 9-year observations. Results. Occlusal activity in terms of reported awareness of bruxism and occlusal tooth wear of lower anterior teeth did not differ significantly between the groups. In contrast, occlusal tooth wear of premolars in shortened dental arches with or without extension dentures was significantly higher than in the controls. Differences amongst groups with respect to signs and symptoms related to temporomandibular disorders were not found. Occlusal support of the dentures did not influence anterior spatial relationship. Occlusal contacts of the denture teeth decreased from 70% for second premolars via 50% for first molars, to 30% for second molars. Conclusions. Mandibular distal extension removable partial dentures in moderate shortened dental arches had no effects on occlusion and temporomandibular function.

Tibiopedal Access for Crossing of Infrainguinal Artery Occlusions

Science.gov (United States)

Walker, Craig M.; Mustapha, Jihad; Zeller, Thomas; Schmidt, Andrej; Montero-Baker, Miguel; Nanjundappa, Aravinda; Manzi, Marco; Palena, Luis Mariano; Bernardo, Nelson; Khatib, Yazan; Beasley, Robert; Leon, Luis; Saab, Fadi A.; Shields, Adam R.; Adams, George L.

2016-01-01

Purpose: To report a prospective, multicenter, observational study (ClinicalTrials.gov identifier NCT01609621) of the safety and effectiveness of tibiopedal access and retrograde crossing in the treatment of infrainguinal chronic total occlusions (CTOs). Methods: Twelve sites around the world prospectively enrolled 197 patients (mean age 71±11 years, range 41-93; 129 men) from May 2012 to July 2013 who met the inclusion criterion of at least one CTO for which a retrograde crossing procedure was planned or became necessary. The population consisted of 64 (32.5%) claudicants (Rutherford categories 2/3) and 133 (67.5%) patients with critical limb ischemia (Rutherford category ≥4). A primary antegrade attempt to cross had been made prior to the tibiopedal attempt in 132 (67.0%) cases. Techniques used for access, retrograde lesion crossing, and treatment were at the operator’s discretion. Follow-up data were obtained 30 days after the procedure. Results: Technical tibiopedal access success was achieved in 184 (93.4%) of 197 patients and technical occlusion crossing success in 157 (85.3%) of the 184 successful tibial accesses. Failed access attempts were more common in women (9 of 13 failures). The rate of successful crossing was roughly equivalent between sexes [84.7% (50/59) women compared to 85.6% (107/125) men]. Technical success did not differ significantly based on a prior failed antegrade attempt: the access success rate was 92.4% (122/132) after a failed antegrade access vs 95.4% (62/65) in those with a primary tibiopedal attempt (p=0.55). Similarly, crossing success was achieved in 82.8% (101/122) after a failed antegrade access vs 90.3% (56/62) for patients with no prior antegrade attempt (p=0.19). Minor complications related to the access site occurred in 11 (5.6%) cases; no patient had access vessel thrombosis, compartment syndrome, or surgical revascularization. Conclusion: Tibiopedal access appears to be safe and can be used effectively for the

Hemi-central retinal artery occlusion in young adults

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Rishi Pukhraj

2010-01-01

Full Text Available Amongst the clinical presentations of retinal artery occlusion, hemi-central retinal artery occlusion (Hemi-CRAO is rarely described. This case series of four adults aged between 22 and 36 years attempts to describe the clinical profile, etiology and management of Hemi-CRAO. Case 1 had an artificial mitral valve implant. Polycythemia and malignant hypertension were noted in Case 2. The third patient had Leiden mutation while the fourth patient had Eisenmenger′s syndrome. Clinical examination and fundus fluorescein angiography revealed a bifurcated central retinal artery at emergence from the optic nerve head, in all cases. Color Doppler examination of the central retinal artery confirmed branching of the artery behind the lamina cribrosa. It is hypothesized that bifurcation of central retinal artery behind the lamina cribrosa may predispose these hemi-trunks to develop an acute occlusion if associated with underlying risk factors. The prognosis depends upon arterial recanalisation and etiology of the thromboembolic event.

The role of robotic surgical system in the management of vascular disease.

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Lin, Judith C

2013-10-01

The evolution of minimally invasive treatment for aneurysms and occlusive disease has led to the development of endovascular, laparoscopic, and robot-assisted techniques. This article reviews the current literature on the clinical use of robotic surgical systems in the treatment of patients with aneurysms and occlusive disease. A MEDLINE search was performed using the keywords "robotic, vascular, AND surgery." All pertinent articles concerning the use of the robotic surgical system on aneurysms and occlusive disease were reviewed. The author's personal experience consisted of a retrospective review of a prospectively maintained confidential database on all procedures performed with the da Vinci(®) surgical system. Several robot-assisted laparoscopic series on the treatment of aortic disease were identified, including review articles of potential clinical applications in hybrid, laparoscopic vascular, and endovascular treatments for vascular patients using robotic technology. The use of computer-enhanced or robotic technology as a sole modality for bypass of occlusive disease and repair of abdominal aortic, splenic, and renal aneurysms was described in case series with satisfactory patient outcomes. Current robotic endovascular technology was also described. Minimally invasive techniques using endovascular, laparoscopic, or robot-assisted technology have revolutionized the treatment of aortoiliac, splanchnic, and renal aneurysms and occlusive disease. However, robot-assisted techniques for aortic disease may involve a learning curve and increased operating times. Although endovascular therapy is preferred because of faster recovery, this preference for improved short-term outcomes will be balanced with the superiority and durability of robot-assisted endoscopic methods as comparable to open surgery. Copyright © 2013 Elsevier Inc. All rights reserved.

Reversal of myopic anisometropic amblyopia with occlusion therapy in a 25 year old.

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Megbelayin, E; Ekpenyong, S M; Azunobi, J; Ejiro, G

2014-03-01

To report a reversal of myopic anisometropic amblyopia with occlusion therapy in a 25 year old. Case report. Eye clinic of a University Teaching Hospital in a metropolitan city. an index patient. Occlusion therapy. Post occlusion visual acuity. Presenting unaided visual acuity of right eye: 6/6, left eye: 4/60. Refraction result was: right eye: -0.50DS (6/6), left eye: -3.50DS (6/18). Following day time occlusion therapy of at least 6 hours for about 4 weeks, subjective refraction was: right eye: -0.5DS (6/5), left eye: -3.50DS (6/6(+3)). The remarkable improvement in vision at age 25 years of a patient with myopic anisometropic amblyopia shows that occlusion therapy might still be useful long after amblyogenic period.

Temporary Arterial Balloon Occlusion as an Adjunct to Yttrium-90 Radioembolization

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Hagspiel, Klaus D., E-mail: kdh2n@virginia.edu [University of Virginia Health System, Department of Radiology and Medical Imaging (United States); Nambiar, Ashwin, E-mail: uvashwin@gmail.com [SUNY Downstate Medical Center, Department of Radiology (United States); Hagspiel, Lauren M., E-mail: lmh4gg@virginia.edu [University of Virginia, College of Arts and Sciences (United States); Ahmad, Ehab Ali, E-mail: ehabradiodiagnosis@yahoo.com [Minia University, Department of Radiology (Egypt); Bozlar, Ugur, E-mail: ubozlar@yahoo.com [Gulhane Military Medical Academy, Department of Radiology (Turkey)

2013-06-15

Purpose. This study was designed to describe the technique of arterial occlusion using a temporary occlusion balloon system as an alternative to coil occlusion during Yttrium-90 radioembolization of hepatic tumors. Methods. Review of charts, angiography, and follow-up imaging studies of consecutive patients undergoing oncological embolization procedures in which a HyperForm system (ev3 Neurovascular, Irvine, CA) was used. Intraprocedural target vessel occlusion and patency of the target vessel on follow-up were recorded. Clinical data and Bremsstrahlung scans were reviewed for evidence of nontarget embolization. Results. Four radioembolization procedures were performed in three patients (all female, age 48-54 (mean 52) years). Five arteries were temporarily occluded (three gastroduodenal arteries, one right gastric artery, and one cystic artery). All radioembolization procedures were successfully completed. Follow-up imaging (either digital subtraction angiography (DSA) or computed tomography angiography (CTA)) was available for all patients between 28-454 (mean 183) days following the procedure, demonstrating all five vessels to be patent. No clinical or imaging evidence for nontarget embolization was found. Conclusions. Temporary balloon occlusion of small and medium-sized arteries during radioembolization allows safe therapy with preserved postprocedural vessel patency on early and midterm follow-up.

The effect of occlusion therapy on motion perception deficits in amblyopia.

Science.gov (United States)

Giaschi, Deborah; Chapman, Christine; Meier, Kimberly; Narasimhan, Sathyasri; Regan, David

2015-09-01

There is growing evidence for deficits in motion perception in amblyopia, but these are rarely assessed clinically. In this prospective study we examined the effect of occlusion therapy on motion-defined form perception and multiple-object tracking. Participants included children (3-10years old) with unilateral anisometropic and/or strabismic amblyopia who were currently undergoing occlusion therapy and age-matched control children with normal vision. At the start of the study, deficits in motion-defined form perception were present in at least one eye in 69% of the children with amblyopia. These deficits were still present at the end of the study in 55% of the amblyopia group. For multiple-object tracking, deficits were present initially in 64% and finally in 55% of the children with amblyopia, even after completion of occlusion therapy. Many of these deficits persisted in spite of an improvement in amblyopic eye visual acuity in response to occlusion therapy. The prevalence of motion perception deficits in amblyopia as well as their resistance to occlusion therapy, support the need for new approaches to amblyopia treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

Combined central retinal artery and vein occlusion in Churg-Strauss syndrome

DEFF Research Database (Denmark)

Hamann, Steffen; Johansen, Sven; Hamann, Steffen Ellitsgaard

2006-01-01

PURPOSE: To describe a rare case of Churg-Strauss syndrome presenting with severe visual loss due to a combined central retinal vein and artery occlusion. METHODS: A 42-year old man with a medical history of asthma and blood hypereosinophilia developed a sudden loss of vision in his right eye. We...... and dilated and tortuous veins. The diagnosis was confirmed by a fluorescein angiogram showing absence of retinal filling and normal choroidal filling. Churg-Strauss syndrome was diagnosed based on the necessary presence of four of six criteria for the disease proposed by the American College of Rheumatology...... the vascular occlusion and experienced no visual improvement. CONCLUSION: Combined central retinal artery and vein occlusion can occur in Churg-Strauss syndrome. We suggest that regional vasculitis may be the pathological mechanism underlying the vascular occlusions observed in our case. The condition carries...

Power Doppler Imaging in Acute Renal Vein Occlusion and Recanalization: a Canine Model

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Yoo, So-Young; Kim, In-One; Kim, Young-Il; Lee, Kyoung Ho; Lee, Min Woo; Youn, Byung Jae; Kim, Woo Sun; Yeon, Kyung Mo [Seoul National University College of Medicine, Seoul (Korea, Republic of)

2008-04-15

Objective : To evaluate the dynamic changes of the power Doppler (PD) in acute renal vein occlusion and recanalization in a canine model. Materials and Methods : We performed a PD of the kidney during graded renal vein occlusion and recanalization induced by balloon inflation and deflation in nine dogs. The PD images were transferred to a personal computer, and the PD signals were quantified. Result : We observed the temporal change of the PD signal during renal vein occlusion and recanalization, with a decrease in the PD signal during occlusion and an increase during recanalization. The mean PD signal decreased gradually as the renal vein was occluded, and conversely increased gradually with sequential relief of occlusion. The sequential change of the mean value of the PD signal was statistically significant. Conclusion : The PD can detect a change in renal blood flow during acute renal vein occlusion and recanalization in a canine model. The PD may be used as a helpful tool for the early detection of acute renal vein thrombosis and the monitoring of renal perfusion.

Power Doppler Imaging in Acute Renal Vein Occlusion and Recanalization: a Canine Model

International Nuclear Information System (INIS)

Yoo, So-Young; Kim, In-One; Kim, Young-Il; Lee, Kyoung Ho; Lee, Min Woo; Youn, Byung Jae; Kim, Woo Sun; Yeon, Kyung Mo

2008-01-01

Objective : To evaluate the dynamic changes of the power Doppler (PD) in acute renal vein occlusion and recanalization in a canine model. Materials and Methods : We performed a PD of the kidney during graded renal vein occlusion and recanalization induced by balloon inflation and deflation in nine dogs. The PD images were transferred to a personal computer, and the PD signals were quantified. Result : We observed the temporal change of the PD signal during renal vein occlusion and recanalization, with a decrease in the PD signal during occlusion and an increase during recanalization. The mean PD signal decreased gradually as the renal vein was occluded, and conversely increased gradually with sequential relief of occlusion. The sequential change of the mean value of the PD signal was statistically significant. Conclusion : The PD can detect a change in renal blood flow during acute renal vein occlusion and recanalization in a canine model. The PD may be used as a helpful tool for the early detection of acute renal vein thrombosis and the monitoring of renal perfusion

Endograft Limb Occlusion in EVAR

DEFF Research Database (Denmark)

Taudorf, M; Jensen, L P; Vogt, K C

2014-01-01

% at 3 years. Logistic regression showed that iliac artery tortuosity (DIS) (p = .001) and body mass index (p = .007) had a significant impact on graft patency. CONCLUSION: A tortuous vessel on the preoperative CTA is associated with an increased risk of limb occlusion after EVAR. Adjunctive stenting...

Dorzolamide increases retinal oxygen tension after branch retinal vein occlusion

DEFF Research Database (Denmark)

Noergaard, Michael Hove; Bach-Holm, Daniella; Scherfig, Erik

2008-01-01

To study the effect of dorzolamide on the preretinal oxygen tension (RPO(2)) in retinal areas affected by experimental branch retinal vein occlusion (BRVO) in pigs.......To study the effect of dorzolamide on the preretinal oxygen tension (RPO(2)) in retinal areas affected by experimental branch retinal vein occlusion (BRVO) in pigs....

Guide wire extension for shape memory polymer occlusion removal devices

Science.gov (United States)

Maitland, Duncan J [Pleasant Hill, CA; Small, IV, Ward; Hartman, Jonathan [Sacramento, CA

2009-11-03

A flexible extension for a shape memory polymer occlusion removal device. A shape memory polymer instrument is transported through a vessel via a catheter. A flexible elongated unit is operatively connected to the distal end of the shape memory polymer instrument to enhance maneuverability through tortuous paths en route to the occlusion.

Evaluation of recovery in lip closing pressure and occlusal force and contact area after orthognathic surgery.

Science.gov (United States)

Ueki, Koichiro; Moroi, Akinori; Sotobori, Megumi; Ishihara, Yuri; Marukawa, Kohei; Iguchi, Ran; Kosaka, Akihiko; Ikawa, Hiroumi; Nakazawa, Ryuichi; Higuchi, Masatoshi

2014-10-01

The purpose of this study was to evaluate the relationship between lip closing force, occlusal contact area and occlusal force after orthognathic surgery in skeletal Class III patients. The subjects consisted of 54 patients (28 female and 26 male) diagnosed with mandibular prognathism who underwent sagittal split ramus osteotomy with and without Le Fort I osteotomy. Maximum and minimum lip closing forces, occlusal contact area and occlusal force were measured pre-operatively, 6 months and 1 year post-operative. Maximum and minimum lip closing forces, occlusal contact area and occlusal force increased with time after surgery, however a significant increase was not found in the occlusal contact area in women. In increased ratio (6 months/pre-operative and 1 year/pre-operative), the maximum lip closing force was significantly correlated with the occlusal contact area (P contact area and lip closing force, and an increase ratio in maximum lip closing force was associated with an increased ratio in occlusal contact area. Copyright © 2014 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Clinical Effectiveness of Using Aesthetic Fixed Prosthetic Appliances with Combined Occlusal Surface

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Andrii Biben

2017-06-01

Conclusions. Aesthetic fixed prosthetic appliances with combined occlusal surface demonstrated high functional and aesthetic characteristics. The use of the USHPS system showed a decisive advantage of milled frameworks and combined occlusal surface over traditional cast ceramic frameworks.The combination of high mechanical, strength and tribological properties of zirconium dioxide and high biological as well as aesthetic properties of ceramic materials helped reveal high clinical characteristics of aesthetic appliances with combined occlusal surface.

Fetoscopic tracheal occlusion for severe congenital diaphragmatic hernia: retrospective study

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Angélica de Fátima de Assunção Braga

Full Text Available Abstract Background and objectives: The temporary fetal tracheal occlusion performed by fetoscopy accelerates lung development and reduces neonatal mortality. The aim of this paper is to present an anesthetic experience in pregnant women, whose fetuses have diaphragmatic hernia, undergoing fetoscopic tracheal occlusion (FETO. Method: Retrospective, descriptive study, approved by the Institutional Ethics Committee. Data were obtained from medical and anesthetic records. Results: FETO was performed in 28 pregnant women. Demographic characteristics: age 29.8 ± 6.5; weight 68.64 ± 12.26; ASA I and II. Obstetric: IG 26.1 ± 1.10 weeks (in FETO; 32.86 ± 1.58 (reversal of occlusion; 34.96 ± 2.78 (delivery. Delivery: cesarean section, vaginal delivery. Fetal data: Weight (g in the occlusion and delivery times, respectively (1045.82 ± 222.2 and 2294 ± 553; RPC in FETO and reversal of occlusion: 0.7 ± 0.15 and 1.32 ± 0.34, respectively. Preoperative maternal anesthesia included ranitidine and metoclopramide, nifedipine (VO and indomethacin (rectal. Preanesthetic medication with midazolam IV. Anesthetic techniques: combination of 0.5% hyperbaric bupivacaine (5-10 mg and sufentanil; continuous epidural predominantly with 0.5% bupivacaine associated with sufentanil, fentanyl, or morphine; general. In 8 cases, there was need to complement via catheter, with 5 submitted to PC and 3 to BC. Thirteen patients required intraoperative sedation; ephedrine was used in 15 patients. Fetal anesthesia: fentanyl 10-20 mg.kg-1 and pancuronium 0.1-0.2 mg.kg-1 (IM. Neonatal survival rate was 60.7%. Conclusion: FETO is a minimally invasive technique for severe congenital diaphragmatic hernia repair. Combined blockade associated with sedation and fetal anesthesia proved safe and effective for tracheal occlusion.

The difficult relationship between occlusal interferences and temporomandibular disorder - insights from animal and human experimental studies.

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Xie, Q; Li, X; Xu, X

2013-04-01

The aetiology of temporomandibular disorder (TMD) is multifactorial, and numerous studies have addressed that occlusion may be of great importance. However, whether occlusion plays a crucial role in the pathogenesis of TMD remains controversial. Study designs utilising animal models have been used to study the effects of artificial occlusal alterations. Experimental traumatic occlusion affects blood flow in the temporomandibular joint and results in changes in the condylar cartilage, and artificial occlusal interference induces masticatory muscle nociceptive responses that are associated with peripheral sensitisation and lead to central sensitisation, which maintains masticatory muscle hyperalgesia. The possibility that occlusal interference results in TMD has been investigated in humans using a double-blind randomised design. Subjects without a history of TMD show fairly good adaptation to interferences. In contrast, subjects with a history of TMD develop a significant increase in clinical signs and self-report stronger symptoms (occlusal discomfort and chewing difficulties) in response to interferences. Meanwhile, psychological factors appear meaningful for symptomatic responses to artificial interferences in subjects with a history of TMD. Thus, individual differences in vulnerability to occlusal interferences do exist. Although there are advantages and disadvantages to using human and animal occlusal interference models, these approaches are indispensable for discovering the role of occlusion in TMD pathogenesis. © 2013 Blackwell Publishing Ltd.

[A cephalometric study on determining the orientation of occlusal plane].

Science.gov (United States)

Xie, J; Zhao, Y; Chao, Y; Luo, W

1993-12-01

A study of the parallel relationship between the occlusal plane and the line connecting nasal alar and tragus was made in 90 dentulous cases by using cephalometry. The results show that the line connecting the inferior point of nasal alar and the mid-point of tragus runs much more parallel with the occlusal plane. The regression equation reveals a "line of closest fitting". It was used in the prosthetic treatment for 50 edentulous patients with good clinical results. The line connecting the inferior point of nasal alar and the mid-point of tragus therefore represents a proper reference plane for determining occlusal plane and hence should be still a valuable index in clinical dentistry.

Computed tomographic findings in acute superior mesenteric arterial occlusion

International Nuclear Information System (INIS)

Kuwabara, Yoshiyuki; Kataoka, Makoto; Kureyama, Yasuyuki; Iwata, Hiroshi; Kashima, Taketoshi; Sinoda, Noriyuki; Sato, Atsushi; Hattori, Kohji; Masaoka, Akira

1993-01-01

In this study computed tomography (CT) findings were examined in 6 cases of acute superior mesenteric arterial (SMA) occlusion. With simple CT, occluded site of SMA revealed a slightly high density in 2 cases, while no findings were noted in other cases. Slightly dilated multiple loops of the intestine were confirmed in 3 cases, but no particular changes in the intestinal wall were found. As other findings, ascites and air in the portal vein were found in each one case. Contrast enhanced CT was conducted in 2 out of the 6 cases, and occluded site was visualized as spots in one case but no findings were noted in the other. The contrast enhancement effect in vessels in SMA region was examined from its root to the peripheral in this order, and the 2 cases showed common findings that the contrast enhancement effect abruptly disappeared at a point in vessels in SMA region (discontinuance). The point was consistent with the occluded site on angiography. These findings indicate that simple CT alone is difficult to offer correct diagnosis of SMA occlusion, but contrast enhanced CT is able to visualize the SMA occlusion as a discontinuance picture. It is thought that contrast enhanced CT can be a useful procedure for early diagnosis of SMA occlusion. (author)

CORRELATIONS BETWEEN FINDINGS OF OCCLUSAL AND MANUAL ANALYSIS IN TMD-PATIENTS

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Mariana Dimova

2016-08-01

Full Text Available The aim of this study was to investigate and analyze the possible correlations between findings by manual functional analysis and clinical occlusal analysis in TMD-patients. Material and methods: Material of this study are 111 TMD-patients selected after visual diagnostics, functional brief review under Ahlers Jakstatt, intraoral examination and taking periodontal status. In the period September 2014 - March 2016 all patients were subjected to manual functional analysis and clinical occlusal analysis. 17 people (10 women and 7 men underwent imaging with cone-beam computed tomography. Results: There were found many statistically significant correlations between tests of the structural analysis that indicate the relationships between findings. Conclusion: The presence of statistically significant correlations between occlusal relationships, freedom in the centric and condition of the muscle complex of masticatory system and TMJ confirm the relationship between the state of occlusal components and TMD.

Pulmonary veno-occlusive disease in a female gardener.

Science.gov (United States)

Rodríguez Rodríguez, Paula; Pedraza Serrano, Fernando; Morán Caicedo, Liliana Patricia; Rodríguez de Guzmán, Maria Carmen; Cebollero Presmanes, María; de Miguel Díez, Javier

2014-01-01

Pulmonary veno-occlusive disease (PVOD) is a subgroup of pulmonary arterial hypertension with a poor prognosis. The diagnosis is usually delayed and treatment options other than lung transplantation are unfortunately limited. We report the case of 51-year-old female gardener diagnosed with PVOD by open lung biopsy before her death. Although there are many reported cases of hepatic veno-occlusive disease due to toxic agents present in nature, such as pyrrolizidine alkaloid exposure, to date this has not been linked to PVOD. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

Clinical Effectiveness of Using Aesthetic Fixed Prosthetic Appliances with Combined Occlusal Surface

OpenAIRE

Andrii Biben; Zinovii Ozhohan

2017-01-01

The objective of the research was to evaluate the clinical effectiveness of using aesthetic fixed prosthetic appliances with combined occlusal surface. Materials and methods. The study included 30 patients who were divided into 2 groups: Group I included 20 patients with combined occlusal surface of the crowns; Group II included 22 patients with ceramic occlusal surface of the crowns. The patients were observed 3, 6 and 12 months after prosthetic repair. Results. 6 months after prosthet...

Motor learning interference is proportional to occlusion of LTP-like plasticity.

Science.gov (United States)

Cantarero, Gabriela; Tang, Byron; O'Malley, Rebecca; Salas, Rachel; Celnik, Pablo

2013-03-13

Learning interference occurs when learning something new causes forgetting of an older memory (retrograde interference) or when learning a new task disrupts learning of a second subsequent task (anterograde interference). This phenomenon, described in cognitive, sensory, and motor domains, limits our ability to learn multiple tasks in close succession. It has been suggested that the source of interference is competition of neural resources, although the neuronal mechanisms are unknown. Learning induces long-term potentiation (LTP), which can ultimately limit the ability to induce further LTP, a phenomenon known as occlusion. In humans we quantified the magnitude of occlusion of anodal transcranial direct current stimulation-induced increased excitability after learning a skill task as an index of the amount of LTP-like plasticity used. We found that retention of a newly acquired skill, as reflected by performance in the second day of practice, is proportional to the magnitude of occlusion. Moreover, the degree of behavioral interference was correlated with the magnitude of occlusion. Individuals with larger occlusion after learning the first skill were (1) more resilient to retrograde interference and (2) experienced larger anterograde interference when training a second task, as expressed by decreased performance of the learned skill in the second day of practice. This effect was not observed if sufficient time elapsed between training the two skills and LTP-like occlusion was not present. These findings suggest competition of LTP-like plasticity is a factor that limits the ability to remember multiple tasks trained in close succession.

Towards a contemporary, comprehensive scoring system for determining technical outcomes of hybrid percutaneous chronic total occlusion treatment: The RECHARGE score.

Science.gov (United States)

Maeremans, Joren; Spratt, James C; Knaapen, Paul; Walsh, Simon; Agostoni, Pierfrancesco; Wilson, William; Avran, Alexandre; Faurie, Benjamin; Bressollette, Erwan; Kayaert, Peter; Bagnall, Alan J; Smith, Dave; McEntegart, Margaret B; Smith, William H T; Kelly, Paul; Irving, John; Smith, Elliot J; Strange, Julian W; Dens, Jo

2018-02-01

This study sought to create a contemporary scoring tool to predict technical outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) from patients treated by hybrid operators with differing experience levels. Current scoring systems need regular updating to cope with the positive evolutions regarding materials, techniques, and outcomes, while at the same time being applicable for a broad range of operators. Clinical and angiographic characteristics from 880 CTO-PCIs included in the REgistry of CrossBoss and Hybrid procedures in FrAnce, the NetheRlands, BelGium and UnitEd Kingdom (RECHARGE) were analyzed by using a derivation and validation set (2:1 ratio). Variables significantly associated with technical failure in the multivariable analysis were incorporated in the score. Subsequently, the discriminatory capacity was assessed and the validation set was used to compare with the J-CTO score and PROGRESS scores. Technical success in the derivation and validation sets was 83% and 85%, respectively. Multivariate analysis identified six parameters associated with technical failure: blunt stump (beta coefficient (b) = 1.014); calcification (b = 0.908); tortuosity ≥45° (b = 0.964); lesion length 20 mm (b = 0.556); diseased distal landing zone (b = 0.794), and previous bypass graft on CTO vessel (b = 0.833). Score variables remained significant after bootstrapping. The RECHARGE score showed better discriminatory capacity in both sets (area-under-the-curve (AUC) = 0.783 and 0.711), compared to the J-CTO (AUC = 0.676) and PROGRESS (AUC = 0.608) scores. The RECHARGE score is a novel, easy-to-use tool for assessing the risk for technical failure in hybrid CTO-PCI and has the potential to perform well for a broad community of operators. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

First-Generation Versus Second-Generation Drug-Eluting Stents in Coronary Chronic Total Occlusions: Two-Year Results of a Multicenter Registry.

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Jong-Hwa Ahn

Full Text Available Limited data are available regarding the long-term clinical outcomes of second-generation drug-eluting stents (DES versus first-generation DES in patients with coronary chronic total occlusion (CTO who undergo percutaneous coronary intervention (PCI. The aim of this study was to compare the clinical outcomes of second-generation DES with those of first-generation DES for the treatment of CTO.Between March 2003 and February 2012, 1,006 consecutive patients with CTO who underwent successful PCI using either first-generation DES (n = 557 or second-generation DES (n = 449 were enrolled in a multicenter, observational registry. Propensity-score matching was also performed. The primary outcome was cardiac death over a 2-year follow-up period. No significant differences were observed between the two groups regarding the incidence of cardiac death (first-generation DES versus second-generation DES; 2.5% vs 2.0%; hazard ratio [HR]: 0.86; 95% confidence interval [CI]: 0.37 to 1.98; p = 0.72 or major adverse cardiac events (MACE, 11.8% vs 11.4%; HR: 1.00; 95% CI: 0.67 to 1.50; p = 0.99. After propensity score matching, the incidences of cardiac death (HR: 0.86; 95% CI: 0.35 to 2.06; p = 0.86 and MACE (HR: 0.93; 95% CI: 0.63 to 1.37; p = 0.71 were still similar in both groups. Furthermore, no significant differences were observed between sirolimus-eluting, paclitaxel-eluting, zotarolimus-eluting, and everolimus-eluting stents regarding the incidence of cardiac death or MACE.This study shows that the efficacy of second-generation DES is comparable to that of first-generation DES for treatment of CTO over 2 years of follow-up.

Platelet indices and platelet-to-lymphocyte ratio predict coronary chronic total occlusion in patients with acute ST-elevation myocardial infarction

Directory of Open Access Journals (Sweden)

Hadadi Laszlo

2015-12-01

Full Text Available Coronary chronic total occlusion (CTO is caused by organized thrombi or atherosclerotic plaque progression. The presence of a CTO is an independent predictor of mortality in patients presenting with ST-segment elevation myocardial infarction (STEMI. Platelets have a crucial role in the pathophysiology of atherosclerosis. The aim of this retrospective study was to investigate platelet indices as predictors of CTO in patients with STEMI treated with primary percutaneous coronary intervention (pPCI. A total number of 334 patients admitted for STEMI between January 2011 and December 2013 were included and divided in two groups based on the presence of CTO (48 patients in CTO+ group, 286 patients in CTO-group. Platelet count, mean platelet volume (MPV, platelet distribution width (PDW, platelet-large cell ratio (P-LCR, lymphocyte and neutrophil count determined on admission were analyzed. MPV was larger in patients with CTO compared with patients without CTO (p=0.02, as were PDW (p=0.03 and P-LCR (p=0.01. Platelet-to-lymphocyte ratio (PLT/LYM was lower in patients with CTO: 105.2 (75.86-159.1 compared to 137 (97-188.1, p<0.01. Receiver-operator characteristic curve analysis identified an area under the curve of 0.61 (95%CI=0.57-0.67, p< 0.01 for PLT/LYM in predicting the presence of a CTO, with a cut-off value at 97.73. Lower values than this were independent predictors of a CTO in multivariate logistic regression analysis, with an Odds Ratio of 2.2 (95%CI=1.15-4.20, p=0.02. Our results support the use of platelet indices and PLT/LYM as predictors of CTO in patients presenting with STEMI.

Comparison of partial and complete arterial occlusion models for studying intestinal ischemia

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Parks, D.A.; Grogaard, B.; Granger, D.N.

1982-01-01

Mucosal albumin clearance was measured in jejunal segments of dogs under control conditions and following complete or partial arterial occlusion of varying durations (1, 2, 3, or 4 hours). The rate of albumin clearance was estimated from the luminal perfusion rate and the activity of protein bound 125 I in the perfusate and plasma. Partial and total arterial occlusions of 60 minutes to 4 hours' duration produced significant increases in mucosal albumin clearance. The magnitude of the rise in albumin clearance was directly related to the duration of ischemia in both total and partial arterial occlusion models. However, the magnitude of the increase in albumin clearance was significantly greater with total arterial occlusion for any given duration of ischemia. The albumin clearance results obtained in the present study compare favorably with previously reported morphologic changes in the intestinal mucosa produced by both total and partial occlusion of the superior mesenteric artery. The agreement between morphologic and physiologic measurements indicates that mucosal albumin clearance may be a useful tool for studying the pathophysiology of intestinal ischemia

Outcomes of Percutaneous Coronary Interventions for Chronic Total Occlusion Performed by Highly Experienced Japanese Specialists: The First Report From the Japanese CTO-PCI Expert Registry.

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Suzuki, Yoriyasu; Tsuchikane, Etsuo; Katoh, Osamu; Muramatsu, Toshiya; Muto, Makoto; Kishi, Koichi; Hamazaki, Yuji; Oikawa, Yuji; Kawasaki, Tomohiro; Okamura, Atsunori

2017-11-13

This report describes the registry and presents an initial analysis of outcomes for the different PCI approaches taken by the specialists. Strategies for percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) are complex. The Japanese Board of CTO Interventional Specialists has developed a prospective, nonrandomized registry of patients undergoing CTO-PCIs performed by 41 highly experienced Japanese specialists. Over the study period of January 2014 to December 2015, the registry included 2,846 consecutive CTO-PCI cases undertaken in Japan. The authors compared clinical outcomes between the different PCI approaches, following the intention-to-treat principle. The overall technical success rate of the procedures was 89.9%. The specialists frequently chose a retrograde approach as the primary CTO-PCI strategy (in 27.8% of cases). The technical success rate of the primary antegrade approach was significantly better than that of the primary retrograde approach (91.0% vs. 87.3%; p PCI with a high technical success rate (75.0% to 88.9%). Severe lesion calcification was a strong predictor of failed CTO-PCI. CTO-PCI performed by highly experienced specialists achieved a high technical success rate. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Occlusal plane rotation: aesthetic enhancement in mandibular micrognathia.

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Rosen, H M

1993-06-01

Patients afflicted with extreme degrees of mandibular micrognathia typically have vertically deficient rami as well as sagittally deficient mandibular bodies. This results in deficient posterior facial height, an obtuse gonial angle, excessively steep occlusal and mandibular planes, and a compensatory increase in anterior facial height. The entire maxillomandibular complex is overrotated in a clockwise direction. Standard orthognathic surgical correction fails to address this rotational deformity. As a consequence, the achieved projection of the lower face is inadequate, posterior facial height is further reduced, and occlusal and mandibular planes remain steep. Eleven patients with severe mandibular micrognathia underwent a surgical correction involving occlusal plane rotation to its normal orientation relative to Frankfort horizontal. This was accomplished by Le Fort I osteotomy to shorten the anterior maxilla (creating open bites in seven patients and making preexisting open bites worse in four patients) and sagittal split ramus osteotomies to advance and rotate the mandibular body counterclockwise, thus closing the surgically produced open bite. Counterclockwise rotation of the mandible afforded significantly greater sagittal displacement at the B point (mean 17 mm) than at the first molar (mean 10 mm) and produced adequate degrees of projection of the lower face when accompanied by a modest sliding genioplasty (mean 6.9 mm). Total advancement at the pogonion was a mean of 25.2 mm. In addition, posterior facial height was preserved, and mandibular and occlusal planes were normalized to mean angles of 27 and 10 degrees, respectively. At follow-up, which ranged from 9 to 24 months with a mean of 14.1 months, the mean sagittal relapse at the B point was 1.9 mm. Although heretofore considered unstable and therefore not clinically accepted, maxillomandibular counterclockwise rotation to normalize the occlusal plane rotational deformity provides stable, aesthetically

Skeletal muscle metaboreflex in patients with chronic renal failure.

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Vieira, Paulo J C; Silva, Leonardo R; Maldamer, Vinicius Z; Cipriano, Gerson; Chiappa, Adriana M G; Schuster, Rodrigo; Boni, Victor H F; Grandi, Tatiani; Wolpat, Andiara; Roseguini, Bruno T; Chiappa, Gaspar R

2017-03-01

The sympathetic nervous system is affected in patients with chronic renal failure (CRF). This study tested the hypothesis that patients with CRF have an altered skeletal muscle metaboreflex. Twenty patients with CRF and 18 healthy subjects of similar age participated in the study. The muscle metaboreflex was determined based on heart rate (HR), mean arterial pressure, calf blood flow and calf vascular resistance (CVR) in response to handgrip exercise. The control of vascular resistance in the calf muscle mediated by the metaboreflex was estimated by subtracting the area under the curve with circulatory occlusion from that without occlusion. Arterial pressure and HR responses during exercise and recovery were similar in two groups of subjects. In the control group, CVR increased during exercise and remained elevated during circulatory occlusion, whereas no significant change was seen in the patients. Thus, the index of the metaboreflex was 7·82 ± 9·57 in the patients versus16·52 ± 14 units in the controls. The findings demonstrate that patients with CRF have a decreased vascular resistance response in the calf during the handgrip exercise, which suggests that CRF condition attenuates this reflex. © 2015 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Patching compliance with full-time vs. part-time occlusion therapy.

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Kane, Jessica; Biernacki, Ron; Fraine, Lisa; Fukuda, Neva; Haskins, Kelsie; Morrison, David G

2013-01-01

Amblyopia is commonly treated with part-time occlusion (PTO) therapy. We have made two anecdotal observations regarding this therapy. First, children undergoing full-time occlusion seem to have better success and compliance rates. Secondly, a subset of children exists that fail PTO but can improve with more aggressive therapy. A retrospective review where treatment, visual outcome, and compliance scores were recorded. Compliance was graded on percent adherence reported by family. Patients scored “1” (for no compliance), “2” (for 1–25% of prescribed treatment performed), “3” (for 26–50%), “4” (for 51–75%), or “5” (for 76–100%). Seventy-six children were enrolled in the study: forty-five were treated with part-time occlusion, twenty-two were treated with full time occlusion (FTO), and nine had a history of failed PTO and were subsequently treated with FTO. Visual outcomes for FTO versus PTO were not statistically significant (P = 0.82). However, compliance rates in FTO were significantly better (P = 0.02). Of the nine patients that failed PTO, four improved an average of three lines with full-time occlusion, and five had no change with more aggressive patching. This study confirms previous reports of similar visual outcomes between PTO and FTO. However, compliance rates for FTO seem to be higher and some children who have failed PTO may improve with FTO.

Predictors for better blood-flow restoration of long-segmental below-the-knee chronic total occlusions after endovascular therapy in diabetic patients

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Song, Xiao Li [Dept. of Radiology, Chonnam National University Medical School, Gwangju (Korea, Republic of); Zhu, Yue Qi; Lu, Hai Tao; Lui, Fang; Wei, Li Ming; Kang, Heoung Keun; Zhao, Jun Gong [Shanghai Jiao Tong University Affiliated Sixth People' s Hospital, Shanghai (China)

2016-11-15

To prospectively investigate predictors for good restoration of blood flow of below-the-knee (BTK) chronic total occlusions (CTOs) after endovascular therapy in diabetes mellitus (DM) patients. A total of 120 long-segmental (≥ 5 cm) BTK, CTOs in 81 patients who underwent recanalization were included in this study. After angioplasty, blood-flow restoration was assessed using modified thrombolysis in myocardial ischemia grades and classified as good flow (grade 3) and poor flow (grade 1/2). One hundred and six CTOs with successful recanalization were divided into a good flow group (GFG; n = 68) and poor flow group (PFG; n = 38). Multivariate logistic regression analyses were undertaken to determine independent predictors of blood-flow restoration. Receiver operating characteristic curves were constructed to determine the best cutoff value. The prevalence of target-lesion restenosis during follow-up was compared between two groups. Univariate analyses suggested that CTOs in GFG were characterized by lighter limb ischemia (p = 0.03), shorter course of ischemic symptoms (p < 0.01) and lesion length (p = 0.04), more frequent use of intraluminal angioplasty (p = 0.03), and higher runoff score (p < 0.01) than those in PFG. Multivariate regression analyses suggested that distal runoffs (p = 0.001; odds ratio [OR], 10.32; 95% confidence interval [CI]: 4.082-26.071) and lesion length (p < 0.001; OR, 1.26; 95% CI: 1.091-1.449) were independent predictors for good flow restoration. Kaplan-Meier analyses at 12 months showed a higher prevalence of non-restenosis in GFG (p < 0.01). Distal runoffs and lesion length are independent predictors for good flow restoration for long-segmental BTK, CTOs in DM patients who receive endovascular therapy.

The ultrastructure and etiology of chronic radiotherapy damage in human skin

International Nuclear Information System (INIS)

Rudolph, R.; Arganese, T.; Woodward, M.

1982-01-01

Ulcerated and nonulcerated skin from 5 patients with chronic radiation skin damage was examined using electron microscopy. Noticeable fibroblast disorganization was seen, with swollen and degenerating mitochondria, multiple vacuoles, and dilated irregular rough endoplasmic reticulum. Unusual crystalline inclusions were seen in some fibroblasts. In the ulcerated skin, contractile fibroblasts (myofibroblasts) were seen in 2 of 4 specimens. Stroma showed dense collagen and prominent elastosis. The microvasculature in the radiation-damaged tissue showed occasional lumen occlusion and vacuolization of endothelial cells, without consistent abnormality. These data suggest that permanent damage to fibroblasts or fibroblast stem cells may play an important role in chronic radiation skin ulceration

Effect of Occlusal Scheme on the Pressure Distribution of Complete Denture Supporting Tissues: An In Vitro Study.

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Madalli, Poornima; Murali, C R; Subhas, Sambit; Garg, Surbhi; Shahi, Prinka; Parasher, Pragati

2015-01-01

The complete denture teeth arrangement that gives maximum denture stability, comfort, esthetics, and function have been studied since several years. Many occlusal schemes have been advised in which the lingualized occlusion, balanced occlusion, and monoplane occlusion are advocated most popularly. The purpose of this study was to compare the pressure values on the supporting tissue using three diff erent posterior occlusal schemes: Balanced occlusion, lingualized occlusion, and monoplane occlusion in simulated dentures. The simulators used in this study, composed of the maxillary, and mandibular clear heat cure acrylic resin edentulous models. Pressures on the supporting structure under the complete denture were measured using eight strain gauges placed on the model surface on the buccal and lingual slopes of the ridges on the molar and pre-molar region. Pressure on the supporting structure was measured and signals from the sensors were amplifi ed and recorded by the multi-channel electronic strain indicator. The mean pressure which was obtained at each measurement point was compared by one-way ANOVA test. Overall monoplane occlusion had lesser pressure values compared to completely balanced and lingualized occlusal scheme. Lingualized occlusal scheme was found to transfer stresses from working side to non-working side to stabilize the mandibular denture.

In vivo THz imaging of human skin: Accounting for occlusion effects.

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Sun, Qiushuo; Parrott, Edward P J; He, Yuezhi; Pickwell-MacPherson, Emma

2018-02-01

In vivo terahertz (THz) imaging of human skin needs to be done in reflection geometry due to the high attenuation of THz light by water in the skin. To aid the measurement procedure, there is typically an imaging window onto which the patient places the area of interest. The window enables better pulse alignment and helps keep the patient correctly positioned during the measurement. In this paper, we demonstrate how the occlusion caused by the skin contact with the imaging window during the measurement affects the THz response. By studying both rapid point measurements and imaging over an area of a human volar forearm, we find that even 5 seconds of occlusion affects the THz response. As the occlusion time increases, the skin surface water content increases, resulting in the reduction of the amplitude of the reflected THz pulse, especially in the first 3 minutes. Furthermore, it was found that the refractive index of the volar forearm increased by 10% to 15% after 20 minutes of occlusion. In this work, we examine and propose a model for the occlusion effects due to the quartz window with a view to compensating for its influence. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

The effect of resting blood flow occlusion on exercise tolerance and W'.

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Broxterman, Ryan M; Craig, Jesse C; Ade, Carl J; Wilcox, Samuel L; Barstow, Thomas J

2015-09-15

It has previously been postulated that the anaerobic work capacity (W') may be utilized during resting blood flow occlusion in the absence of mechanical work. We tested the hypothesis that W' would not be utilized during an initial range of time following the onset of resting blood flow occlusion, after which W' would be utilized progressively more. Seven men completed blood flow occlusion constant power severe intensity handgrip exercise to task failure following 0, 300, 600, 900, and 1,200 s of resting blood flow occlusion. The work performed above critical power (CP) was not significantly different between the 0-, 300-, and 600-s conditions and was not significantly different from the total W' available. Significantly less work was performed above CP during the 1,200-s condition than the 900-s condition (P W' available (P W' during resting blood flow occlusion did not begin until 751 ± 118 s, after which time W' was progressively utilized. The current findings demonstrate that W' is not utilized during the initial ∼751 s of resting blood flow occlusion, but is progressively utilized thereafter, despite no mechanical work being performed. Thus, the utilization of W' is not exclusive to exercise, and a constant amount of work that can be performed above CP is not the determining mechanism of W'. Copyright © 2015 the American Physiological Society.

Effects of experimental occlusal interference on body posture: an optoelectronic stereophotogrammetric analysis.

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Marini, I; Gatto, M R; Bartolucci, M L; Bortolotti, F; Alessandri Bonetti, G; Michelotti, A

2013-07-01

In recent years, there has been increasing interest in the relationship between dental occlusion and body posture both among people and in scientific literature. The aim of the present longitudinal study is to investigate the effects of an experimental occlusal interference on body posture by means of a force platform and an optoelectronic stereophotogrammetric analysis. An occlusal interference of a 0- to 2-mm-thick glass composite was prepared to disturb the intercuspal position while not creating interference during lateral or protrusive mandibular excursions. Frontal and sagittal kinematic parameters, dynamic gait measurements and superficial electromyographic (SEMG) activity of head and neck muscles were performed on 12 healthy subjects. Measurements were taken 10 days before the application of the occlusal interference, and then immediately before the application, the day after it, and at a distance of 7 and 14 days under four different exteroceptive conditions. The outcomes of this study show that an occlusal interference does not modify significantly over time static and dynamic parameters of body posture under different exteroceptive conditions. It has a minimal influence only on the frontal kinematic parameters related to mandibular position, and it induces a transient increase of the activity of masticatory muscles. In this study, the experimental occlusal interference did not significantly influence the body posture during a 14-day follow-up period. © 2013 John Wiley & Sons Ltd.

Evaluation of in-vehicle HMI using occlusion techniques: experimental results and practical implications.

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Baumann, Martin; Keinath, Andreas; Krems, Josef F; Bengler, Klaus

2004-05-01

Despite the usefulness of new on-board information systems one has to be concerned about the potential distraction effects that they impose on the driver. Therefore, methods and procedures are necessary to assess the visual demand that is connected to the usage of an on-board system. The occlusion-method is considered a strong candidate as a procedure for evaluating display designs with regard to their visual demand. This paper reports results from two experimental studies conducted to further evaluate this method. In the first study, performance in using an in-car navigation system was measured under three conditions: static (parking lot), occlusion (shutter glasses), and driving. The results show that the occlusion-procedure can be used to simulate visual requirements of real traffic conditions. In a second study the occlusion method was compared to a global evaluation criterion based on the total task time. It can be demonstrated that the occlusion method can identify tasks which meet this criterion, but are yet irresolvable under driving conditions. It is concluded that the occlusion technique seems to be a reliable and valid method for evaluating visual and dialogue aspects of in-car information systems.

Apparent brain temperature imaging with multi-voxel proton magnetic resonance spectroscopy compared with cerebral blood flow and metabolism imaging on positron emission tomography in patients with unilateral chronic major cerebral artery steno-occlusive disease

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Nanba, Takamasa; Nishimoto, Hideaki; Murakami, Toshiyuki; Fujiwara, Shunrou; Ogasawara, Kuniaki [Iwate Medical University, Department of Neurosurgery, Iwate (Japan); Yoshioka, Yoshichika [Osaka University, Open and Transdisciplinary Research Initiatives, Osaka (Japan); Sasaki, Makoto; Uwano, Ikuko [Iwate Medical University, Institute for Biomedical Science, Iwate (Japan); Terasaki, Kazunori [Iwate Medical University, Cyclotron Research Center, Iwate (Japan)

2017-09-15

The purpose of the present study was to determine whether apparent brain temperature imaging using multi-voxel proton magnetic resonance (MR) spectroscopy correlates with cerebral blood flow (CBF) and metabolism imaging in the deep white matter of patients with unilateral chronic major cerebral artery steno-occlusive disease. Apparent brain temperature and CBF and metabolism imaging were measured using proton MR spectroscopy and {sup 15}O-positron emission tomography (PET), respectively, in 35 patients. A set of regions of interest (ROIs) of 5 x 5 voxels was placed on an MR image so that the voxel row at each edge was located in the deep white matter of the centrum semiovale in each cerebral hemisphere. PET images were co-registered with MR images with these ROIs and were re-sliced automatically using image analysis software. In 175 voxel pairs located in the deep white matter, the brain temperature difference (affected hemisphere - contralateral hemisphere: ΔBT) was correlated with cerebral blood volume (CBV) (r = 0.570) and oxygen extraction fraction (OEF) ratios (affected hemisphere/contralateral hemisphere) (r = 0.641). We excluded voxels that contained ischemic lesions or cerebrospinal fluid and calculated the mean values of voxel pairs in each patient. The mean ΔBT was correlated with the mean CBF (r = - 0.376), mean CBV (r = 0.702), and mean OEF ratio (r = 0.774). Apparent brain temperature imaging using multi-voxel proton MR spectroscopy was correlated with CBF and metabolism imaging in the deep white matter of patients with unilateral major cerebral artery steno-occlusive disease. (orig.)

Influence of balanced occlusion in complete dentures on the decrease in reduction of an edentulous ridge

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Poštić Srđan D.

2012-01-01

Full Text Available Background/Aim. Balanced occlusal arrangement of artificial teeth and balanced occlusion is a specific type of occlusion that preserves the stability of complete dentures. Balanced occlusion comprises realization of tooth contacts at the working side as well as at the balancing side, at the same time. The aim of this study was to assess the influence of balanced occlusal arrangement of artificial teeth on the decrease in reduction of edentulous alveolar ridge. Methods. A longitudinal study on 91 fully edentulous patients was conducted using their panoramic radiographs and parameters of vertical dimension of edentulous ridges. All the patients were clinically examined by the same and a qualified dental practitioner. Numerical values of parameters of vertical dimensions of edentulous ridges and lines were statistically processed and compared using the Student’s t-test. Results. Vertical dimensions and heights of edentulous ridges were different after comparison of parameters in complete denture wearers with balanced occlusion and complete denture wearers without bilaterally balanced occlusion, as well as between male and female edentulous patients. Statistically significant differences of heights were established in complete denture wearers’ with a set of artificial teeth without balanced occlusion, at the baseline and 12 months after wearing of complete dentures. Conclusion. Balanced occlusion is a favored occlusal design in setting of artificial teeth in conventional complete dentures, which preserves edentulous ridge and influence the stability of dentures.

Comparative study to evaluate the accuracy of polyether occlusal bite registration material and occlusal registration wax as a guide for occlusal reduction during tooth preparation.

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Joshi, Niranjan; Shetty, Sridhar N; Prasad, Krishna D

2013-01-01

The use of different materials and techniques has been studied to decide the safest quantum of reduction of the occlusal surfaces. However, these methods provide limited information as to the actual amount of reduction with limitations in accuracy, accessibility and complexity. The objective of this study was to compare and evaluate the reliability of the most commonly used occlusal registration wax that with polyether bite registration material as a guide for occlusal reduction required during tooth preparations. For the purpose of this study, 25 abutment teeth requiring tooth preparation for fixed prosthesis were selected and tooth preparations carried out. Modeling wax strips of specific dimensions were placed onto the cast of prepared tooth, which was mounted on maximum intercuspation on the articulator and the articulator was closed. The thickness of the wax registration was measured at three zones namely two functional cusps and central fossa. Similar measurements were made using the polyether bite registration material and prosthesis at the same zones. The data was tabulated and was subjected to statistical analysis using anova test and Tukey honestly significant difference test. The differences in thickness between wax record and prosthesis by 0.1346 mm, whereas the difference between polyether and prosthesis was 0.02 mm with a P value of 0.042, which is statistically significant. This means that the wax record was 8.25% larger than the prosthesis while polyether was just 1.27% larger than the prosthesis. The clinical significance of the above analysis is that Ramitec polyether bite registration material is most suitable material when compared with commonly used modeling wax during the tooth preparation.

Using the T-scan III system to analyze occlusal function in mandibular reconstruction patients: A pilot study

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Chao-Wei Liu

2015-02-01

Full Text Available Background: This study was designed to analyze the post-rehabilitation occlusal function of subjects treated with complex mandibular resection and subsequently rehabilitated with fibula osteoseptocutaneous flaps, dental implants, and fixed prostheses utilizing the T-scan system. Methods: Ten mandibular complex resection cases that adopted fibula osteoseptocutaneous flaps, dental implants, and fixed prostheses to reconstruct occlusal function were analyzed. The mandibular reconstructions were divided into three groups based on size: full mandibular reconstructions, mandibular reconstructions larger than half of the arch, and mandibular reconstructions smaller than half of the arch. The T-scan III system was used to measure maximum occlusal force, occlusal time, anterior-posterior as well as left-right occlusal force asymmetries, and anterior-posterior as well as left-right asymmetrical locations of occlusal centers. Results: Subjects with larger mandibular reconstructions and dental implants with fixed partial dentures demonstrated decreased average occlusal force; however, the difference did not reach the statistically significant level (p > 0.05. The most significant asymmetry of occlusal center location occurred among subjects with mandibular reconstructed areas larger than half of the mandibular arch. Conclusions: Comparison of the parameters of T-scan system used to analyze the occlusal function showed that the occlusal force was not an objective reference. Measurements of the location of the occlusal center appeared more repeatable, and were less affected by additional factors. The research results of this study showed that the size of a reconstruction did not affect the occlusal force after reconstruction and larger reconstructed areas did not decrease the average occlusal force. The most significant parameter was left and right asymmetry of the occlusion center (LROC and was measured in subjects with reconstruction areas larger than half

The effect of prolonged monocular occlusion on latent nystagmus in the treatment of amblyopia

NARCIS (Netherlands)

H.J. Simonsz (Huib)

1989-01-01

textabstractWe recorded eye movements in 5 patients with latent nystagmus (LN) before and after 2 days of occlusion of the better eye. The slow-phase speed of the nystagmus (SPS) was in general, before occlusion, lower when the better eye fixated but, after occlusion, lower when the worse eye

Interobserver variability in the assessment of aneurysm occlusion with the WEB aneurysm embolization system.

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Fiorella, David; Arthur, Adam; Byrne, James; Pierot, Laurent; Molyneux, Andy; Duckwiler, Gary; McCarthy, Thomas; Strother, Charles

2015-08-01

The WEB (WEB aneurysm embolization system, Sequent Medical, Aliso Viejo, California, USA) is a self-expanding, nitinol, mesh device designed to achieve aneurysm occlusion after endosaccular deployment. The WEB Occlusion Scale (WOS) is a standardized angiographic assessment scale for reporting aneurysm occlusion achieved with intrasaccular mesh implants. This study was performed to assess the interobserver variability of the WOS. Seven experienced neurovascular specialists were trained to apply the WOS. These physicians independently reviewed angiographic image sets from 30 patients treated with the WEB under blinded conditions. No additional clinical information was provided. Raters graded each image according to the WOS (complete occlusion, residual neck or residual aneurysm). Final statistics were calculated using the dichotomous outcomes of complete occlusion or incomplete occlusion. The interobserver agreement was measured by the generalized κ statistic. In this series of 30 test case aneurysms, observers rated 12-17 as completely occluded, 3-9 as nearly completely occluded, and 9-11 as demonstrating residual aneurysm filling. Agreement was perfect across all seven observers for the presence or absence of complete occlusion in 22 of 30 cases. Overall, interobserver agreement was substantial (κ statistic 0.779 with a 95% CI of 0.700 to 0.857). The WOS allows a consistent means of reporting angiographic occlusion for aneurysms treated with the WEB device. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Sheathotomy in complicated cases of branch retinal vein occlusion

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