Sample records for evaluate paclitaxel-eluting balloons

  1. Combined paclitaxel-eluting balloon and Genous cobalt-chromium alloy stent utilization in de novo coronary stenoses (PEGASUS). (United States)

    Jim, Man-Hong; Fung, Raymond Chi-Yan; Yiu, Kai-Hang; Ng, Andrew Kei-Yan; Siu, Chung-Wah; Fan, Katherine Yu-Yan


    The aim of this study was to examine the angiographic result and its outcome predictors using the combination of paclitaxel-eluting balloon (PEB) and Genous stent. This approach to treat coronary stenoses is a logical strategy to strike a balance between minimizing restenosis and stent thrombosis. From November 2010 to June 2012, 40 symptomatic patients with 44 de novo coronary lesions of diameter stenosis ≥ 50% were treated with the combination of PEB and Genous stents. Angiographic and clinical follow-up were intended at 6 and 9 months, respectively. The mean age of patients was 61 ± 11 years, with male predominance (83%). Diabetes mellitus and end-stage renal failure on peritoneal dialysis were found in 15 (38%) and 10 (25%) patients, respectively. Patients received dual antiplatelet therapy for 5.1 ± 1.5 months post procedure. The size and length of PEB used was larger than the stents (3.13 ± 0.46 mm and 28 ± 9 mm vs. 2.98 ± 0.36 mm and 23 ± 7 mm). Restudy angiography was performed on 41 (95%) lesions in 37 (93%) patients at 5.9 ± 1.7 months. Angiographic restenosis was seen in 5 (12%) lesions, and significantly associated with diabetes mellitus and dialysis dependency; the late lumen loss was 0.38 ± 0.37 mm. At 9-month follow-up, no stent thrombosis was observed. The use of PEB combined with Genous stent is associated with a reasonably low restenosis and late lumen loss, whereas diabetes mellitus and renal failure with dialysis are poor predictors of angiographic restenosis. © 2013, Wiley Periodicals, Inc.

  2. Paclitaxel-eluting balloon angioplasty and cobalt-chromium stents versus conventional angioplasty and paclitaxel-eluting stents in the treatment of native coronary artery stenoses in patients with diabetes mellitus. (United States)

    Ali, Rosli Mohd; Degenhardt, Ralf; Zambahari, Robaayah; Tresukosol, Damras; Ahmad, Wan Azman Wan; Kamar, Haizal bin Haron; Kui-Hian, Sim; Ong, Tiong Kiam; bin Ismail, Omar; bin Elis, Safari; Udychalerm, Wasan; Ackermann, Hanns; Boxberger, Michael; Unverdorben, Martin


    Coronary lesions in diabetics (DM) are associated with a high recurrence following percutaneous coronary intervention (PCI), even after drug-eluting stent (DES) deployment. Encouraging clinical data of the drug-eluting balloon catheter (DEB) SeQuent Please warrant its investigation in these patients. Eighty-four diabetic patients (60.8 ± 9.1 years, 76.2% male) were randomised to either the DEB SeQuent Please or the DES Taxus Liberté to compare the 9-month clinical and angiographic outcome of PCI in native coronary arteries. Comparing the DEB vs. the DES the 9-month results (follow-up DEB 39/45 [86.7%], DES 36/39 [92.3%]) are statistically not different at the 0.05 level for the primary endpoint of in-segment (0.37 ± 0.59 mm vs. 0.35 ± 0.63 mm) and in-stent (0.51 ± 0.61 mm vs. 0.53 ± 0.67 mm) late lumen loss, overall and cardiac deaths (2/45 [4.4%] and 3/45 [6.7%] vs. 0), target lesion revascularisation (3/45 [8.9%] vs. 4/39 [10.3%]), the total MACE rate (6/45 [13.3%] vs. 6/39 [15.4%]), and the event free survival after 10.2 ± 3.8 months (Kaplan-Meier analysis, pcobalt chromium stent compared to the drug eluting Taxus stent are similar.

  3. Critical evaluation of stents in the peripheral arterial disease of the superficial femoral artery – focus on the paclitaxel eluting stent

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    Litsky J


    Full Text Available Jason Litsky,1 Arijit Chanda,2 Erik Stilp,1 Alexandra Lansky,1 Carlos Mena11Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA; 2Section of Cardiology, Department of Internal Medicine, Bridgeport Hospital, Bridgeport, CT, USAAbstract: The endovascular management of obstructive disease of the superficial femoral artery (SFA is challenging due to unique anatomical and biomechanical forces. Obstructive lesions of the SFA make up the largest proportion of lesions leading to symptomatic peripheral arterial disease. Accordingly, endovascular treatment of SFA disease is becoming increasingly common and, in many cases, is the preferred initial therapy. The use of self-expanding nitinol stents have proven superior to percutaneous transluminal balloon angioplasty in the treatment of intermediate length SFA stenosis. However, achieving durable results, as well as attaining adequate therapy for long occlusions typically seen in clinical practice, remains problematic. Newer technologies, such as paclitaxel eluting stents, seem promising in improving outcomes.Keywords: Zilver PTX, self-expanding stent, atherosclerotic disease, superficial femoral artery

  4. A prospective evaluation of the safety and efficacy of the TAXUS Element paclitaxel-eluting coronary stent system for the treatment of de novo coronary artery lesions: Design and statistical methods of the PERSEUS clinical program

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    Wehrenberg Scott


    Full Text Available Abstract Background Paclitaxel-eluting stents decrease angiographic and clinical restenosis following percutaneous coronary intervention compared to bare metal stents. TAXUS Element is a third-generation paclitaxel-eluting stent which incorporates a novel, thinner-strut, platinum-enriched metal alloy platform. The stent is intended to have enhanced radiopacity and improved deliverability compared to other paclitaxel-eluting stents. The safety and efficacy of the TAXUS Element stent are being evaluated in the pivotal PERSEUS clinical trials. Methods/Design The PERSEUS trials include two parallel studies of the TAXUS Element stent in single, de novo coronary atherosclerotic lesions. The PERSEUS Workhorse study is a prospective, randomized (3:1, single-blind, non-inferiority trial in subjects with lesion length ≤28 mm and vessel diameter ≥2.75 mm to ≤4.0 mm which compares TAXUS Element to the TAXUS Express2 paclitaxel-eluting stent system. The Workhorse study employs a novel Bayesian statistical approach that uses prior information to limit the number of study subjects exposed to the investigational device and thus provide a safer and more efficient analysis of the TAXUS Element stent. PERSEUS Small Vessel is a prospective, single-arm, superiority trial in subjects with lesion length ≤20 mm and vessel diameter ≥2.25 mm to Discussion The TAXUS PERSEUS clinical trial program uses a novel statistical approach to evaluate whether design and metal alloy iterations in the TAXUS Element stent platform provide comparable safety and improved procedural performance compared to the previous generation Express stent. PERSEUS trial enrollment is complete and primary endpoint data are expected in 2010. PERSEUS Workhorse and Small Vessel are registered at, identification numbers NCT00484315 and NCT00489541.

  5. A novel paclitaxel-eluting porous carbon-carbon nanoparticle coated, nonpolymeric cobalt-chromium stent: evaluation in a porcine model. (United States)

    Bhargava, Balram; Reddy, N Krishna; Karthikeyan, Ganesan; Raju, Raghava; Mishra, Sundeep; Singh, Sandeep; Waksman, Ron; Virmani, Renu; Somaraju, B


    We aimed to evaluate the response of porcine coronary arteries to a novel paclitaxel-eluting porous carbon-carbon nanoparticle coated, nonpolymeric cobalt chromium stent. Polymer based drug-eluting stents significantly reduce restenosis. However, the indefinite presence of polymer is thought to initiate and sustain inflammation and contribute to the occurrence of late complications. Sixteen carbon-carbon coated, nonpolymeric cobalt chromium stents with two different doses of paclitaxel (eight of each) were implanted in porcine coronary arteries. In addition, eight cobalt chromium stents coated with a biodegradable polymer were also studied. Animals were sacrificed 6 weeks after stent implantation and histomorphometric analysis was performed. Results were compared among the three groups of stents. The cobalt chromium stents coated with carbon-carbon with low and medium doses of paclitaxel both showed acceptable performance characteristics, with respect to endothelialization, neointimal hyperplasia, percentage diameter stenosis, inflammatory response, and tendency to fibrin deposition, when compared to historical data with the Cypher stent. On the other hand, the stents coated with poly(lactide) and poly(lactide-co-glycolide) biodegradable polymers and 0.7 microg/mm2 paclitaxel showed poor performance. There was a significant tendency to poor endothelialization, greater neointimal hyperplasia, percentage diameter stenosis, greater inflammatory response, and tendency to fibrin deposition (P cobalt chromium stent with a carbon-carbon coating and low and medium doses of paclitaxel. (c) 2006 Wiley-Liss, Inc.

  6. Paclitaxel-Eluting Balloon vs Standard Angioplasty to Reduce Restenosis in Diabetic Patients With In-Stent Restenosis of the Superficial Femoral and Proximal Popliteal Arteries: Three-Year Results of the DEBATE-ISR Study. (United States)

    Grotti, Simone; Liistro, Francesco; Angioli, Paolo; Ducci, Kenneth; Falsini, Giovanni; Porto, Italo; Ricci, Lucia; Ventoruzzo, Giorgio; Turini, Filippo; Bellandi, Guido; Bolognese, Leonardo


    To report the 3-year safety and effectiveness outcomes from the prospective all-comers DEBATE-ISR study ( identifier NCT01558531) of symptomatic diabetic patients with femoropopliteal in-stent restenosis (ISR) undergoing treatment with paclitaxel-eluting balloons compared with historical diabetic controls. From January 2010 to December 2011, 44 consecutive diabetic patients (mean age 74±11 years; 32 men) were treated with drug-eluting balloons (DEBs) and enrolled in the study. The control group comprised 42 consecutive diabetic patients (age 76±7 years; 23 men) treated with conventional balloon angioplasty (BA) from 2008 to 2009. No significant differences in terms of clinical, angiographic, or procedural characteristics were observed between the study groups. Critical limb ischemia was present in the majority of patients. Tosaka class III ISR was observed in more than half of the patients. Mean lesion length was 132±86 and 137±82 mm in the DEB and BA groups, respectively (p=0.7). At 3-year follow-up, the rate of target lesion revascularization (TLR) was 40% in the DEB group vs 43% in the BA group (p=0.8); Kaplan-Meier analysis showed no significant differences in terms of freedom from TLR. The presence of a Tosaka class III occlusion was associated with a worse outcome in both study groups (odds ratio 3.96, 95% confidence interval 1.55 to 10.1, p=0.004). Using DEBs for femoropopliteal ISR yielded similar results to BA in terms of TLR at 3-year follow-up. The treatment of more complex ISR lesions was associated with an increased rate of TLR, irrespective of the technology used. © The Author(s) 2015.

  7. A randomized, controlled, multicenter trial to evaluate the safety and efficacy of Zotarolimus- vs. Paclitaxel-eluting stents in de novo occlusive lesions in coronary arteries

    DEFF Research Database (Denmark)

    Chevalier, Bernard; Dimario, Carlo; Neumann, Franz-Josef


    The ZOMAXX I trial tested the noninferiority of a zotarolimus-eluting coronary stent (ZoMaxx(™) ) when compared with a paclitaxel-eluting coronary stent (Taxus(™) Express(2™) ) in a randomized trial of percutaneous intervention for de novo coronary artery stenosis. Angiographic analysis at the pr......The ZOMAXX I trial tested the noninferiority of a zotarolimus-eluting coronary stent (ZoMaxx(™) ) when compared with a paclitaxel-eluting coronary stent (Taxus(™) Express(2™) ) in a randomized trial of percutaneous intervention for de novo coronary artery stenosis. Angiographic analysis...... at the primary endpoint of 9 months has been reported previously. The purpose of this follow-on analysis was to describe the clinical results of the ZoMaxx and Taxus cohorts of the ZOMAXX I trial after 5 years....

  8. Impact of Paclitaxel-Eluting Balloons Compared to Second-Generation Drug-Eluting Stents for of In-Stent Restenosis in a Primarily Acute Coronary Syndrome Population

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    Guillaume Marquis-Gravel


    Full Text Available Abstract Background: The place of drug-eluting balloons (DEB in the treatment of in-stent restenosis (ISR is not well-defined, particularly in a population of all-comers with acute coronary syndromes (ACS. Objective: Compare the clinical outcomes of DEB with second-generation drug-eluting stents (DES for the treatment of ISR in a real-world population with a high proportion of ACS. Methods: A retrospective analysis of consecutive patients with ISR treated with a DEB compared to patients treated with a second-generation DES was performed. The primary endpoint was a composite of major adverse cardiovascular events (MACE: all-cause death, non-fatal myocardial infarction, and target lesion revascularization. Comparisons were performed using Cox proportional hazards multivariate adjustment and Kaplan-Meier analysis with log-rank. Results: The cohort included 91 patients treated with a DEB and 89 patients treated with a DES (74% ACS. Median follow-up was 26 months. MACE occurred in 33 patients (36% in the DEB group, compared to 17 patients (19% in the DES group (p log-rank = 0.02. After multivariate adjustment, there was no significant difference between the groups (HR for DEB = 1.45 [95%CI: 0.75-2.83]; p = 0.27. Mortality rates at 1 year were 11% with DEB, and 3% with DES (p = 0.04; adjusted HR = 2.85 [95%CI: 0.98-8.32]; p = 0.06. Conclusion: In a population with a high proportion of ACS, a non-significant numerical signal towards increased rates of MACE with DEB compared to second-generation DES for the treatment of ISR was observed, mainly driven by a higher mortality rate. An adequately-powered randomized controlled trial is necessary to confirm these findings.

  9. Primary percutaneous coronary intervention by drug-eluting balloon angioplasty : The nonrandomized fourth arm of the DEB-AMI (drug-eluting balloon in ST-segment elevation myocardial infarction) trial

    NARCIS (Netherlands)

    Nijhoff, Freek|info:eu-repo/dai/nl/413968146; Agostoni, Pierfrancesco|info:eu-repo/dai/nl/34169276X; Belkacemi, Anouar; Nathoe, Hendrik M.|info:eu-repo/dai/nl/267961472; Voskuil, Michiel|info:eu-repo/dai/nl/254745954; Samim, Mariam; Doevendans, Pieter A.|info:eu-repo/dai/nl/164248366; Stella, Pieter R.|info:eu-repo/dai/nl/304814717


    ObjectiveTo evaluate a paclitaxel drug-eluting balloon (DEB) only strategy in primary percutaneous coronary intervention (PPCI), aiming at a comparison with bare metal stent (BMS) alone, DEB followed by BMS, and paclitaxel eluting stent (PES), as assessed in the randomized Drug Eluting Balloon in

  10. The Paclitaxel-eluting PTCA-balloon in combination with a cobalt-chromium stent in two different sequences to treat de novo coronary artery lesions: An angiographic follow up study

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    Upendra Kaul


    Conclusion: Drug-coated balloon first followed by cobalt chromium stent deployment versus a reverse sequence is not associated with statistically significantly different 6-month angiographic or 12-month clinical outcomes.

  11. The paclitaxel-eluting PTCA-balloon in combination with a cobalt-chromium stent in two different sequences to treat de novo coronary artery lesions: an angiographic follow up study. (United States)

    Kaul, Upendra; Unverdorben, Martin; Degenhardt, Ralf; Seth, Ashok; Bahl, Vinay K; Hiremath, Shirish M S; Chandra, Praveen; Mullesari, Ajit S; Sandhu, P S; Rao, Seshagiri; George, Oommen; Ackermann, Hanns; Boxberger, Michael


    The paclitaxel-coated balloon catheter (DCB) based on the PACCOCATH(®) technology has yielded angiographic and clinical results superior to drug-eluting stents (DES) in situations like in-stent restenosis (ISR) and a trend towards superior results in small coronary vessels and side branches of coronary bifurcations. Using the DCB followed by cobalt-chromium stent (CoCr) deployment or with a reverse sequence may yield different outcomes in terms of late loss. 97 patients with de-novo coronary stenosis (55.6 ± 10.7 years, 79.4% male, ≥70%, length: ≤25 mm, vessel diameter: 2.5-4.0 mm) were randomly treated with the DCB (3 μg/mm²) followed by a CoCr-stent or stent first and DCB later. Six-month angiographic and one-year clinical follow-up intention-to-treat analyses were performed. Angiographic and demographic baseline data was comparable between the two groups. When comparing balloon first versus stent first technique, the primary outcome variables were not statistically different for mean in-segment (0.51 ± 0.56 mm vs. 0.36 ± 0.55 mm, p = 0.23) and in-stent (0.52 ± 0.55 mm vs. 0.46 ± 0.52 mm, p = 0.65) late lumen loss. The lesion related 12-month MACE rates were 5/49 (10.2%) and 2/48 (4.2%) (p = 0.44). Lesion related thrombotic events occurred in three patients in balloon first and in one patient in stent first group, two of which were associated with early discontinuation of continuous dual anti-platelet therapy, two with suboptimal PCI, and one each were performed in a thrombotic lesion and a bifurcation type 1.1.0. Drug-coated balloon first followed by cobalt chromium stent deployment versus a reverse sequence is not associated with statistically significantly different 6-month angiographic or 12-month clinical outcomes. Copyright © 2013 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.

  12. TAXUS VI 2-year follow-up: randomized comparison of polymer-based paclitaxel-eluting with bare metal stents for treatment of long, complex lesions

    DEFF Research Database (Denmark)

    Grube, Eberhard; Dawkins, Keith D; Guagliumi, Giulio


    ) paclitaxel-eluting TAXUS MR stent in treatment of complex lesion subsets, we evaluated the 2-year follow-up of TAXUS VI. METHOD AND RESULTS: TAXUS VI was a randomized multi-centre study enrolling 446 patients with complex lesions, including small vessels in 28% of patients and a mean lesion length of 20.6 mm...... re-percutaneous coronary intervention at 2 years was 12.5. CONCLUSION: Treatment of complex coronary lesions with the polymer-based MR paclitaxel-eluting TAXUS MR stent is associated with a sustained clinical benefit and low rates of TVR up to 2 years after device implantation. Udgivelsesdato: 2007...

  13. The unrestricted use of sirolimus- and paclitaxel-eluting stents results in better clinical outcomes during 6-year follow-up than bare-metal stents: An analysis of the RESEARCH (Rapamycin-Eluting Stent Evaluated at Rotterdam Cardiology Hospital) and T-SEARCH (TaxusStent Evaluated at Rotterdam Cardiology Hospital) registries

    NARCIS (Netherlands)

    C. Simsek (Cihan); M. Magro (Michael); H. Boersma (Eric); Y. Onuma (Yoshinobu); S.T. Nauta (Sjoerd); M.P. Gaspersz (Marcia); W.J. van der Giessen (Wim); R.T. van Domburg (Ron); P.W.J.C. Serruys (Patrick)


    textabstractObjectives The aim of this study was to assess the 6-year clinical outcome after unrestricted use of sirolimus-eluting stents (SES) or paclitaxel-eluting stents (PES) as compared with bare-metal stents (BMS) in consecutive de novo patients undergoing percutaneous coronary intervention

  14. Outcomes of the largest multi-center trial stratified by the presence of diabetes mellitus comparing sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) in patients with coronary artery disease. The Japan drug-eluting stents evaluation: a randomized trial (J-DESsERT). (United States)

    Nakamura, Masato; Muramatsu, Toshiya; Yokoi, Hiroyoshi; Okada, Hisayuki; Ochiai, Masahiko; Suwa, Satoru; Hozawa, Hidenari; Kawai, Kazuya; Awata, Masaki; Mukawa, Hiroaki; Fujita, Hiroshi; Shiode, Nobuo; Asano, Ryuta; Tsukamoto, Yoshiaki; Yamada, Takahisa; Yasumura, Yoshio; Ohira, Hiroshi; Miyamoto, Akira; Takashima, Hiroaki; Ogawa, Takayuki; Matsuyama, Yutaka; Nanto, Shinsuke


    The Japan drug-eluting stents evaluation: a randomized trial (J-DESsERT) was conducted to compare the effectiveness of 2 different drug-eluting stents (DES). It remains uncertain which is more efficacious in diabetic patients, sirolimus-eluting stents (SES) or paclitaxel-eluting stents (PES). In this trial, the largest of its kind, 3,533 patients including 1,724 diabetes mellitus (DM) patients were randomized to either SES or PES. Stratification was based on the presence or absence of DM. PES target vessel failure (TVF) non-inferiority at 8 months (primary endpoint) was not demonstrated when compared to SES (SES 4.5 % vs. PES 6.4 %, p = 0.23). In addition, PES TVF superiority at 8 months in the DM subset (secondary endpoint) was not shown (SES 5.6 % vs. PES 7.6 %, p = 0.10). Insulin treatment was associated with increased TVF rates, however, this was less pronounced in the PES group. At 8 months, the similar TVF rates for SES and PES up to that point diverged significantly, favoring SES out to 12 months. Patients undergoing routine angiographic follow-up demonstrated lower TVF prior to the 8-month point, and higher TVF after 8 months, as compared to those followed clinically. In conclusion, the current study failed to demonstrate the proposed superiority of PES for DM patients. In addition, the diversion of TVF at 8 months may reflect an "oculo-stenotic reflex" bias (the tendency to treat lesions found during routine, rather than clinically driven, angiographic follow-up), which could constitute an obstacle for evaluating the true clinical effect of new devices.

  15. Effect of a paclitaxel-eluting metallic stent on rabbit esophagus. (United States)

    Zhang, Yin; Gao, Ying; Chen, Jianping; Ma, Limei; Liu, Li; Wang, Xiang; Fan, Zhining


    The use of self-expanding metallic stents (SEMS) is the current treatment of choice for malignant gastrointestinal obstructions. A paclitaxel-eluting metallic SEMS (PEMS) may have an antitumor effect on esophageal tissue. PEMS with 10% paclitaxel or conventional SEMS were inserted into the lower esophagus of rabbits. Following the insertion of the stents for 1, 2, 4 and 6 weeks, the rabbits were sacrificed and the status of the stent insertion was examined, as well as any macroscopic or microscopic mucosal changes in the esophageal tissue. All the rabbits survived until death without any complications. No migration following stent insertion occurred. The number of cases with proximal obstruction increased in a time-dependent manner, and no significant difference was observed between the two groups. Gross histological examination showed similar tissue reaction to the stents at 1, 2 and 4 weeks, and inflammatory cell infiltrating was higher in the SEMS group at 1 and 2 weeks. However, inflammatory cell infiltration was markedly higher in the PEMS group at 4 and 6 weeks. Food-intake and weight were similar in the two groups. The results of the present study demonstrated that PEMS may serve as a safe alternative treatment strategy for esophageal obstruction. Furthermore, PEMS may inhibit the tumor growth of the esophageal wall through inflammatory infiltration and targeted drug delivery. A tumor model will be required in the future for evaluating the prognosis of patients with advanced esophageal carcinoma.

  16. Target lesion revascularisation in patients treated with a sirolimus-eluting or paclitaxel-eluting stent

    DEFF Research Database (Denmark)

    Maeng, Michael; Okkels Jensen, Lisette; Rasmussen, Klaus


    OBJECTIVE: To identify risk factors for clinical-driven target lesion revascularisation (TLR) in patients treated with sirolimus-eluting (Cypher) or paclitaxel-eluting (Taxus) stents in a real-world scenario. DESIGN: From 1 January 2003 to 18 May 2005, all patients treated with a Cypher or Taxus...

  17. Safety and efficacy of a non-polymeric paclitaxel-eluting microporous stent in real-world percutaneous coronary intervention (United States)



    At present, there is an increasing focus on stents that have a biodegradable polymer coating, rather than a permanent polymer coating. This is due to the fact that following the implantation of a drug-eluting stent (DES) with a permanent polymer coating, the continued existence of the coating may result in a foreign body reaction and delayed re-endothelialization. The aim of the present study was to evaluate the safety and efficacy of a non-polymeric paclitaxel-eluting microporous (YINYI™) stent in real-life percutaneous coronary intervention (PCI) for patients with coronary artery disease (CAD). A total of 686 YINYI™ stents were implanted in 404 patients with CAD in a PCI procedure and outpatient follow-ups were performed 1, 6, 12 and 15 months subsequent to the PCI, respectively. The observation endpoints were major adverse cardiac events (MACEs), including cardiac death, non-fatal myocardial infarction (MI), restenosis, target lesion revascularization, stent thrombosis and recurrence of angina pectoris. The average follow-up time was 15 months. The results revealed that the cumulative incidences of MACEs were as follows: mortality, 0.99%; non-fatal MI, 0.74%; restenosis, 4.0%; and target lesion revascularization, 2.7%. The results at the short- and long-term clinical follow-ups indicated that YINYI™ stents are effective and safe for use in PCI for patients with CAD. PMID:24137271

  18. Comparison of the sirolimus-eluting versus paclitaxel-eluting coronary stent in patients with diabetes mellitus: the diabetes and drug-eluting stent (DiabeDES) randomized angiography trial

    DEFF Research Database (Denmark)

    Maeng, Michael; Jensen, Lisette Okkels; Galloe, Anders Michael


    The aim of the present study was to evaluate angiographic late luminal loss after the implantation of sirolimus-eluting Cypher stents and paclitaxel-eluting Taxus stents in patients with diabetes. The study was a Danish multicenter, open-label, randomized trial. One hundred fifty-three patients...... stent thrombosis, or target lesion revascularization) were observed in 17 patients (Cypher, n = 6; Taxus, n = 11; p = 0.19). In conclusion, angiographic in-stent late luminal loss is significantly reduced in patients with diabetes by use of the sirolimus-eluting Cypher stent compared with the paclitaxel...

  19. 10-Year Clinical Outcome After Randomization to Treatment by Sirolimus- or Paclitaxel-Eluting Coronary Stents

    DEFF Research Database (Denmark)

    Galløe, Anders M.; Kelbæk, Henning; Thuesen, Leif


    . During the follow-up period, MACE occurred in 346 (32.5%) in the group receiving a sirolimus-eluting stent and in 342 (33.1%) in the group receiving a paclitaxel-eluting stent (hazard ratio: 0.96; 95% confidence interval: 0.83 to 1.11; p = 0.60), with a steady annual rate of 2.6% after the first year...

  20. Incomplete stent apposition after implantation of paclitaxel-eluting stents or bare metal stents: insights from the randomized TAXUS II trial.

    NARCIS (Netherlands)

    K. Tanabe (Kengo); P.W.J.C. Serruys (Patrick); M. Degertekin (Muzaffer); E. Grube (Eberhard); G. Guagliumi (Giulio); W. Urbaszek (Wilhelm); J.J.R.M. Bonnier (Hans); J.M. Lanblanche (Jean-Michel); T. Siminiak (Tomasz); J. Nordrehaug (Jan); H. Figulla (Hans); J. Drzewiecki (Janusz); A. Banning (Adrian); K. Hauptmann (Karl); D. Dudek (Dariusz); N. Bruining (Nico); R. Hamers (Ronald); A. Hoye (Angela); J.M.R. Ligthart (Jürgen); C. Disco (Clemens); J. Koglin (Jörg); M.E. Russell (Mary); A. Colombo (Antonio)


    textabstractBACKGROUND: The clinical impact of late incomplete stent apposition (ISA) for drug-eluting stents is unknown. We sought to prospectively investigate the incidence and extent of ISA after the procedure and at 6-month follow-up of paclitaxel-eluting stents in comparison with bare metal

  1. 2-year clinical outcomes after implantation of sirolimus-eluting, paclitaxel-eluting, and bare-metal coronary stents: results from the WDHR (Western Denmark Heart Registry)

    DEFF Research Database (Denmark)

    Kaltoft, Anne; Jensen, Lisette Okkels; Maeng, Michael


    OBJECTIVES: This registry study assessed the safety and efficacy of the 2 types of drug-eluting stents (DES), sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES), compared with bare-metal stents (BMS). BACKGROUND: Drug-eluting stents may increase the risk of stent thrombosis (ST...

  2. Comparison of sirolimus- and paclitaxel-eluting stents in patients with moderate renal insufficiency: results from the J-DESsERT trial. (United States)

    Otsuka, Masaya; Yokoi, Hiroyoshi; Matsuyama, Yutaka; Hayashi, Yasuhiko; Shiode, Nobuo; Masaoka, Yoshiko; Okimoto, Tomokazu; Tamekiyo, Hiromichi; Kawase, Tomoharu; Yamane, Kenichi; Kagawa, Yuzo; Nakamura, Masato; Muramatsu, Toshiya; Nanto, Shinsuke


    It is unclear whether there are differences in clinical outcomes between sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) in patients with moderate renal insufficiency (RI). The Japan-Drug Eluting Stents Evaluation; a Randomized Trial (J-DESsERT) was a prospective, randomized multicenter trial which compared 1:1 coronary stenting between SES and PES patients. Patient with serious RI (serum creatinine value 2mg/dL or higher) were excluded. Patients were classified into 2 arms according to renal function: a non-RI arm of 2220 patients (SES 1094 and PES 1126 patients with estimated glomerular filtration rate (eGFR) ≥60 mL min(-1) 1.73 m(-2)) and an RI arm of 1206 patients (SES 613, PES 593 with 30≤eGFR <60 mL min(-1) 1.73 m(-2)). At 12 months, the primary endpoint of target vessel failure in the non-RI arm occurred in 6.0% in the SES group and 8.7% in the PES group (p=0.02). In the RI arm, this occurred in 5.7% and 8.1% (p=0.10). Mortality rates were 0.8% vs 0.7% (p=0.78) in the non-RI arm, and 2.2% vs 2.1% (p=0.90) in the RI arm. Cardiac death was 0.4% vs 0.1% (p=0.17) in the non-RI arm, and 1.0% vs 1.0% (p=0.96) in the RI arm. Mortality was higher in patients with RI than those without RI (2.1% vs 0.8%; p<0.01). Cardiac death rates increased in the RI arm compared with those in the non-RI arm (1.0% vs 0.2%; p<0.01). Regardless of the presence or absence of moderate RI, differences in outcomes between SES and PES change little except mortality and cardiac death. Copyright © 2014 Elsevier Inc. All rights reserved.

  3. Comparison of long-term outcomes of bare-metal and paclitaxel-eluting stents in New York. (United States)

    Qian, Feng; Zhong, Ye; Kheocha-On, Tammie; Hannan, Edward


    Bare-metal stents (BMS) as the first-generation coronary stent and paclitaxel-eluting stents (PES) as a first-generation drug-eluting stent have been employed in percutaneous coronary intervention (PCI). However, the long-term comparative effectiveness of BMS versus PES in real practice remains unclear. To assess long-term outcomes for patients undergoing PCI with either BMS or PES placement and to determine comparative effectiveness of BMS versus PES in six 'off-label' and two 'high-risk' patient subgroups. A longitudinal database was created by linking the New York State cardiac registries, statewide hospital discharge data, the National Death Index and the US Census file (2010) for patients undergoing PCI with BMS or PES placement in 2006 and 2007. Outcomes included all-cause mortality, acute myocardial infarction (AMI), target vessel PCI (TVPCI) and target vessel coronary artery bypass graft (TVCABG) surgery for a 5.5-year follow-up period. A total of 13 879 propensity score matched pairs were compared with respect to outcomes using Kaplan-Meier method with further adjustment using Cox proportional hazards regression. At 5.5 years, PES use was associated with significantly lower mortality (adjusted hazard ratio (AHR): 0.73, 95% confidence interval : 0.69-0.77), AMI (AHR: 0.90, 95% CI: 0.83-0.98), TVPCI (AHR: 0.92, 95% CI: 0.86-0.99) and TVCABG (AHR, 0.63, 95% CI: 0.53-0.74). For 'off-label' and 'high-risk' subgroups, PES was associated with lower mortality and improved/similar AMI, TVPCI and TVCABG rates relative to BMS. Compared with BMS, PES was associated with improved mortality and better or comparable AMI, TVPCI and TVCABG outcomes at 5.5 years. © 2016 John Wiley & Sons, Ltd.

  4. Six-Month Clinical and Angiographic Results of Paclitaxel Eluting Simpax Stent

    Directory of Open Access Journals (Sweden)

    Mehmet Muhsin Türkmen


    Full Text Available Introduction: We aimed to evaluate the safety and efficacy of the simpax stent in the treatmentof different patient groups.Patients and Methods: Forty-five patients were treated with the simpax stent. Of these patients,23 patients gave consent for six months of follow-up by quantitative coronary angiography (QSAand six patients were evaluated by exercise electrocardiographic test. Only the patients havinglesions with stenosis > 50% of diameter and lengths > 16 mm with reference diameters < 2.75mm were included.Results: The device success rate was 100% and procedure success rate was 97.7%. The meanstent length was 24.6 ± 7.3 mm and stent size was 2.54 ± 0.24 mm. The overall six months incidenceof major adverse cardiac events (MACE was 8.8%. MACE was consisted of two casesof non-Q wave myocardial infarction and two cases of repeated revascularization of the targetlesion. MACE rate was higher in chronic total occlusion (CTO group than non-CTO group (respectively33.3% and 5.1. Also when compared to stent size, MACE rate was 25% in < 2.5 mm,0% ≥ 2.5 mm. The QSA results at six months showed in-stent late lumen loss witha diameter of0.25 ± 0.15 mm in 17 patients.Conclusion: The six month results in this study demonsrated excellent procedural and devicesuccess. Simpax stent was associated with a low in-stent late lumen loss. Also this study showedsimpax stent was a safe and effective device in non-CTO group with stent size ≥ 2.5 mm.

  5. Effect of paclitaxel elution from reservoirs with bioabsorbable polymer compared to a bare metal stent for the elective percutaneous treatment of de novo coronary stenosis: the EUROSTAR-II randomised clinical trial

    NARCIS (Netherlands)

    Silber, S.; Gutierrez-Chico, J.L.; Behrens, S.; Witzenbichler, B.; Wiemer, M.; Hoffmann, S.; Slagboom, T.; Harald, D.; Suryapranata, H.; Nienaber, C.; Chevalier, B.; Serruys, P.W.


    AIMS: To compare the angiographic and clinical performance of a paclitaxel-eluting stent using reservoirs technology and a bioabsorbable polymer, without surface coating (CoStar), vs. an equivalent bare metal stent (BMS) using an identical metallic platform. METHODS AND RESULTS: Three hundred and

  6. Effect of paclitaxel elution from reservoirs with bioabsorbable polymer compared to a bare metal stent for the elective percutaneous treatment of de novo coronary stenosis: The EUROSTAR-II randomised clinical trial

    NARCIS (Netherlands)

    S. Silber (Sigmund); J.L. Gutiérrez-Chico; T.W. Behrens (Timothy); B. Witzenbichler (Bernhard); M. Wiemer (Marcus); S. Hoffmann (Stefan); T. Slagboom (Ton); D. Harald (Darius); H. Suryapranata (Harry); C. Nienaber (Christoph); B. Chevalier (Bernard); P.W.J.C. Serruys (Patrick)


    textabstractAims: To compare the angiographic and clinical performance of a paclitaxel-eluting stent using reservoirs technology and a bioabsorbable polymer, without surface coating (CoStar), vs. an equivalent bare metal stent (BMS) using an identical metallic platform. Methods and results: Three

  7. Neointimal hyperplasia after sirolimus-eluting and paclitaxel-eluting stent implantation in diabetic patients: the Randomized Diabetes and Drug-Eluting Stent (DiabeDES) Intravascular Ultrasound Trial

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Maeng, Michael; Thayssen, Per


    -eluting (Cypher) or paclitaxel-eluting (Taxus) stents in diabetic patients. METHODS AND RESULTS: One hundred and thirty diabetic patients were randomized to Cypher or Taxus stent implantation. IVUS was performed at 8 month follow-up. NIH volume was significantly reduced in the Cypher group when compared...

  8. Comparison of zotarolimus-eluting stents with sirolimus- and paclitaxel-eluting stents for coronary revascularization: the ZEST (comparison of the efficacy and safety of zotarolimus-eluting stent with sirolimus-eluting and paclitaxel-eluting stent for coronary lesions) randomized trial. (United States)

    Park, Duk-Woo; Kim, Young-Hak; Yun, Sung-Cheol; Kang, Soo-Jin; Lee, Seung-Whan; Lee, Cheol-Whan; Park, Seong-Wook; Seong, In-Whan; Lee, Jae-Hwan; Tahk, Seung-Jea; Jeong, Myung-Ho; Jang, Yangsoo; Cheong, Sang-Sig; Yang, Joo-Young; Lim, Do-Sun; Seung, Ki-Bae; Chae, Jei-Keon; Hur, Seung-Ho; Lee, Sang-Gon; Yoon, Junghan; Lee, Nae-Hee; Choi, Young-Jin; Kim, Hyun-Sook; Kim, Kee-Sik; Kim, Hyo-Soo; Hong, Taeg-Jong; Park, Hun-Sik; Park, Seung-Jung


    The aim of this study was to evaluate the relative efficacy and safety of zotarolimus-eluting stents (ZES) in comparison with the established and widely used sirolimus- (SES) and paclitaxel-eluting stents (PES) in routine clinical practice. Whether ZES might provide similar clinical and angiographic outcomes in a broad spectrum of patients compared with SES or PES is undetermined. We performed a single-blind, multicenter, prospectively randomized trial to compare ZES with SES and PES in 2,645 patients undergoing percutaneous coronary intervention. The primary end point was a composite of major adverse cardiac events (MACE) (death, myocardial infarction, and ischemia-driven target vessel revascularization) at 12 months. A noninferiority comparison (ZES vs. SES) and a superiority comparison (ZES vs. PES) were performed for the primary end point. Baseline clinical and angiographic characteristics were similar in the 3 groups. At 12 months, the ZES group showed noninferior rates of MACE compared with the SES group (10.2% vs. 8.3%, p for noninferiority = 0.01, p for superiority = 0.17) and significantly fewer MACE than the PES group (10.2% vs. 14.1%, p for superiority = 0.01). The incidence of death or myocardial infarction was similar among the groups (ZES vs. SES vs. PES, 5.8% vs. 6.9% vs. 7.6%, respectively, p = 0.31). The incidence of stent thrombosis was significantly lower in the SES group (ZES vs. SES vs. PES, 0.7% vs. 0% vs. 0.8%, respectively, p = 0.02). In this large-scale, practical randomized trial, the use of ZES resulted in similar rates of MACE compared with SES and in fewer MACE compared with PES at 12 months. (Comparison of the Efficacy and the Safety of Zotarolimus-Eluting Stent Versus Sirolimus-Eluting Stent and PacliTaxel-Eluting Stent for Coronary Lesions; NCT00418067). Copyright © 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  9. Intravascular ultrasound results from the NEVO ResElution-I trial: a randomized, blinded comparison of sirolimus-eluting NEVO stents with paclitaxel-eluting TAXUS Liberté stents in de novo native coronary artery lesions. (United States)

    Otake, Hiromasa; Honda, Yasuhiro; Courtney, Brian K; Shimohama, Takao; Ako, Junya; Waseda, Katsuhisa; Macours, Nathalie; Rogers, Campbell; Popma, Jeffrey J; Abizaid, Alexandre; Ormiston, John A; Spaulding, Christian; Cohen, Sidney A; Fitzgerald, Peter J


    The NEVO sirolimus-eluting stent (NEVO SES) is a novel cobalt-chromium stent combining sirolimus release from reservoirs with bioabsorbable polymer to reduce spatial and temporal polymer exposure. The aim of this study was to assess the arterial response to the NEVO SES in a randomized, blinded comparison versus the surface-coated TAXUS Liberte paclitaxel-eluting stent (TAXUS Liberté PES) in human native coronary lesions using intravascular ultrasound (IVUS). The NEVO ResElution-I IVUS substudy enrolled 100 patients (1:1 randomization). In addition to standard IVUS variables, uniformity of neointimal distribution within stents was evaluated in 3 dimensions by computing mean neointimal thickness within 12 equally spaced radial sectors on every 1-mm cross section along the stented segment. The NEVO SES showed significantly less neointimal proliferation (neointimal obstruction: 5.5±11.0% versus 11.5±9.7%, P=0.02), resulting in less late lumen area loss and smaller maximum cross-sectional narrowing at 6 months. The absolute variability of neointima distribution, assessed by the standard deviation of neointimal thickness within each stent, was significantly reduced with the NEVO SES compared with the TAXUS Liberté PES(0.04±0.04 mm versus 0.10±0.07 mm, PNEVO SES (Δvessel volume index: 1.30±1.36 mm(3)/mm versus 0.36±0.63 mm(3)/mm, respectively, P=0.003). The NEVO SES with focal release of sirolimus from reservoirs achieved significantly greater and more consistent suppression of neointimal hyperplasia than the surface-coated TAXUS Liberté PES. This was associated with less positive remodeling and no increased morphological or morphometric abnormalities surrounding the stent or at the stent margins. URL: Unique identifier: NCT00714883. © 2011 American Heart Association, Inc.

  10. Evaluation of the distribution of Paclitaxel by immunohistochemistry and nuclear magnetic resonance spectroscopy after the application of a drug-eluting balloon in the porcine ureter. (United States)

    Liourdi, Despoina; Kallidonis, Panagiotis; Kyriazis, Iason; Tsamandas, Athanasios; Karnabatidis, Dimitrios; Kitrou, Panagiotis; Spyroulias, Georgios A; Kostopoulou, Ourania N; Marousis, Kostas; Kalpaxis, Dimitrios L; Goumenos, Dimitrios S; Liatsikos, Evangelos


    The urothelium represents "the tightest and most impermeable barrier in the body." We investigated the distribution of paclitaxel (PTX) in the ureteral wall after the inflation of a paclitaxel-eluting balloon (PEB) in an attempt to elucidate the possibility of clinical application of PEBs in the ureter. Nine domestic pigs were used. Nine PEBs and nine conventional percutaneous angioplasty balloons (CB) were inflated in the right and left ureter of each animal, respectively. The ureter treated by CB was the control for the contralateral ureter. Specimens were removed: Immediately after inflation (group A), after 12 hours (group B), and after 24 hours (group C). Two samples were obtained from each ureter of groups A, B and C. One sample was investigated by nuclear magnetic resonance spectroscopy (NMR), the other by histology and immunohistochemistry (IHC) using a specific for PTX polyclonal antibody. Reduced inflammation was observed in the group B and C samples in comparison with their controls. PTX was distributed mostly in the urothelium and submucosal layer in group A (IHC). The agent was present in the urothelial, submucosal, and muscle layer in groups B and C. The concentration of PTX (NMR) has been reduced in group C compared with the tissue extracts of group B. The distribution of PTX includes the urothelial, submucosal, and smooth muscle layers. Inflammation was reduced in the case of drug-eluting balloons.

  11. Comparison of the efficacy and safety of zotarolimus-, sirolimus-, and paclitaxel-eluting stents in patients with ST-elevation myocardial infarction. (United States)

    Lee, Cheol Whan; Park, Duk-Woo; Lee, Seung-Hwan; Kim, Young-Hak; Hong, Myeong-Ki; Kim, Jae-Joong; Park, Seong-Wook; Yun, Sung-Cheol; Seong, In-Whan; Lee, Jae-Hwan; Lee, Nae-Hee; Cho, Yoon Haeng; Cheong, Sang-Sig; Lim, Do-Sun; Yang, Joo-Young; Lee, Sang-Gon; Kim, Kee-Sik; Yoon, Junghan; Jeong, Myung-Ho; Seung, Ki Bae; Hong, Taeg Jong; Park, Seung-Jung


    Drug-eluting stents (DESs) are increasingly used for treatment of acute ST-segment elevation myocardial infarction (STEMI), but there are few comparisons of outcomes of various types of DES. We compared the efficacy and safety of zotarolimus-eluting stents (ZESs), sirolimus-eluting stents (SESs), and paclitaxel-eluting stents (PESs) in primary intervention for STEMI. This multicenter, prospectively randomized ZEST-AMI trial included 328 patients at 12 medical centers who were randomly assigned to ZES (n = 108), SES (n = 110), or PES (n = 110) deployment. The primary end point was major adverse cardiac events (death, MI, and ischemia-driven target vessel revascularization) at 12 months. Secondary end points included the individual components of the primary end point, late loss, angiographic restenosis, and stent thrombosis. Baseline clinical and angiographic characteristics were well matched. In-segment late loss (0.28 +/- 0.42 vs 0.46 +/- 0.48 vs 0.47 +/- 0.50 mm, respectively, p = 0.029) and restenosis rate (2.7% vs 15.9% vs 12.3%, respectively, p = 0.027) at 8 months were lowest in the SES group compared to the ZES and PES groups. At 12 months, cumulative incidence rates of primary end points in the ZES, SES, and PES groups were 11.3%, 8.2%, and 8.2%, respectively (p = 0.834). There were 2 acute (in the SES group) and 5 subacute (2 in the SES group and 3 in the PES group) stent thromboses. Incidence of death, recurrent MI, or ischemia-driven target vessel revascularization did not differ among the 3 groups. In conclusion, despite the difference in restenosis rate, the efficacy and safety of the 3 different DESs showed similar, acceptable results in the treatment of STEMI.

  12. Twelve-Month Results From the MAJESTIC Trial of the Eluvia Paclitaxel-Eluting Stent for Treatment of Obstructive Femoropopliteal Disease. (United States)

    Müller-Hülsbeck, Stefan; Keirse, Koen; Zeller, Thomas; Schroë, Herman; Diaz-Cartelle, Juan


    To report the 12-month results of the MAJESTIC clinical study of the self-expanding Eluvia paclitaxel-eluting stent in the treatment of femoropopliteal lesions. The prospective, single-arm, multicenter trial ( identifier NCT01820637) enrolled 57 patients (mean age 69±9 years; 47 men) with chronic lower limb ischemia referable to de novo or restenotic lesions in the native superficial femoral and/or proximal popliteal arteries. A third of the patients had diabetes. Mean lesion length was 70.8±28.1 mm, and diameter stenosis was 86.3%±16.2%; 26 (46%) lesions were occluded. Primary patency was defined as duplex ultrasound peak systolic velocity ratio ≤2.5 and the absence of target lesion revascularization (TLR) or bypass. Major adverse events (MAEs) included all-cause death through 1 month and target limb major amputation and TLR through 12 months. All 57 patients had a single Eluvia stent implanted, employing pre- and postdilation in 93% (53/57) and 95% (54/57) of cases, respectively. Technical success was 97% (55/57; 2 failures due to residual stenosis >30%). At 12 months, primary patency was 96% (49/51) and the MAE rate was 4% (2/53); both MAEs were TLRs. No stent fractures were identified. There were no major amputations. One death occurred 368 days postprocedure, unrelated to the device or procedure. Improvements in the Rutherford category were sustained through 1 year, with 81% (43/53) exhibiting no symptoms (category 0) and 13% (7/53) presenting with mild claudication (category 1). Mean ABI improved from 0.73±0.22 at baseline to 1.02±0.20 at 12 months. MAJESTIC results showed that patients whose femoropopliteal arteries were treated with the Eluvia drug-eluting stent sustained high patency and low MAE rates through 12 months. © The Author(s) 2016.

  13. Intravascular ultrasound insights from the Cobalt Chromium Stent With Antiproliferative for Restenosis II (COSTAR II) trial comparing CoStar and Taxus paclitaxel-eluting stents. (United States)

    Tsujino, Ichizo; Koizumi, Tomomi; Shimohama, Takao; Ako, Junya; Waseda, Katsuhisa; Krucoff, Mitchell; Honda, Yasuhiro; Fitzgerald, Peter J


    Dedicated IVUS analyses of the second CObalt chromium STent with Antiproliferative for Restenosis (COSTAR II) trial have not been documented. We aim to compare IVUS findings between CoStar paclitaxel-eluting stent (PES) and Taxus PES in patients enrolled in the COSTAR II trial. We also attempted to examine the possible regional impact of multiple stenting. Among the 1700 patients enrolled, 238 were assigned to an IVUS cohort including 168 patients treated by provisional multiple stenting. At 9 months, qualitative and quantitative IVUS observations including incomplete stent apposition (ISA) and neointimal proliferation (neointimal obstruction: neointimal volume/stent volume ×100) were compared between CoStar and Taxus PESs. In qualitative analysis, late-acquired ISA was observed in 1 patient treated by Taxus PES. Impaired strut continuity suggestive of stent fracture was observed in 2 out of 33 patients treated by multiple CoStar, and 4 out of 21 patients treated by multiple Taxus (P=.14). No such findings were found in single-stented patients in either stent subset. Quantitative analysis showed greater neointimal obstruction in CoStar (19.7%±13.4%, n=52) than in Taxus (10.7%±9.9%, n=38), whereas no significant difference in neointimal obstruction was found between single and multiple stenting in either CoStar or Taxus PES. The CoStar PES exhibits greater neointimal proliferation compared with Taxus PES at 9 months but with similar qualitative outcomes including late-acquired ISA. IVUS findings suggestive of stent fracture were found only in multiple-stenting cases irrespective of the stent used. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Impact of coronary artery calcification in percutaneous coronary intervention with paclitaxel-eluting stents: Two-year clinical outcomes of paclitaxel-eluting stents in patients from the ARRIVE program. (United States)

    Lee, Michael S; Yang, Tae; Lasala, John; Cox, David


    The purpose of this study was to evaluate clinical outcomes after percutaneous coronary intervention (PCI) in patients with coronary artery calcification (CAC). Smaller studies have reported worse clinical outcomes in patients with CAC who undergo PCI. The impact of CAC in the drug-eluting stent era is unclear. Data from 7,492 patients treated by PCI with ≥1 TAXUS Express stent in the ARRIVE registry with no inclusion/exclusion criteria were stratified by the severity of CAC, as determined by the operator. Endpoints were independently adjudicated. All major adverse cardiac events were assessed at 2 years. Moderate/severe CAC was present in 19.6%. The nil/mild CAC group had higher rate of current smokers. The moderate/severe CAC group was older and had a higher prevalence of hypertension, kidney disease, prior coronary artery bypass grafting, congestive heart failure, and left main disease. After adjustment for imbalanced baseline variables, patients with moderate/severe CAC had higher 2 year rates of major adverse cardiac events (18.3% vs 13.5%, p = 0.01) and death (10.3% vs 5.6%, p = 0.02). Moderate/severe CAC was associated with increased clinical events in patients who underwent PCI with TAXUS stents. This may be explained in part due to differences important baseline characteristics including more patients with more comorbidities and more complex lesions. After adjustment for imbalanced baseline variables, the moderate/severe CAC group had a higher risk of major adverse cardiac events and death. Improvements in treatment strategies are needed for this high-risk group of patients who undergo PCI. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  15. Design and evaluation of a continuum robot with extendable balloons

    Directory of Open Access Journals (Sweden)

    E. Y. Yarbasi


    Full Text Available This article presents the design and preliminary evaluation of a novel continuum robot actuated by two extendable balloons. Extendable balloons are utilized as the actuation mechanism of the robot, and they are attached to the tip from their slack sections. These balloons can extend very much in length without having a significant change in diameter. Employing two balloons in an axially extendable, radially rigid flexible shaft, radial strain becomes constricted, allowing high elongation. As inflated, the balloons apply a force on the wall of the tip, pushing it forward. This force enables the robot to move forward. The air is supplied to the balloons by an air compressor and its flow rate to each balloon can be independently controlled. Changing the air volumes differently in each balloon, when they are radially constricted, orients the robot, allowing navigation. Elongation and force generation capabilities and pressure data are measured for different balloons during inflation and deflation. Afterward, the robot is subjected to open field and maze-like environment navigation tests. The contribution of this study is the introduction of a novel actuation mechanism for soft robots to have extreme elongation (2000 % in order to be navigated in substantially long and narrow environments.

  16. OCT evaluation of directional atherectomy compared to balloon angioplasty

    Energy Technology Data Exchange (ETDEWEB)

    Marmagkiolis, Konstantinos [Citizens Memorial Hospital Heart and Vascular Institute, Bolivar, MO (United States); Lendel, Vasili [Arkansas Heart Hospital, Peripheral Vascular Institute, Little Rock, AR (United States); Cilingiroglu, Mehmet, E-mail: [Arkansas Heart Hospital, Peripheral Vascular Institute, Little Rock, AR (United States); Koc University, School of Medicine, Istanbul (Turkey)


    Directional atherectomy (DA) is one of the most commonly used modalities for the treatment of obstructive femoropopliteal peripheral arterial disease (PAD), especially in patients with large and calcified atherosclerotic plaques. The effect of directional atherectomy to the vascular wall compared to balloon angioplasty by optical coherence tomography (OCT) has not been previously described. We present the first case of OCT after directional atherectomy with SilverHawk followed by angiosculpt balloon angioplasty. - Highlights: • Directional atherectomy avoids the vascular mechanical damage caused by angioplasty balloons and the exposure of stent struts or the potential of stent fracture with stents. • OCT can accurately assess the effect of endovacular interventions to the vessel wall. • Although angiographic results after directional atherectomy are acceptable, OCT use demonstrated suboptimal improvement of the MLA requiring additional balloon angioplasty. • Longer studies are needed to define whether the improved OCT results with angioplasty compared to DA may offer better clinical outcomes.

  17. Performance evaluation of a family-size, rubber-balloon biogas plant under hilly conditions

    Energy Technology Data Exchange (ETDEWEB)

    Kanwar, S.S.; Guleri, R.L. [Himachal Pradesh Agricultural Univ., Palampur (India). Bioenergy Lab.


    The performance of a 2-m{sup 3} rubber-balloon biogas plant was evaluated under hilly conditions and compared with a fixed-dome type Deenbandhu biogas plant of the same capacity. The daily average (over one year) biogas production in the rubber-balloon plant was 0.92 m{sup 3}/d, compared to 1.23 m{sup 3}/d in the Deenbandhu plant. A reduction of about 77% was found in the rate of biogas production from the rubber-balloon plant during winter months compared to the summer months. However, the corresponding reduction in gas from the Deenbandhu biogas plant was only 16%. The methane contents of the biogas of both plants were almost identical, but the moisture in the gas was 43% higher in the rubber-balloon than in the Deenbandhu plant. The changes in ambient temperature affected the rubber-balloon plant more than they affected the conventional plant. (author)

  18. Comparison of 2-year clinical outcomes with sirolimus and paclitaxel-eluting stents for patients with diabetes: results of the Registro Regionale AngiopLastiche Emilia-Romagna Registry. (United States)

    Balducelli, Marco; Ortolani, Paolo; Marzaroli, Paolo; Piovaccari, Giancarlo; Menozzi, Alberto; Manari, Antonio; Sangiorgio, Pietro; Tarantino, Fabio; Rossi, Rosario; Maresta, Aleardo; Tondi, Stefano; Passerini, Francesco; Guastaroba, Paolo; Grilli, Roberto; Marzocchi, Antonio


    Long-term outcomes of percutaneous coronary interventions (PCI) with sirolimus-eluting stents (SES) compared to paclitaxel-eluting-stents (PES) in unselected diabetics in routine practice is still debated. This study compared the 2-year incidence of MACE (all-cause mortality, nonfatal myocardial infarction and target vessel revascularization) of SES and PES in a real-world setting of patients with diabetes. Observational, multicenter, nonrandomized study. Prospective web-based registry (REAL Registry; study period, 2002-2005) comprising all 13 hospitals performing PCI. Among the 945 eligible patients treated with either SES alone (n = 606) or PES alone (n = 339), 29% were insulin-requiring, 72% had multivessel coronary disease, 26% had prior myocardial infarction and 10% had poor left ventricular function. Unadjusted and propensity score-adjusted 2-year clinical outcome. After propensity score adjustment, 2-year MACE incidence in the SES and PES groups was equivalent (23.3% vs. 23.7%, HR 1.01, 95%CI 0.72-1.42, P = 0.96). Adjusted 2-year angiographic stent thrombosis occurred in 1.1% of the SES patients versus 2.6% of the PES patients (P = 0.15). In this large, real-world, diabetic population treated with DES, there was no difference in outcome between SES and PES. Further studies are needed to demonstrate the long-term safety of different types of DES in patients with diabetes.

  19. Three-Year Clinical Outcomes of a Polymer-Free Paclitaxel-Eluting Microporous Stent in Real-World Practice: Final Results of the Safety and Efficacy Registry of the Yinyi Stent (SERY-I). (United States)

    Zhu, Jinzhou; Zhang, Qi; Chen, Lianglong; Zhang, Chenyun; Zhou, Xuchen; Yuan, Yong; Zhang, Ruiyan


    The safety and efficacy of a China-made polymer-free paclitaxel-eluting microporous stent (Yinyi) at 1-year has been previously reported. However, limited evidence exists regarding the long-term performance of this novel drug-eluting stent (DES). This study investigated the 3-year efficacy and safety of the Yinyi stent in the setting of safety and efficacy registry of the Yinyi stent (SERY-I) clinical trial. Between June 2008 and August 2009, a total of 1045 patients undergoing percutaneous coronary intervention (PCI) were implanted with ≥ 1 Yinyi stents at 27 medical centers in mainland China. Thereafter, clinical follow-up was performed for a period of 3 years after enrollment. The primary endpoint was the cumulative rate of composite major adverse cardiac events (MACE) including target lesion revascularization (TLR), the combined incidence of cardiac death, and non-fatal myocardial infarction; the second endpoint was the incidence of stent thrombosis. Overall, 1376 lesions were treated successfully with 1713 Yinyi stents, and 1019 (98.7%) patients received dual antiplatelet therapy for at least 12 months. At 3 years, a total of 13 (1.33%) patients had suffered cardiac death. The incidence of non-fatal myocardial infarction and TLR was 9 (0.92%) and 58 (5.92%) among the patients. Stent thrombosis occurred in 13 (1.33%) patients, and the rate of Academic Research Consortium (ARC) definite or probable stent thrombosis was 0.82%. Given the limitations that SERY-I was a single arm, nonrandomized study and only telephone follow-up was performed without angiographic analysis, the safety and efficacy of Yinyi stent observed in this extended follow-up Registry needs further verification.

  20. First-in-human experience using the Volcano VIBE-RX vascular imaging balloon catheter system (Volcano IVUS-guided Balloon Evaluation - New Zealand: VIBE-NZ Study). (United States)

    Watson, Timothy; El-Jack, Seifeddin; Stewart, James T; Ormiston, John


    Intravascular ultrasound (IVUS) is a proven and safe imaging modality used to guide percutaneous coronary intervention (PCI). The Volcano VIBE™ RX Vascular Imaging Balloon Catheter is a novel rapid exchange, 0.014" wire-compatible multi-lumen conventional balloon catheter modified with the addition of an IVUS transducer proximal to the balloon, delivered via a standard 6 Fr sheath. We sought to evaluate the safety, balloon performance, and image quality of the VIBE™ RX in patients scheduled for coronary intervention. Patients aged >21 and <85 years with single or multivessel coronary disease scheduled for PCI due to coronary ischaemic symptoms were included. Those with angiographic features that precluded the safe or informative use of the device were excluded. Twenty-nine patients having angiography because of ischaemic symptoms underwent 44 VIBE RX imaging runs, with balloon dilation in 20. Successful device deployment was achieved in all but one patient. All images were adequate and reproducible. One patient had a non-ST-elevation MI felt to be due to the complexity of the procedure rather than directly related to the VIBE™ RX. The study demonstrated the safety and effectiveness of the VIBE™ RX for its intended purpose with minimal failure rate and no directly related complications.

  1. In vivo evaluation of a biolimus eluting nickel titanium self expanding stent with overlapping balloon expandable drug eluting and bare metal stents in a porcine coronary model. (United States)

    Cilingiroglu, Mehmet; Elliott, James; Sangi, Pramod; Matthews, Holly; Tio, Fermin; Trauthen, Brett; Elicker, John; Bailey, Steven R


    Long lesions and complex vessel anatomy frequently require the use of overlapping stents to treat a lesion. The purpose of this study was to evaluate the long-term effects of overlapping the Axxess Biolimus A9 eluting stent (BES) with two of the most commonly used, commercially available drug eluting stents. These stents were compared to BxVelocity bare metal (BMS) stents in a porcine coronary stent-injury model. Nineteen juvenile farm swine, 25-35 kg in weight, 3-6 months in age were utilised. Each animal received an Axxess stent to their coronary artery as permitted by the individual animal's anatomy. A second stent, either a Cypher, sirolimus eluting stent (SES) or, a Taxus, paclitaxel eluting stent (PES), or a BxVelocity bare metal stent (BMS) were implanted in an overlapped fashion. The animals were then followed for either 28 or 180 days as specified by a randomisation scheme. At the end of each follow-up period, they were euthenised, and the vessels containing the overlapping stents were harvested, processed into histological sections, and analysed. Compared to bare metal stents, overlapped segments using DES exhibited delayed vascular healing compared to both the proximal and distal non-overlap sites at each of the follow-up time point. Overall, in the non-overlap stent segments, SES induced significantly more inflammation and neointimal hyperplasia compared to PES and BMS. In this study of BMS and two different types of DES overlapped with the Axxess Biolimus A9 eluting stent, we found that while there was a delay in the degree of vascular healing with DES compared to BMS, the specific type of DES that was overlapped with BES did not affect the behaviour of the overlap zone in terms of most of the histomorphometric measures at 28 or 180 days. This was true whether the stent was drug eluting or bare metal. More inflammation with delayed healing was seen in the SES compared to PES and BMS.

  2. Evaluation of a balloon dilator before second-trimester abortion by vacuum curettage. (United States)

    Stubblefield, P G; Frederiksen, M C; Berek, J S; Gatter, M A; Kayman, D J; Borten, M


    We evaluated the cervical dilator device (CDD), an expanding balloon, as a substitute for laminaria tents before abortion at 13 to 16 1/2 weeks by extraction and vacuum curettage. The CDD was found to be an effective dilator, although it did not appear to have any advantage over laminaria tents when placed overnight and was associated with significant pain upon insertion and an apparent increased risk of endometritis. The present CDD or a subsequent modification may offer advantages over laminaria tents for short-term placement.

  3. The Balloon-Based Manometry Evaluation of Swallowing in Patients with Amyotrophic Lateral Sclerosis

    Directory of Open Access Journals (Sweden)

    Jerzy Tomik


    Full Text Available The aim of the study was to analyse the disturbances of the oro-pharyngeal swallowing phase of dysphagia in amyotrophic lateral sclerosis (ALS patients with the use of specific manometric measurements and to evaluate their plausible association with the duration of the disease. Seventeen patients with ALS were evaluated with manometric examinations of the oral and pharyngeal part of the gastrointestinal tract. Tests were carried out by using the oesophageal balloon-based method with four balloon transducers located 5 cm away from each other. The following manometric parameters were analysed: the base of tongue contraction (BTC and the upper oesophageal sphincter pressure (UESP, and the hypopharyngeal suction pump (HSP as well as the oro-pharyngeal, pharyngeal and hypopharyngeal transit time and average pharyngeal bolus velocity (oropharyngeal transit time (OTT, pharyngeal transit time (PTT, hypopharyngeal transit time (HTT and average pharyngeal bolus velocity (APBV, respectively. Manomatric examinations during swallowing in patients with ALS showed significant weakness of BTC, a decrease of HSP and a decrease of the velocity of bolus transit inside the pharynx which were particularly marked between the first and the third examination. Manometric examinations of the oro-pharyngeal part of the gastrointestinal tract are useful and supportive methods in the analysis of swallowing disturbances in ALS patients.

  4. Evaluation of Magnetic Resonance Imaging Safety and Imaging Issues Associated with the Occlusion Balloon Used during Fetoscopic Endoluminal Tracheal Occlusion. (United States)

    Victoria, Teresa; Johnson, Ann M; Adzick, N Scott; Hedrick, Holly L; Shellock, Frank G


    Congenital diaphragmatic hernias can be successfully treated by fetoscopic tracheal occlusion (FETO), a minimally invasive procedure that may improve postnatal survival. The endoluminal balloon utilized for FETO contains a metallic component that may pose possible risks for the fetus and mother related to the use of magnetic resonance imaging (MRI). The objective of this study is to evaluate MRI-related imaging and safety issues (magnetic field interactions, heating, and artifacts) for the occlusion balloon used in FETO. Using well-established techniques, tests were performed to assess magnetic field interactions (translational attraction and torque) and MRI-related heating and artifacts that occurred when exposing the occlusion balloon typically used for FETO (Goldbal2, Balt, to a 3-T magnet. MRI-related heating was determined by placing the occlusion balloon in a gelled-saline-filled, head-torso phantom and conducting MRI at relatively high, whole-body-averaged specific absorption rate (2.9 W/kg) for 15 min. Artifacts were measured in association with the use of T1-weighted, spin-echo and gradient-echo pulse sequences. The balloon displayed minor magnetic field interactions and physiologically inconsequential heating (highest temperature rise: 0.1°C above background). Artifacts extended approximately 10 mm from the occlusion balloon on the gradient-echo pulse sequence, suggesting that anatomy located at a position greater than this distance may be visualized on MRI. In this paper, we demonstrate that the risks of performing MRI at 3 T or less in a patient who has this occlusion balloon in place are acceptable (or MR conditional, using current terminology). © 2017 S. Karger AG, Basel.

  5. In vitro evaluation of paclitaxel coatings for delivery via drug-coated balloons. (United States)

    Kempin, Wiebke; Kaule, Sebastian; Reske, Thomas; Grabow, Niels; Petersen, Svea; Nagel, Stefan; Schmitz, Klaus-Peter; Weitschies, Werner; Seidlitz, Anne


    Lately, drug-coated balloons have been introduced in interventional cardiology as an approach to treat occluded blood vessel. They were developed for the rapid transfer of antiproliferative drugs during the angioplasty procedure in stenosed vessels with the intent to reduce the risk of restenosis. In this study five different paclitaxel (PTX) balloon coatings were tested in vitro in order to examine how solvents and additives influence coating stability and drug transfer rates. PTX-coated balloons were advanced through a guiding catheter and a simulated coronary artery pathway under perfusion and were then inflated in a hydrogel acceptor compartment. The fractions transferred to the gel, remaining on the balloon and the PTX lost in the simulated coronary pathway were then analysed. The results obtained suggest that the solvent used for the coating process strongly influences the surface structure and the stability of the coating. Ethanol/water and acetone based PTX coatings showed the lowest drug transfer rates to the simulated vessel wall (both coated with PTX from ethyl acetate-solutions showed smaller drug loss (83%±9%), but most of the remaining PTX was not transferred (mean balloon residue approximately 15%). Beside the solvent, the use of additives seemed to have a great impact on transfer properties. The balloon pre-treatment with a crosslinked polyvinylpyrrolidone (PVP) film was able to increase the PTX transfer rate from less than 1% (without PVP) to approximately 6%. The best results in this study were obtained for balloon coatings with commercially available SeQuent© Please balloons containing the contrast agent iopromide. For this formulation drug transfer rates of approximately 17% were determined. Fluorescence microscopic imaging could visualize the particulate transfer of labelled PTX from the balloon surface during dilatation. The findings of this study underline the importance of drug adhesion and coating stability for the efficiency of PTX

  6. BALLOON SUPPORT, (United States)

    Two instrument bearing arrays were supported by balloons on the Double Tracks event. One large balloon supported a 750-foot high by 1,500-foot wide...array at 2,500 feet downwind from ground zero, and 8 small evenly spaced balloons supported instruments up to 1,000 feet high over a 7,500foot wide...area at 13,000 feet downwind from ground zero. Air samplers, cascade impactors, and sticky cylinders were supported by the arrays. The balloons used for

  7. Thermal Balloon Endometrial Ablation: Safety Aspects Evaluated by Serosal Temperature, Light Microscopy and Electron Microscopy

    DEFF Research Database (Denmark)

    Andersen, L F; Meinert, L; Rygaard, Carsten


    OBJECTIVES: Thermal balloon endometrial ablation is a new method for treating menorrhagia. The technique appears to be less difficult compared to standard hysteroscopic ablation techniques and to be significantly safer. The influence into the uterine wall of the thermal balloon ablation procedure...... was investigated with special reference to the ability of total destruction of the endometrium and the thermal action on the myometrium and the serosa. STUDY DESIGN: Temperatures were measured at the uterine serosal surface during thermal balloon endometrial ablation for 8-16 min in eight patients. After...... in all patients, with a maximum depth of 11.5 mm. By electron microscopy no influence of heat could be demonstrated beyond 15 mm from the endometrial surface. CONCLUSION: Up to 16 min of thermal balloon endometrial ablation therapy can destroy the endometrium and the submucosal layers. The myometrium...

  8. Thermal balloon endometrial ablation: safety aspects evaluated by serosal temperature, light microscopy and electron microscopy

    DEFF Research Database (Denmark)

    Andersen, L F; Meinert, L; Rygaard, Carsten


    OBJECTIVES: Thermal balloon endometrial ablation is a new method for treating menorrhagia. The technique appears to be less difficult compared to standard hysteroscopic ablation techniques and to be significantly safer. The influence into the uterine wall of the thermal balloon ablation procedure...... was investigated with special reference to the ability of total destruction of the endometrium and the thermal action on the myometrium and the serosa. STUDY DESIGN: Temperatures were measured at the uterine serosal surface during thermal balloon endometrial ablation for 8-16 min in eight patients. After...... in all patients, with a maximum depth of 11.5 mm. By electron microscopy no influence of heat could be demonstrated beyond 15 mm from the endometrial surface. CONCLUSION: Up to 16 min of thermal balloon endometrial ablation therapy can destroy the endometrium and the submucosal layers. The myometrium...

  9. Six-month results of the NEVO Res-Elution I (NEVO RES-I) trial: a randomized, multicenter comparison of the NEVO sirolimus-eluting coronary stent with the TAXUS Liberté paclitaxel-eluting stent in de novo native coronary artery lesions. (United States)

    Ormiston, John A; Abizaid, Alexandre; Spertus, John; Fajadet, Jean; Mauri, Laura; Schofer, Joachim; Verheye, Stefan; Dens, Joseph; Thuesen, Leif; Dubois, Christophe; Hoffmann, Rainer; Wijns, William; Fitzgerald, Peter J; Popma, Jeffrey J; Macours, Nathalie; Cebrian, Ana; Stoll, Hans-Peter; Rogers, Campbell; Spaulding, Christian


    Drug-eluting stents reduce restenosis and reintervention rates but are complicated by stent thrombosis, which may be related to polymer coating. The NEVO sirolimus-eluting coronary stent (NEVO SES) is designed to improve long-term percutaneous coronary intervention safety by combining sirolimus release from reservoirs with bioabsorbable polymer to reduce spatial and temporal polymer exposure. NEVO ResElution-I was a prospective randomized study in 394 patients with coronary artery disease comparing the NEVO SES with the TAXUS Liberté paclitaxel-eluting coronary stent (TAXUS Liberté PES) stent. The primary end point was in-stent angiographic late loss at 6 months. Six months after percutaneous coronary intervention (PCI), the primary end point favored NEVO SES (0.13±0.31 mm versus 0.36±0.48 mm, PNEVO SES versus TAXUS Liberté PES: death: 0.5 versus 1.6%, P=0.36; myocardial infarction: 2.0 versus 2.6%, P=0.75; target lesion revascularization: 1.5 versus 3.2%, P=0.33; major adverse cardiac events: 4.0 versus 7.4%, P=0.19. No stent thrombosis was observed with NEVO SES, whereas 2 cases occurred in TAXUS Liberté PES. Intravascular ultrasound showed lower percent volume obstruction for NEVO SES (5.5±11% versus 11.5±9.7%, P=0.016). This trial proved the superiority of NEVO SES over TAXUS Liberté PES for the primary angiographic end point of in-stent late loss. No stent thrombosis occurred in the NEVO SES group. URL: Unique identifier: NCT00606333.

  10. Two-year follow-up of the NEVO ResElution-I(NEVO RES-I) trial: a randomised, multicentre comparison of the NEVO sirolimus-eluting coronary stent with the TAXUS Liberté paclitaxel-eluting stent in de novo native coronary artery lesions. (United States)

    Abizaid, Alexandre; Ormiston, John A; Fajadet, Jean; Mauri, Laura; Schofer, Joachim; Verheye, Stefan; Dens, Joseph; Thuesen, Leif; Macours, Nathalie; Qureshi, Ayesha C; Spaulding, Christian


    To assess the two-year clinical follow-up of the NEVO RES-1 study, a randomised comparison between the NEVO™ sirolimus-eluting coronary stent system (NEVO SES) and the TAXUS Liberté™ paclitaxel-eluting stent (TAXUS PES). NEVO RES-I randomised 394 patients with single de novo lesions with a maximum length of 28 mm and diameter of 2.5-3.5 mm to NEVO SES (n=202) versus TAXUS PES (n=192). Six-month angiographic results demonstrated the superiority of the NEVO SES over the TAXUS PES for the primary endpoint, in-stent late loss. At one year, MACE (death, emergent CABG, TLR, and MI) in the NEVO SES group was 6.1% versus 10.6% in the TAXUS PES group (p=0.139). After two years, MACE was 7.2% in the NEVO SES group versus 13.0% in TAXUS PES group (p=0.086). Corresponding rates of TLR were 3.6% versus 7.6% (p=0.116). No ARC-defined definite or probable stent thromboses (ST) were reported with NEVO SES while two occurred with TAXUS PES. While not designed or powered for clinical endpoints, individual and composite clinical endpoints numerically favoured the NEVO SES over the TAXUS PES, with continued separation over time up to two years. No ARC-defined definite or probable ST was reported in the NEVO SES group at two years. Clinical trial identifier: NCT00606333

  11. Final results of a self-apposing paclitaxel-eluting stent fOr the PErcutaNeous treatment of de novo lesions in native bifurcated coronary arteries study

    DEFF Research Database (Denmark)

    Naber, Christoph K; Pyxaras, Stylianos A; Nef, Holger


    AIMS: We aimed to evaluate the long-term safety and efficacy of the STENTYS self-apposing paclitaxeleluting stent (STENTYS-PES) in bifurcation lesions in routine clinical practice. METHODS AND RESULTS: The primary endpoint of the study was the composite major adverse cardiac events (MACE: cardiac...

  12. Optical coherence tomography study of chronic-phase vessel healing after implantation of bare metal and paclitaxel-eluting self-expanding nitinol stents in the superficial femoral artery. (United States)

    Kozuki, Amane; Shinke, Toshiro; Otake, Hiromasa; Kijima, Yoichi; Masano, Tomoya; Nagoshi, Ryoji; Imamura, Kimitake; Fujiwara, Ryudo; Shibata, Hiroyuki; Takeshige, Ryo; Tsukiyama, Yoshiro; Yanaka, Kenichi; Nakano, Shinsuke; Fukuyama, Yusuke; Kawashima, Seinosuke; Hirata, Ken-ichi; Shite, Junya


    This study aimed to assess chronic-phase suppression of neointimal proliferation and arterial healing following paclitaxel-coated (PTX) and bare metal stent (BMS) implantation in the superficial femoral artery using optical coherence tomography (OCT). Twenty-five patients with 68 stents underwent an 8-month OCT follow-up. Besides standard OCT variables, neointimal characterization and frequencies of peri-strut low-intensity area (PLIA), macrophage accumulation, and in-stent thrombi were evaluated. The mean neointimal thickness was significantly less with PTX stents (544.9±202.2 μm vs. 865.0±230.6 μm, phealing was observed compared with BMS. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  13. A Retrospective Evaluation of the Utility of Capsule Endoscopy and Double-Balloon Endoscopy in Crohn’s Disease

    Directory of Open Access Journals (Sweden)

    Masanao Nakamura


    Full Text Available Background. Although the usefulness of capsule endoscopy (CE and double-balloon endoscopy (DBE for the evaluation of Crohn’s disease (CD is established, their capabilities in the differential diagnosis of small bowel stenosis have not been sufficiently addressed. The present study therefore aimed to retrospectively determine the types of patients for whom CE and DBE would confer the most benefit. Patients and Methods. We retrospectively reviewed data from 185 patients with established CD. A change of treatment based on CE or DBE results or successful DBE balloon dilation was defined as clinically useful indication. We then analyzed the factors significantly related to useful and poor indications. Results. CE results were assessed as useful indications in 28 (45% of 62 patients. Multivariate analysis demonstrated that positive CRP and low IOIBD score are factors significantly related to a useful indication. DBE results were recognized as useful indications in 118 (77% of 153 patients. Multivariate analysis indicated small bowel stenosis and abdominal pain as factors significantly associated with useful indications. All patients with a poor indication on CE had small bowel stenosis. Conclusions. CE was most useful for patients in clinical remission with positive CRP and without stenosis, whereas DBE was useful for patients with symptoms of stenosis.

  14. Evaluation of balloon and satellite water vapour measurements in the Southern tropical and subtropical UTLS during the HIBISCUS campaign

    Directory of Open Access Journals (Sweden)

    N. Montoux


    Full Text Available Balloon water vapour in situ and remote measurements in the tropical upper troposphere and lower stratosphere (UTLS obtained during the HIBISCUS campaign around 20° S in Brazil in February–March 2004 using a tunable diode laser (μSDLA, a surface acoustic wave (SAW and a Vis-NIR solar occultation spectrometer (SAOZ on a long duration balloon, have been used for evaluating the performances of satellite borne remote water vapour instruments available at the same latitude and measurement period. In the stratosphere, HALOE displays the best precision (2.5%, followed by SAGE II (7%, MIPAS (10%, SAOZ (20–25% and SCIAMACHY (35%, all of which show approximately constant H2O mixing ratios between 20–25 km. Compared to HALOE of ±10% accuracy between 0.1–100 hPa, SAGE II and SAOZ show insignificant biases, MIPAS is wetter by 10% and SCIAMACHY dryer by 20%. The currently available GOMOS profiles of 25% precision show a positive vertical gradient in error for identified reasons. Compared to these, the water vapour of the Reprobus Chemistry Transport Model, forced at pressures higher than 95 hPa by the ECMWF analyses, is dryer by about 1 ppmv (20%.

    In the lower stratosphere between 16–20 km, most notable features are the steep degradation of MIPAS precision below 18 km, and the appearance of biases between instruments far larger than their quoted total uncertainty. HALOE and SAGE II (after spectral adjustment for reducing the bias with HALOE at northern mid-latitudes both show decreases of water vapour with a minimum at the tropopause not seen by other instruments or the model, possibly attributable to an increasing error in the HALOE altitude registration. Between 16–18 km where the water vapour concentration shows little horizontal variability, and where the μSDLA balloon measurements are not perturbed by outgassing, the average mixing ratios reported by the remote sensing instruments are substantially lower than the 4–5

  15. Evaluation of a teaching tool to increase the accuracy of pilot balloon palpation for measuring tracheostomy tube cuff pressure. (United States)

    Jiang, Nancy; Del Signore, Anthony G; Iloreta, Alfred M; Malkin, Benjamin D


    The purpose of this study was to evaluate the efficacy of a novel teaching tool to improve health care providers' ability to inflate tracheostomy tube cuffs to the appropriate pressure. Single-blinded, randomized, controlled trial. Subjects were randomized to a control and study group. The control group viewed a video about inflating tracheostomy tube cuffs to safe pressure levels. The study group viewed the same video and also got to palpate the pilot balloons of tracheostomy tube cuffs inflated to three different pressures. All subjects inflated tracheostomy tube cuffs to pressures they believed to be appropriate based on palpation of the pilot balloon preintervention, and immediately, 2 weeks, and 3 months postintervention. Forty-nine health care providers participated in the study. There was no significant difference in the mean preintervention cuff inflation pressures between the two groups (36 cm H2 O vs. 38 cm H2 O, P = 0.4888), with both initially overinflating. Postintervention, the study group inflated the cuffs to significantly lower pressures than the control group, closer to the ideal of 25 cm H2 O (26 cm H2 O vs. 35 cm H2 O, P = 0.0001). This difference was also observed 2 weeks (28 cm H2 O vs. 37 cm H2 O P <0.0001) and 3 months (28 cm H2 O vs. 36 cm H2 O, P = 0.0002) postintervention. The novel teaching tool evaluated in this study is simple, easily reproducible, and low-cost. Its use leads to long-lasting improvement in health care providers' ability to more accurately inflate tracheostomy tube cuffs to safe pressures. © 2013 The American Laryngological, Rhinological and Otological Society, Inc.

  16. Pharmacokinetic Evaluation of Two Paclitaxel-Coated Balloons with Different Drug Load in a Short-Term Porcine Study

    Energy Technology Data Exchange (ETDEWEB)

    Abadal, J. M., E-mail: [Hospital Universitario Severo Ochoa, Vascular and Interventional Radiology Department (Spain); Vazquez, Esther, E-mail: [Hospital Universitario Severo Ochoa, Vascular Surgery Department (Spain); Morales, Miguel, E-mail:; Toro, Arturo, E-mail: [Hospital Universitario Severo Ochoa, Vascular and Interventional Radiology Department (Spain); Quintana, Manuel, E-mail:; Araujo, Miguel, E-mail: [Hospital Universitario Severo Ochoa, Vascular Surgery Department (Spain)


    PurposeThe aim of the study was to evaluate the pharmacokinetics and tissue absorption of 2 paclitaxel (PTX) drug-coated balloons (DCB) using different drug loads in a porcine-injured iliac artery model.Materials and MethodsTwenty-eight pigs were randomized into 2 groups. In group B1, angioplasty was performed with a 1.0 µg/mm{sup 2} DCB with PTX and in group B3, with a 3.0 µg/mm{sup 2} DCB with PTX. An overstretched model of the iliac artery was used for angioplasty under fluoroscopy. Blood and vessel wall PTX were measured with liquid-chromatography mass spectrometry at 1, 5, 30 min, 1, 7, and 28 days. Remaining drug in the balloon was analyzed.ResultsMean PTX in blood was significantly higher in the group B3 0.269 ± 0.085 µg/ml compared with the B1 0.218 ± 0.085 µg/ml; p = 0.01. Peak blood PTX concentration was detected at 1 min, and PTX was undetectable 24 h post-angioplasty. There were no statistically significant differences in the mean arterial wall concentration from the treated iliac artery between group-B1 (15.24 ± 21.29 ng/mg) and B3 (15.68 ± 16.33 ng/mg), or in the PTX wall concentration measured at different time points. Mean remaining drug in assayed balloons was lower for group-B1 and represented 8 % of the initial dose.ConclusionsBlood PTX was higher when using 3.0 µg/mm{sup 2} DCB, with a peak drug concentration at 1-min, although the drug was undetectable at 24 h, independently of the loading dose. This study demonstrates no difference in arterial wall uptake of a low dose DCB (1.0 µg/mm{sup 2}), when compared to a common dose DCB (3.0 µg/mm{sup 2}) suggesting that the dose of drug in the DCB could be reduced obtaining a similar clinical effect.

  17. Percutaneous balloon dilatation of calcific aortic valve stenosis: anatomical and haemodynamic evaluation. (United States)

    Commeau, P; Grollier, G; Lamy, E; Foucault, J P; Durand, C; Maffei, G; Maiza, D; Khayat, A; Potier, J C


    Two groups of elderly patients with calcified aortic stenosis were treated by balloon dilatation. In group 1, the valve was dilated just before surgical replacement of the valve. The valvar and annular changes occurring during dilatation were examined visually. In 20 of the 26 patients in this group there was no change. In the six remaining patients mobilisation of friable calcific deposits (1 case), slight tearing of the commissure (4 cases), or tearing of the aortic ring (1 case) were seen. Dilatation did not appear to alter valvar rigidity. In 14 patients (group 2) the haemodynamic gradient across the aortic valve was measured before and immediately after dilatation and one week after the procedure. Dilatation produced an immediate significant decrease of the aortic mean gradient and a significant increase of the aortic valve area. Eight days later the mean gradient had increased and the aortic valve area had decreased. Nevertheless there was a significant difference between the initial gradient and the gradient eight days after dilatation. The initial aortic valve area was also significantly larger than the area eight days after dilatation. The aortic valve gradient rose significantly in the eight days after dilatation and at follow up the gradients were those of severe aortic stenosis. Images Fig 1 Fig 2 Fig 3 Fig 4 Fig 5 Fig 6 Fig 7 PMID:3342163

  18. A pilot study to evaluate the safety, tolerance, and efficacy of a novel stationary antral balloon (SAB) for obesity. (United States)

    Lopasso, Fabio P; Sakai, Paulo; Gazi, Bashir M; Artifon, Everson L A; Kfouri, Christiane; Souza, Jussara P B; Kumar, Atul


    A 150 cm pear-shaped gastric balloon with a 30 cm-long duodenal stem and a 7 g metallic weight at its distal end was designed and developed to facilitate weight loss by (a) delaying gastric emptying thus enhancing interprandial satiety, and (b) stimulating antral and duodenal receptors of satiation. Twenty-six patients (body mass index of 29 to 40 kg/m) who failed to lose weight despite dietary intervention underwent endoscopic implantation of the balloon device. Patients were monitored for tolerance to the balloon, complications, weight loss, and compliance with a restricted caloric intake. Six men and 20 women with a median body weight of 93.0 kg (range, 73.5 to 119.9), median body mass index 34.3 kg/m (range, 28.8 to 39.5) underwent balloon implantation for a median period of 4.0 months (range, 0.75 to 6.0). Twenty-two patients successfully complied with a 1250 to 1500 kcal daily diet restriction during the study period. Median weight reduction was 6.5 kg (range, 3.7 to 19.9). Patients with initial body weight of >90 kg tended to loose more weight (8.1 kg) than patients weighing <90 kg (4.5 kg) (P=0.14). Nine patients with dwell times of 6 months lost 11.5+/-4.6 kg. The balloon malfunctioned in 4 patients (in 1 patient, the balloon leaked spontaneously but remained in the stomach and in 3 patients, the balloon migrated distally). Our novel balloon device may be effective in inducing weight loss by promoting compliance with a restricted caloric intake and is well tolerated due to its small size. Complications resulted from balloon rupture, which can be easily prevented by enhancements in design and use of alternative materials.

  19. Prospective comparison between two different magnetic resonance defecography techniques for evaluating pelvic floor disorders: air-balloon versus gel for rectal filling

    Energy Technology Data Exchange (ETDEWEB)

    Francesca, Maccioni; Najwa, Al Ansari; Valeria, Buonocore; Fabrizio, Mazzamurro; Carlo, Catalano [Sapienza University of Rome, Department of Radiological Sciences, Oncology and Pathology, Policlinico Umberto I Hospital, Rome (Italy); Marileda, Indinnimeo; Massimo, Mongardini [Sapienza University of Rome, Department of Surgical Sciences, Policlinico Umberto I Hospital, Rome (Italy)


    to prospectively compare two rectal filling techniques for dynamic MRI of pelvic floor disorders (PFD). Twenty-six patients with PFD underwent the two techniques during the same procedure, one based on rectal placement of a balloon-catheter filled with saline and air insufflation (air-balloon technique or AB); another based on rectal filling with 180 cc of gel (gel-filling technique or GF). The examinations were compared for assessment and staging of PFD, including rectal-descent, rectocele, cystocele, colpocele, enterocele, rectal invagination. Surgery and clinical examinations were the gold standard. AB showed sensitivity of 96 % for rectal descent, 100 % for both rectocele and colpocele, 86 % for rectal invagination and 100 % for enterocele; understaged 11 % of rectal descents and 19 % of rectoceles. GF showed sensitivity of 100 % for rectal descent, 91 % for rectocele, 83 % for colpocele, 100 % for rectal invagination and 73 % for enterocele; understaged 3.8 % of rectal descent and 11.5 % of rectoceles. Both techniques showed 100 % of specificity. Agreement between air-balloon and gel filling was 84 % for rectal descent, 69 % for rectocele, 88 % for rectal invagination, 84 % for enterocele, 88 % for cystocele and 92 % for colpocele. Both techniques allowed a satisfactory evaluation of PFD. The gel filling was superior for rectal invagination, the air-balloon for rectocele and anterior/middle compartment disorders. (orig.)

  20. Obesity and gastric balloon

    Directory of Open Access Journals (Sweden)

    Mohammed I Yasawy


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

  1. Rationale and design of the edwards SAPIEN-3 periprosthetic leakage evaluation versus medtronic corevalve in transfemoral aortic valve implantation (ELECT) trial : A randomised comparison of balloon-expandable versus self-expanding transcatheter aortic valve prostheses

    NARCIS (Netherlands)

    Abawi, M; Agostoni, Pierfrancesco; Kooistra, N H M; Samim, M; Nijhoff, F; Voskuil, M; Nathoe, H; Doevendans, P A; Chamuleau, S A; Urgel, K; Hendrikse, J; Leiner, T; Abrahams, A C; van der Worp, B; Stella, P R


    Background and objectives Periprosthetic aortic regurgitation (PPR) after transcatheter aortic valve implantation (TAVI) remains an important issue associated with impaired long-term outcomes. The current randomised study aims to evaluate potential differences between the balloon-expandable Edwards

  2. Peroxisome proliferator-activated receptor-gamma agonists suppress tissue factor overexpression in rat balloon injury model with paclitaxel infusion.

    Directory of Open Access Journals (Sweden)

    Jun-Bean Park

    Full Text Available The role and underlying mechanisms of rosiglitazone, a peroxisome proliferator-activated receptor-gamma (PPAR-γ agonist, on myocardial infarction are poorly understood. We investigated the effects of this PPAR-γ agonist on the expression of tissue factor (TF, a primary molecule for thrombosis, and elucidated its underlying mechanisms. The PPAR-γ agonist inhibited TF expression in response to TNF-α in human umbilical vein endothelial cells, human monocytic leukemia cell line, and human umbilical arterial smooth muscle cells. The overexpression of TF was mediated by increased phosphorylation of mitogen-activated protein kinase (MAPK, which was blocked by the PPAR-γ agonist. The effective MAPK differed depending on each cell type. Luciferase and ChIP assays showed that transcription factor, activator protein-1 (AP-1, was a pivotal target of the PPAR-γ agonist to lower TF transcription. Intriguingly, two main drugs for drug-eluting stent, paclitaxel or rapamycin, significantly exaggerated thrombin-induced TF expression, which was also effectively blocked by the PPAR-γ agonist in all cell types. This PPAR-γ agonist did not impair TF pathway inhibitor (TFPI in three cell types. In rat balloon injury model (Sprague-Dawley rats, n = 10/group with continuous paclitaxel infusion, the PPAR-γ agonist attenuated TF expression by 70±5% (n = 4; P<0.0001 in injured vasculature. Taken together, rosiglitazone reduced TF expression in three critical cell types involved in vascular thrombus formation via MAPK and AP-1 inhibitions. Also, this PPAR-γ agonist reversed the paclitaxel-induced aggravation of TF expression, which suggests a possibility that the benefits might outweigh its risks in a group of patients with paclitaxel-eluting stent implanted.

  3. Percutaneous balloon dilatation for benign hepaticojejunostomy strictures

    NARCIS (Netherlands)

    Vos, P. M.; van Beek, E. J.; Smits, N. J.; Rauws, E. A.; Gouma, D. J.; Reeders, J. W.


    BACKGROUND: Percutaneous balloon dilatation of biliary tract strictures is generally accepted as a safe and inexpensive procedure. The effectiveness in selected groups of patients remains under discussion. The purpose of this study was to evaluate the results of percutaneous balloon dilatation in

  4. Evaluation of the Balloon Analogue Risk Task (BART) as a Predictor of Adolescent Real-World Risk-Taking Behaviors. (United States)

    Lejuez, C. W.; Aklin, Will M.; Zvolensky, Michael J.; Pedulla, Christina M.


    A sample of 26 adolescents tested the utility of the Balloon Analogue Risk Task (BART) as a behavioral measure of risk-taking propensity. Data indicate that riskyness on the BART was related to self-reported engagement in real-world risk-taking behaviors. These data suggest that the BART may be a useful addition to self-report batteries for the…

  5. Intragastric balloon in the treatment of super-morbid obesity. Double-blind, sham-controlled, crossover evaluation of 500-milliliter balloon

    NARCIS (Netherlands)

    Mathus-Vliegen, E. M.; Tytgat, G. N.; Veldhuyzen-Offermans, E. A.


    A prolonged randomized, prospective, double-blind, crossover study, including a sham-sham-treated group, was undertaken to evaluate the efficacy and safety of a 500-mL gastric bubble (Ballobes; DOT ApS, Rödovre, Denmark) as an adjunct to diet, physical training, and behavioral modification. Only

  6. Dosimetric evaluation of multilumen intracavitary balloon applicator rotation in high-dose-rate brachytherapy for breast cancer. (United States)

    Kim, Yongbok; Trombetta, Mark G


    The objective of this work is to evaluate dosimetric impact of multilumen balloon applicator rotation in high-dose-rate (HDR) brachytherapy for breast cancer. Highly asymmetrical dose distribution was generated for patients A and B, depending upon applicator proximity to skin and rib. Both skin and rib spacing was ≤ 0.7 cm for A; only rib spacing was ≤ 0.7 cm for B. Thirty-five rotation scenarios were simulated for each patient by rotating outer lumens every 10° over ± 180° range with respect to central lumen using mathematically calculated rotational matrix. Thirty-five rotated plans were compared with three plans: 1) original multidwell multilumen (MDML) plan, 2) multidwell single-lumen (MDSL) plan, and 3) single-dwell single-lumen (SDSL) plan. For plan comparison, planning target volume for evaluation (PTV_EVAL) coverage (dose to 95% and 90% volume of PTV_EVAL) (D95 and D90), skin and rib maximal dose (Dmax), and normal breast tissue volume receiving 150% (V150) and 200% (V200) of prescribed dose (PD) were evaluated. Dose variation due to device rotation ranged from -5.6% to 0.8% (A) and -6.5% to 0.2% (B) for PTV_EVAL D95; -5.2% to 0.4% (A) and -4.1% to 0.7% (B) for PTV_EVAL D90; -2.0 to 18.4% (A) and -7.8 to 17.5% (B) for skin Dmax; -11.1 to 22.8% (A) and -4.7 to 55.1% (B) of PD for rib Dmax, respectively. Normal breast tissue V150 and V200 variation was < 1.0 cc, except for -0.1 to 2.5cc (B) of V200. Furthermore, 30° device rotation increased rib Dmax over 145% of PD: 152.9% (A) by clockwise 30° rotation and 152.5% (B) by counterclockwise 30° rotation. For a highly asymmetric dose distribution, device rotation can outweigh the potential benefit of improved dose shaping capability afforded by multilumen and make dosimetric data worse than single-lumen plans unless it is properly corrected.

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

  8. Evaluation of the Biodegradable Igaki-Tamai Scaffold After Drug-Eluting Balloon Treatment of De Novo Superficial Femoral Artery Lesions: The GAIA-DEB Study. (United States)

    Werner, Martin; Schmidt, Andrej; Scheinert, Susanne; Banning-Eichenseer, Ursula; Ulrich, Matthias; Bausback, Yvonne; Steiner, Sabine; Scheinert, Dierk


    To evaluate the safety and efficacy of the Igaki-Tamai biodegradable scaffold after drug-eluting balloon (DEB) angioplasty in patients with occlusive superficial femoral artery (SFA) disease. A prospective, single-center, nonrandomized study enrolled 20 patients (mean age 66.7±11.6 years; 14 men) with symptomatic de novo SFA lesions undergoing angioplasty with the In.Pact Admiral paclitaxel-coated balloon and subsequent implantation of the Igaki-Tamai bioresorbable scaffold. All patients were claudicants. The average diameter stenosis was 89.7%, and the mean length was 43.6 mm. Clinical examinations with duplex sonography were performed after 1, 6, 9, and 12 months. The main study outcomes were technical success, restenosis, target lesion revascularization (TLR), ankle-brachial index (ABI) improvement, and changes in quality of life evaluated with the walking impairment questionnaire. Safety was assessed by monitoring the occurrence of adverse events. Angioplasty with a paclitaxel-coated balloon was performed in all patients, resulting in an average diameter stenosis of 24%. Subsequent implantation of the Igaki-Tamai scaffold reduced the average diameter stenosis to 3.5%. In the first 6 months, 2 cases of restenosis were reported, with no TLRs within that period. However, by the 12-month follow-up in 19 patients, 11 patients had lost in-stent patency. Among these patients, 8 had TLRs, which were the only adverse events recorded that were referable to the procedure. Quality-of-life assessments showed improvement in the majority of patients. The GAIA-DEB study shows that DEB treatment of the femoral artery prior to the implantation of the biodegradable Igaki-Tamai scaffold is safe. However, the antiproliferative actions of paclitaxel in the vessel wall were not effective in preventing restenosis. In-stent restenosis occurred predominantly after 6 months. © The Author(s) 2015.

  9. Novel Software-Assisted Hemodynamic Evaluation of Pelvic Flow During Chemoperfusion of Pelvic Arteries for Bladder Cancer: Double- Versus Single-Balloon Technique

    Energy Technology Data Exchange (ETDEWEB)

    Yamamoto, Kiyohito, E-mail:; Yamamoto, Kazuhiro, E-mail:; Nakai, Go, E-mail: [Osaka Medical College, Department of Radiology (Japan); Azuma, Haruhito, E-mail: [Osaka Medical College, Department of Urology (Japan); Narumi, Yoshifumi, E-mail: [Osaka Medical College, Department of Radiology (Japan)


    PurposeApproximately 83 % of patients with bladder cancer have achieved a complete response after undergoing a novel bladder preservation therapy involving balloon-occluded intra-arterial infusion chemotherapy (BOAI) using a four-lumen double-balloon catheter, known as the Osaka Medical College regimen. This study aimed to show the quantitative difference in hemodynamics of the bladder arteries using syngo iFlow (Siemens Healthcare, Erlangen, Germany), which provides an automatic tool for quantitative blood flow analysis between double BOAI (D-BOAI) and conventional single BOAI (S-BOAI).Materials and MethodsFifty patients were included. The catheters were introduced into both posterior trunks of the internal iliac arteries via contralateral femoral artery access. A side hole between the distal and proximal balloons was placed at the origin of each bladder artery to allow clear visualization of angiographic flow of the injected agent into the urinary bladder. Digital subtraction angiography was used during analysis with the syngo iFlow to evaluate the hemodynamics of the contrast medium in the pelvic arteries during BOAI. The comparative change in the amount of contrast medium in the bladder arteries between D-BOAI and S-BOAI was assessed using syngo iFlow.ResultsOne-hundred pelvic sides were analyzed. The amount of contrast medium in the bladder arteries using D-BOAI was more than twice that using S-BOAI (right, 3.03-fold; left, 2.81-fold).ConclusionThe amount of contrast medium in the bladder arteries using D-BOAI was higher than that using conventional S-BOAI. This may increase the anticancer drug concentration in the affected bladder, leading to a good clinical response.

  10. Electrophysiological and Histological Evaluation of Acute Efficacy and Safety of Balloon Occlusive Ablation at Superior Vena Cava-Right Atrial Junction

    Directory of Open Access Journals (Sweden)

    Kazushi Tanaka, MD


    Full Text Available We evaluated efficacy and safety of occlusive radiofrequency catheter ablation (o-RFA using our thermal balloon catheter (TBC at superior vena cava (SVC-right atrial (RA junction (SVCJ compared to that of RFA with a standard-tip catheter. Methods: To electrically isolate (SVCI SVC from RA in 10 pigs (group 1, the initial o-RFA at a balloon surface temperature of 53.9 ± 3.0°C for 3–5 min (13.56 MHz was achieved at the SVCJ completely obstructed with an inflated balloon. If unsuccessful, subsequent o-RFA was repeated in a ࣘ5°C increments until reaching either SVCI or sinus arrest. Before and after each o-RFA, stimulation protocol from the RA was performed. Additionally, in 5 different pigs (group 2, RFA at 55°C (ࣘ50 W for 1 min with a 4 mm-tip catheter was achieved at multiple sites along the SVCJ. Finally, the neighboring tissues of the SVCJ were histologically investigated. Results: In group 1, successful SVCI could be easily accomplished at the final temperature of 57.2 ± 2.4°C; however, in 3 pigs, a new atrial tachycardia was induced after o-RFA at <55°C and in 2 pigs sinus arrest occurred during o-RFA at 60°C. Histologically, transmural and circumferential contraction band necrosis was mainly confirmed around the SVCJ without damage to collateral tissue. In group 2, coagulation necrosis occupied almost all the ablative lesions, leading to severe degeneration of collateral tissue. Conclusion: O-RFA at the SVCJ may be more feasible and safer than RFA.

  11. SeQuent Please vs. Pantera Lux drug coated balloon angioplasty in real life: Results from the Düsseldorf DCB registry. (United States)

    Assadi-Schmidt, Athena; Mohring, Annemarie; Liebsch, Eva; Dannenberg, Lisa; Achilles, Alina; Pöhl, Martin; Afzal, Shazia; Veulemans, Verena; Horn, Patrick; Sansone, Roberto; Bönner, Florian; Levkau, Bodo; Kelm, Malte; Zeus, Tobias; Polzin, Amin


    In-stent restenosis (ISR) is still a major concern in interventional cardiology. Drug coated balloon (DCB) angioplasty has been shown to be a promising option in treatment of ISR. However heterogeneity of different DCBs in suppression of neointimal growth has been described in a porcine model of coronary ISR. Therefore, in this registry analysis, we compared two frequently used paclitaxel eluting DCBs, the SeQuent Please and the Pantera Lux DCB. 571 patients were treated with DCB angioplasty at the Heinrich-Heine University Düsseldorf between 2009 and 2012. Follow-up was conducted during ambulatory care at our department. Major adverse cardiac events (death, myocardial infarction [MI] and target lesion revascularization) were registered during hospitalization and follow-up. Patient characteristics, prior diseases, clinical presentation, ejection fraction, procedural success and lost-for-follow-up did not differ between patients treated with the SeQuent Please and. The Pantera Lux DCB. MACE during hospital course were similar as well (Pantera Lux: 6 patients [1.6%] vs. SeQuent®Please: 3 patients [1.5%], relative risk 1.06, 95% confidence interval 0.3-4.2, P=0.93). Event free survival was significantly longer in patients treated with the Pantera Lux DCB as compared to SeQuent Please DCB (Hazard ratio: 0.65, 95% confidence interval 0.43-0.98; P value of log-rank test: 0.0405). MACE free survival was longer in Pantera Lux DCB treated patients as compared to SeQuent Please treated patients. This finding has to be confirmed in future clinical trials. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. Test ventilation with smoke, bubbles, and balloons

    Energy Technology Data Exchange (ETDEWEB)

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


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

  13. Balloon sinuplasty: literature review

    Directory of Open Access Journals (Sweden)

    Carreirão Neto, Waldir


    Full Text Available Introduction: The nasosinusal surgery showed a rapid development over the past two decades; but cicatricial stenoses secondary to surgical manipulation still occur, even in the hands of experienced surgeons and, especially, in narrow regions such as the frontal recess. The balloon sinuplasty uses the principle of dilatation of the sinus ostia by balloons guided by catheter. Objective: To present and discuss the surgical technique, indications, costs and results of the balloon sinuplasty, through articles published so far on the subject. Literature's Review: The balloon sinuplasty is an alternative in the treatment of chronic rhinosinusitis. It is not substitute for the functional paranasal sinuses surgery. The use of balloon combined with endoscopic surgical approach may minimize surgical complications such as cicatricial stenosis, especially in regions such as the frontal recess. ICU Patients with a higher anesthetic risk and presenting isolated sphenoid disease may also benefit from the use of the balloon. The possibility of carrying out the dilation with local anesthesia is another advantage. As for the risks, they appear to be low, although there is a possibility of lesion to noble structures as the orbit and skull base. Conclusions: The balloon sinuplasty appears to be a feasible, safe and effective procedure in selected patients. It presents itself as an ancillary therapy and complementary to FESS. It has greater prospects in the treatment of the disease related to the frontal recess, febrile patients in ICU with sinus focus and patients at high anesthetic and bleeding risk.

  14. One-year results of the CRISTAL Trial, a randomized comparison of cypher sirolimus-eluting coronary stents versus balloon angioplasty for restenosis of drug-eluting stents. (United States)

    Chevalier, Bernard; Moulichon, Robert; Teiger, Emmanuel; Brunel, Philippe; Metzger, Jean-Philippe; Pansieri, Michel; Carrie, Didier; Stoll, Hans-Peter; Wittebols, Kristel; Spaulding, Christian; Fajadet, Jean


     We compared the efficacy of the Cypher Select (Cordis Corporation, Bridgewater, NJ, USA) sirolimus-eluting stent (SES) versus balloon angioplasty (BA) in in-stent restenosis (ISR) of Taxus or Taxus Liberté paclitaxel-eluting stents (PES; Boston Scientific, Natick, MA, USA) or Cypher/Cypher Select SES. Optimal treatment strategies have not been identified for drug-eluting stent (DES) ISR. Patients with a native coronary artery SES or PES ISR were randomized to SES or BA. In addition, a control group included BMS ISR treated with SES. Angiographic control was performed at 12 months. 281 patients were enrolled. Significant differences favoring SES over BA were noted in immediate and net gain (1.39 ± 0.51 vs. 0.97 ± 0.54 mm, P < 0.0001 and 1.07 ± 0.69 vs. 0.49 ± 0.67 mm, P < 0.0001), 12-month mean luminal diameter (MLD; 2.14 ± 0.62 vs. 1.71 ± 0.55 mm, P < 0.0001) and percent diameter stenosis (%DS; 21 ± 19.24 vs. 29.82 ± 18.47, P = 0.001). There was no significant difference at 12 months between SES and BA in the primary end-point late lumen loss (LLL; 0.37 ± 0.57 vs.0.41 ± 0.63, P = 0.73) and in in-stent binary restenosis (11.1% vs. 14%, P = 0.59). Target-lesion revascularization (TLR) was numerically lower in patients treated with SES (5.9% vs. 13.1%, P = 0.097). There was no difference according to the initial DES. In contrast, significantly higher immediate and net gains and MLD were noted in the BMS control group treated by SES. In this angiographic randomized trial comparing SES and BA in SES or PES restenosis, 12 month MLD, immediate and net gain, and %DS favored SES whereas no difference was noted in LLL. Condensed abstract optimal treatment strategies have not been identified for sirolimus-(SES) or paclitaxel-eluting stent (PES) in-stent restenosis (ISR). We randomized patients with a native coronary artery SES or PES ISR to SES or BA. In addition, a control group included BMS ISR treated with SES. There

  15. The Descending Helium Balloon (United States)

    Helseth, Lars Egil


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

  16. Evaluation of the fetal dose during prophylactic placement of internal iliac artery balloon occlusion catheters in placenta accreta

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Sik [Dept. of Radiology, Gachon University Gil hospital, Incheon (Korea, Republic of); Ahn, Sung Min [Dept. of Radiological Science, Gachon University, Incheon (Korea, Republic of)


    Placenta accrete patients whose mother mortality rates are rather high due to massive bleeding during childbirth need to have Prophylactic placement of Internal Iliac Artery Balloon Occlusion Catheters procedure to reduce amount of blood loss and inoperative transfusion. Nevertheless, studies for mothers inevitably exposed to dose during PIIABOCs procedure have not been published many yet. Therefore, this study is to investigate exact information on radiation dose exposed to fetus during PIIABOCs procedure. Average effective dose of fetus per organ is 2.38∼8.83 mGy, measured highest at beam center and followed by eyeball, stomach and bladder. The result showed that the longer fluoroscopy time is used, the closer beam center is and the thicker abdominal thickness is, the more effective dose on fetus is increasing. When using the collimator and protection shown to decrease the effective dose and when using higher the patient table shown to decrease the effective dose. It has been reported that the threshold of deterministic effect is about 100mGy. Deterministic effect was regarded as a factor that would influence on fetus exposed by medical radiation than stochastic effect. Consequently, it concluded that dose exposed on fetus in PIIABOCs procedure was approximately 10% of threshold of deterministic effect with effective dose of 0.49∼18.27 mGy.

  17. Treatment of hemodialysis vascular access rupture irresponsive to prolonged balloon tamponade: Retrospective evaluation of the effectiveness of N-butyl cyanoacrylate seal-off technique

    Energy Technology Data Exchange (ETDEWEB)

    Weng, Mei Jul; Liang, Huei Lung; Pan, Huay Ben [Dept. of Radiology, Kaohsiung Veterans General Hospital, Kaohsiung (China); Chen, Matt Chiung Yu [Dept. of Radiology, Yuan' s General Hospital, Kaohsiung (China)


    The current study retrospectively evaluated whether the percutaneous N-butyl cyanoacrylate (NBCA) seal-off technique is an effective treatment for controlling the angioplasty-related ruptures, which are irresponsive to prolonged balloon tamponade, during interventions for failed or failing hemodialysis vascular accesses. We reviewed 1588 interventions performed during a 2-year period for dysfunction and/or failed hemodialysis vascular access sites in 1569 patients. For the angioplasty-related ruptures, which could not be controlled with repeated prolonged balloon tamponade, the rupture sites were sealed off with an injection of a glue mixture (NBCA and lipiodol), via a needle/needle sheath to the rupture site, under a sonographic guidance. Technical success rate, complications and clinical success rate were reported. The post-seal-off primary and secondary functional patency rates were calculated by a survival analysis with the Kaplan-Meier method. Twenty ruptures irresponsive to prolonged balloon tamponade occurred in 1588 interventions (1.3%). Two technical failures were noted; one was salvaged with a bailout stent-graft insertion and the other was lost after access embolization. Eighteen accesses (90.0%) were salvaged with the seal-off technique; of them, 16 ruptures were completely sealed off, and two lesions were controlled as acute pseudoaneurysms. Acute pseudoaneurysms were corrected with stentgraft insertion in one patient, and access ligation in the other. The most significant complication during the follow-up was delayed pseudoaneurysm, which occurred in 43.8% (7 of 16) of the completely sealed off accesses. Delayed pseudoaneurysms were treated with surgical revision (n = 2), access ligation (n = 2) and observation (n = 3). During the follow-up, despite the presence of pseudoaneurysms (acute = 1, delayed = 7), a high clinical success rate of 94.4% (17 of 18) was achieved, and they were utilized for hemodialysis at the mean of 411.0 days. The post

  18. Trends and variability of midlatitude stratospheric water vapour deduced from the re-evaluated Boulder balloon series and HALOE

    Directory of Open Access Journals (Sweden)

    M. Scherer


    Full Text Available This paper presents an updated trend analysis of water vapour in the lower midlatitude stratosphere from the Boulder balloon-borne NOAA frostpoint hygrometer measurements and from the Halogen Occulation Experiment (HALOE. Two corrections for instrumental bias are applied to homogenise the frostpoint data series, and a quality assessment of all soundings after 1991 is presented. Linear trend estimates based on the corrected data for the period 1980–2000 are up to 40% lower than previously reported. Vertically resolved trends and variability are calculated with a multi regression analysis including the quasi-biennal oscillation and equivalent latitude as explanatory variables. In the range of 380 to 640 K potential temperature (≈14 to 25 km, the frostpoint data from 1981 to 2006 show positive linear trends between 0.3±0.3 and 0.7±0.1%/yr. The same dataset shows trends between −0.2±0.3 and 1.0±0.3%/yr for the period 1992 to 2005. HALOE data over the same time period suggest negative trends ranging from −1.1±0.2 to −0.1±0.1%/yr. In the lower stratosphere, a rapid drop of water vapour is observed in 2000/2001 with little change since. At higher altitudes, the transition is more gradual, with slowly decreasing concentrations between 2001 and 2007. This pattern is consistent with a change induced by a drop of water concentrations at entry into the stratosphere. Previously noted differences in trends and variability between frostpoint and HALOE remain for the homogenised data. Due to uncertainties in reanalysis temperatures and stratospheric transport combined with uncertainties in observations, no quantitative inference about changes of water entering the stratosphere in the tropics could be made with the mid latitude measurements analysed here.

  19. Is Endoscopy Really Necessary for Placing Intragastric Balloons?

    NARCIS (Netherlands)

    Mathus-Vliegen, Elisabeth M. H.


    Gastric balloons for weight loss have historically been placed after a screening endoscopy. However, the utility and yield of these endoscopies has not been studied. Therefore, we wanted to evaluate the utility of screening endoscopy and to assess patients who had balloons placed without endoscopy.

  20. Single-balloon versus double-balloon bipedicular kyphoplasty for osteoporotic vertebral compression fractures. (United States)

    Wang, Heng; Sun, Zhenzhong; Wang, Zhiwen; Jiang, Weimin


    Twenty-eight patients with osteoporotic vertebral compression fractures (OVCF) were treated with single-balloon bipedicular kyphoplasty (Group A), and 40 patients were treated with double-balloon bipedicular kyphoplasty (Group B). Visual Analogue Scale (VAS) score, vertebral height, and kyphotic angle (KA) were evaluated pre-operatively, post-operatively (3 days after surgery) and at final follow-up. Operative time, X-ray exposure frequency and costs were recorded. The mean operative time and X-ray exposure frequency in Group A were greater than in Group B (pkyphoplasty is a safe and cost-effective surgical method for the treatment of OVCF. It can achieve pain relief comparable with double-balloon bipedicular kyphoplasty. However, double-balloon bipedicular kyphoplasty is more efficacious in terms of the restoration of vertebral height and reduction of KA, and the operative time and X-ray exposure frequency are lower. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Universal stratospheric balloon gradiometer (United States)

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

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

  2. Mars Solar Balloon Lander Project (United States)

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

  3. Venus Altitude Cycling Balloon Project (United States)

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

  4. Therapeutic balloon-assisted enteroscopy

    NARCIS (Netherlands)

    H. Aktas (Huseyin); P.B.F. Mensink (Peter)


    textabstractSince the introduction of the first balloon-based enteroscopic technique in 2001, therapeutic balloon-assisted enteroscopy (BAE) using either the single or double balloon enteroscopy technique (respectively SBE and DBE) has evolved rapidly. Argon plasma coagulation (APC), polypectomy,

  5. Balloon-Assisted Microdissection "BAM" Technique for Balloon-Uncrossable Chronic Total Occlusions. (United States)

    Vo, Minh N; Christopoulos, Georgios; Karmpaliotis, Dimitri; Lombardi, William L; Grantham, J Aaron; Brilakis, Emmanouil S


    After successful guidewire passage, failure to cross the occluded segment with a balloon is the most common cause of procedural failure in coronary chronic total occlusion (CTO) intervention. We evaluated the safety and efficacy of the balloon-assisted microdissection (BAM) technique for treating these complex balloon-uncrossable lesions. We identified consecutive cases treated with BAM for balloon-uncrossable CTOs between January 2012 and February 2015 at two experienced CTO percutaneous coronary intervention (PCI) centers and reviewed their clinical and angiographic characteristics and procedural outcomes. During the study period, a total of 17 patients had BAM performed for balloon-uncrossable CTOs. Mean age was 65.5 ± 8.7 years and 94% of patients were males who often had prior myocardial infarction, PCI, and coronary artery bypass graft surgery. The most common CTO target vessel was the right coronary artery. Mean J-CTO score was 2.6 ± 1.1. Despite high lesion complexity, overall procedural success was 94% and BAM facilitated success in approximately one-half of these cases. All BAM failure cases except 1 were successfully recanalized utilizing additional techniques. No patient experienced a major complication. BAM is a simple, inexpensive, and safe technique that can facilitate crossing of balloon-uncrossable CTOs and can be considered as first-line treatment for these complex lesions.

  6. PROTECT: PRoximal balloon Occlusion TogEther with direCt Thrombus aspiration during stent retriever thrombectomy - evaluation of a double embolic protection approach in endovascular stroke treatment. (United States)

    Maegerlein, Christian; Mönch, Sebastian; Boeckh-Behrens, Tobias; Lehm, Manuel; Hedderich, Dennis M; Berndt, Maria Teresa; Wunderlich, Silke; Zimmer, Claus; Kaesmacher, Johannes; Friedrich, Benjamin


    Stent retriever-based mechanical thrombectomy (MT) for emergent large vessel occlusions (ELVO) is often complicated by thrombus fragmentation causing distal embolization and embolization to new vascular territories. Well-established embolic protection approaches include proximal flow arrest and distal aspiration techniques during stent retriever maneuvers. Aiming at the reduction of thrombus fragmentation during MT we evaluated a technical approach combining proximal balloon occlusion together with direct thrombus aspiration during MT: the PROTECT technique. We performed a case-control study comparing the PROTECT technique with sole distal aspiration during MT regarding technical and procedural parameters, n=200 patients with ELVO of either the terminus of the internal carotid artery or the proximal middle artery were included. PROTECT resulted in a shorter procedure time (29 vs 40 min; P=0.002), in a higher rate of successful recanalizations (100% vs 78%; P=0.001) and a higher rate of complete reperfusions (70% vs 39%; P<0.001) compared with sole distal aspiration during MT. The PROTECT technique is a promising new approach to significantly reduce thrombus fragmentation and, hence distal embolization during MT. This safe and efficient technique needs to be validated in larger trials to confirm our results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. A comparative evaluation of treatment methods for bile duct stones after hepaticojejunostomy between percutaneous transhepatic cholangioscopy and peroral, short double-balloon enteroscopy. (United States)

    Tsutsumi, Koichiro; Kato, Hironari; Yabe, Shuntaro; Mizukawa, Sho; Seki, Hiroyuki; Akimoto, Yutaka; Uchida, Daisuke; Matsumoto, Kazuyuki; Tomoda, Takeshi; Yamamoto, Naoki; Horiguchi, Shigeru; Kawamoto, Hirofumi; Okada, Hiroyuki


    Bile duct stones after hepaticojejunostomy are considered a troublesome adverse event. Although percutaneous transhepatic procedures using a cholangioscopy is performed to treat these bile duct stones, a peroral endoscopic procedure using a short, double-balloon enteroscope (sDBE) is an alternative. This study aimed to compare the immediate and long-term outcomes of both treatments for bile duct stones in patients who underwent prior hepaticojejunostomy. Between October 2001 and May 2013, 40 consecutive patients were treated for bile duct stones after hepaticojejunostomy at a tertiary care hospital. Initial success with biliary access, biliary intervention-related technical success, clinical success, adverse events, hospitalization duration, and stone-free survival were retrospectively evaluated. The initial success rates for biliary access were 100% (8/8) with percutaneous transhepatic cholangioscopy (PTCS) and 91% (29/32) with sDBE. In three patients in whom biliary access during initial sDBE failed, successful access with subsequent PTCS was achieved, and biliary intervention-related technical success and clinical success were eventually achieved in all 40 patients. The rate of adverse events was significantly lower with sDBE than with PTCS (10% versus 45%; p = 0.025). The median hospitalization duration for complete stone clearance was significantly shorter with sDBE than with PTCS (10 versus 35 days; p bile duct stones in patients with prior hepaticojejunostomy.

  8. A new global real-time Lagrangian diagnostic system for stratosphere-troposphere exchange: evaluation during a balloon sonde campaign in eastern Canada

    Directory of Open Access Journals (Sweden)

    M. S. Bourqui


    Full Text Available A new global real-time Lagrangian diagnostic system for stratosphere-troposphere exchange (STE developed for Environment Canada (EC has been delivering daily archived data since July 2010. The STE calculations are performed following the Lagrangian approach proposed in Bourqui (2006 using medium-range, high-resolution operational global weather forecasts. Following every weather forecast, trajectories are started from a dense three-dimensional grid covering the globe, and are calculated forward in time for six days of the forecast. All trajectories crossing either the dynamical tropopause (±2 PVU or the 380 K isentrope and having a residence time greater than 12 h are archived, and also used to calculate several diagnostics. This system provides daily global STE forecasts that can be used to guide field campaigns, among other applications. The archived data set offers unique high-resolution information on transport across the tropopause for both extra-tropical hemispheres and the tropics. This will be useful for improving our understanding of STE globally, and as a reference for the evaluation of lower-resolution models. This new data set is evaluated here against measurements taken during a balloon sonde campaign with daily launches from three stations in eastern Canada (Montreal, Egbert, and Walsingham for the period 12 July to 4 August 2010. The campaign found an unexpectedly high number of observed stratospheric intrusions: 79% (38% of the profiles appear to show the presence of stratospheric air below than 500 hPa (700 hPa. An objective identification algorithm developed for this study is used to identify layers in the balloon-sonde profiles affected by stratospheric air and to evaluate the Lagrangian STE forecasts. We find that the predictive skill for the overall intrusion depth is very good for intrusions penetrating down to 300 and 500 hPa, while it becomes negligible for intrusions penetrating below 700 hPa. Nevertheless, the

  9. Optimum designs for superpressure balloons (United States)

    Smith, M. S.; Rainwater, E. L.


    The elastica shape is now well known to be the best basic shape for superpressure balloon design. This shape, also known as the pumpkin, or natural shape for balloons, has been well understood since the early 1900s when it was applied to the determination of the shape of descending parachutes. The elastica shape was also investigated in the 1950s when high strength films were used to produce superpressure cylinder balloons. The need for uniform stress distribution in shells of early superpressure balloons led to a long period of the development of spherical superpressure balloons. Not until the late 1970s was the elastica shape revisited for the purpose of the producing superpressure balloons. This paper will review various development efforts in the field of superpressure design and will elaborate on the current state-of-the-art with suggestions for future developments.

  10. Free boundary ballooning mode representation (United States)

    Zheng, Linjin


    Considerable efforts have been made in this field to develop a free boundary ballooning mode representation, which can incorporate the peeling mode stability criterion. Those efforts have not succeeded, simply because the so-called ballooning mode invariance is broken toward plasma edge. This makes 1D description of high n modes at plasma edge become impossible, where n is toroidal mode number. Nevertheless, we prove that the existence of ``half" ballooning mode invariance toward plasma core enables an 1.δ-dimentional representation of the modes, where δ˜O(1/n). This considerably reduces the complicity in investigating high n modes at plasma edge and can be used to study peeling-ballooning modes. This technique can also be useful to extend the 1D calculation of fixed boundary ballooning modes for free boundary ballooning modes. Numerical example will also be presented together with the topological symmetry analysis.

  11. Monte Carlo evaluation of a CZT 3D spectrometer suitable for a Hard X- and soft-γ rays polarimetry balloon borne experiment

    DEFF Research Database (Denmark)

    Caroli, E.; De Cesare, G.; Curado da Silva, R. M.


    will be to provide high sensitivity for polarimetric measurements. In this framework, we have presented the concept of a small high-performance imaging spectrometer optimized for polarimetry between 100 and 600 keV suitable for a stratospheric balloon-borne payload and as a pathfinder for a future satellite mission...

  12. Breakthrough in Mars balloon technology (United States)

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


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

  13. Titan Balloon Convection Model Project (United States)

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

  14. A Budget Impact Model for Paclitaxel-eluting Stent in Femoropopliteal Disease in France

    Energy Technology Data Exchange (ETDEWEB)

    De Cock, Erwin, E-mail: [United BioSource Corporation, Peri- and Post-Approval Services (Spain); Sapoval, Marc, E-mail: [Hopital Europeen Georges Pompidou, Universite Rene Descartes, Department of Cardiovascular and Interventional Radiology (France); Julia, Pierre, E-mail: [Hopital Europeen Georges Pompidou, Universite Rene Descartes, Cardiovascular Surgery Department (France); Lissovoy, Greg de, E-mail: [Johns Hopkins Bloomberg School of Public Health, Department of Health Policy and Management (United States); Lopes, Sandra, E-mail: [Cook Medical, Health Economics and Reimbursement (Denmark)


    The Zilver PTX drug-eluting stent (Cook Ireland Ltd., Limerick, Ireland) represents an advance in endovascular treatments for atherosclerotic superficial femoral artery (SFA) disease. Clinical data demonstrate improved clinical outcomes compared to bare-metal stents (BMS). This analysis assessed the likely impact on the French public health care budget of introducing reimbursement for the Zilver PTX stent. A model was developed in Microsoft Excel to estimate the impact of a progressive transition from BMS to Zilver PTX over a 5-year horizon. The number of patients undergoing SFA stenting was estimated on the basis of hospital episode data. The analysis from the payer perspective used French reimbursement tariffs. Target lesion revascularization (TLR) after primary stent placement was the primary outcome. TLR rates were based on 2-year data from the Zilver PTX single-arm study (6 and 9 %) and BMS rates reported in the literature (average 16 and 22 %) and extrapolated to 5 years. Net budget impact was expressed as the difference in total costs (primary stenting and reinterventions) for a scenario where BMS is progressively replaced by Zilver PTX compared to a scenario of BMS only. The model estimated a net cumulative 5-year budget reduction of Euro-Sign 6,807,202 for a projected population of 82,316 patients (21,361 receiving Zilver PTX). Base case results were confirmed in sensitivity analyses. Adoption of Zilver PTX could lead to important savings for the French public health care payer. Despite higher initial reimbursement for the Zilver PTX stent, fewer expected SFA reinterventions after the primary stenting procedure result in net savings.

  15. Aerodynamics of a Party Balloon (United States)

    Cross, Rod


    It is well-known that a party balloon can be made to fly erratically across a room, but it can also be used for quantitative measurements of other aspects of aerodynamics. Since a balloon is light and has a large surface area, even relatively weak aerodynamic forces can be readily demonstrated or measured in the classroom. Accurate measurements…

  16. Free boundary ballooning mode representation (United States)

    Zheng, L. J.


    A new type of ballooning mode invariance is found in this paper. Application of this invariance is shown to be able to reduce the two-dimensional problem of free boundary high n modes, such as the peeling-ballooning modes, to a one-dimensional problem. Here, n is toroidal mode number. In contrast to the conventional ballooning representation, which requires the translational invariance of the Fourier components of the perturbations, the new invariance reflects that the independent solutions of the high n mode equations are translationally invariant from one radial interval surrounding a single singular surface to the other intervals. The conventional ballooning mode invariance breaks down at the vicinity of plasma edge, since the Fourier components with rational surfaces in vacuum region are completely different from those with rational surfaces in plasma region. But, the new type of invariance remains valid. This overcomes the limitation of the conventional ballooning mode representation for studying free boundary modes.

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

  18. Air Force Cambridge Research Laboratories balloon operations (United States)

    Danaher, T. J.


    The establishment and functions of the AFCRL balloon operations facility are discussed. The types of research work conducted by the facility are defined. The facilities which support the balloon programs are described. The free balloon and tethered balloon capabilities are analyzed.

  19. US Daily Pilot Balloon Observations (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Pilot Balloon observational forms for the United States. Taken by Weather Bureau and U.S. Army observers. Period of record 1918-1960. Records scanned from the NCDC...

  20. US Monthly Pilot Balloon Observations (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — Monthly winds aloft summary forms summarizing Pilot Balloon observational data for the United States. Generally labeled as Form 1114, and then transitioning to Form...

  1. US Air Force Balloon Observations (United States)

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

  2. Superpressure Tow Balloon for Extending Durations and Modifying Trajectories of High Altitude Balloon Systems Project (United States)

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

  3. Late clinical events after drug-eluting stents: the interplay between stent-related and natural history-driven events

    National Research Council Canada - National Science Library

    Leon, Martin B; Allocco, Dominic J; Dawkins, Keith D; Baim, Donald S


    We evaluated the relative contributions of drug-eluting stent-specific and background natural history-driven causes for adverse clinical events between 1 and 5 years, in the paclitaxel-eluting stent (PES...

  4. Sensor System for Super-Pressure Balloon Performance Modeling Project (United States)

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

  5. Balloon sheaths for gastrointestinal guidance and access: a preliminary phantom study

    Energy Technology Data Exchange (ETDEWEB)

    He, Xu; Shin, Ji Hoon; Kim, Hyo Cheol; Woo, Cheol Woong; Woo, Sung Ha; Choi, Won Chan; Kim, Jong Gyu; Lim, Jin Oh; Kim, Tae Hyung; Yoon, Chang Jin; Song, Ho Young [Univerisyt of Ulsan College of Medicine, Seoul (Korea, Republic of); Kang, Wee Chang [Daejeon University, Daejeon (Korea, Republic of)


    We wanted to evaluate the feasibility and usefulness of a newly designed balloon sheath for gastrointestinal guidance and access by conducting a phantom study. The newly designed balloon sheath consisted of an introducer sheath and a supporting balloon. A coil catheter was advanced over a guide wire into two gastroduodenal phantoms (one was with stricture and one was without stricture); group I was without a balloon sheath, group II was with a deflated balloon sheath, and groups III and IV were with an inflated balloon and with the balloon in the fundus and body, respectively. Each test was performed for 2 minutes and it was repeated 10 times in each group by two researchers, and the positions reached by the catheter tip were recorded. Both researchers had better performances with both phantoms in order of group IV, III, II and I. In group IV, both researchers advanced the catheter tip through the fourth duodenal segment in both the phantoms. In group I, however, the catheter tip never reached the third duodenal segment in both the phantoms by both the researchers. The numeric values for the four study groups were significantly different for both the phantoms ({rho} < 0.001). A significant difference was also found between group III and IV for both phantoms ({rho} < 0.001). The balloon sheath seems to be feasible for clinical use, and it has good clinical potential for gastrointestinal guidance and access, particularly when the inflated balloon is placed in the gastric body.

  6. Usefulness of cutting balloon angioplasty for the treatment of congenital heart defects. (United States)

    Kusa, Jacek; Mazurak, Magdalena; Skierska, Agnieszka; Szydlowski, Leslaw; Czesniewicz, Pawel; Manka, Lukasz


    Patients with complex congenital heart defects may have different hemodynamic problems which require a variety of interventional procedures including angioplasty which involves using high-pressure balloons. After failure of conventional balloon angioplasty cutting balloon angioplasty is the next treatment option available. The purpose of this study was to evaluate the safety and efficacy of cutting balloon angioplasty in children with different types of congenital heart defects. Cutting balloon angioplasty was performed in 28 children with different congenital heart defects. The indication for cutting balloon angioplasty was: pulmonary artery stenosis in 17 patients, creating or dilatation of interatrial communication in 10 patients, and stenosis of left subclavian artery in 1 patient. In the pulmonary arteries group there was a significant decrease in systolic blood pressure (SBP) in the proximal part of the artery from the average 74.33 ± 20.4 mm Hg to 55 ± 16.7 mm Hg (p cutting balloon angioplasty was performed after an unsuccessful classic Rashkind procedure. After cutting balloon angioplasty there was a significant widening of the interatrial communication. Cutting balloon angioplasty is a feasible and effective treatment option indifferent congenital heart defects.

  7. Acoustic Detection from Aerial Balloon Platform

    National Research Council Canada - National Science Library

    Reiff, C; Pham, T; Scanlon, M; Noble, J; Van Landuyt, A; Petek, J; Ratches, J


    ... such as unmanned aerial vehicles (UAVs) and balloons. Our most immediate collaboration focuses on the use of acoustic sensors on small balloons and/or aerostats at several elevations and on the ground with the primary goals...

  8. Balloons on planet Venus - Final results (United States)

    Blamont, J.; Boloh, L.; Kerzhanovich, V.; Kogan, L.; Kurganskii, M.; Linkin, V.; Matveenko, L.; Roy, M.; Patsaev, D.; Pichkhadze, K.


    On June 11 and 15, 1985 two packages with balloons have been inserted in the atmosphere of Venus from the Soviet VEGA landing modules. This paper summarizes the pressure, temperature, wind illumination and backscattering data from the balloons.

  9. Pneumothorax, music and balloons: A case series

    Directory of Open Access Journals (Sweden)

    Shiferaw Dejene


    Full Text Available We describe two cases of spontaneous pneumothorax in young healthy adults with no underlying structural lung disease. The onset of pneumothorax was following physical activity including playing musical instruments and blowing of balloons. There is sparse data evaluating the pathophysiology of primary spontaneous pneumothorax in relation to increased mouth pressures. These cases highlight the possible physical effect of valsalva manoeuvre on transpulmonary pressures, and the potential risk of developing pneumothorax in otherwise healthy individuals. This aspect of pneumothorax development is worthy of further exploration, to better elucidate the mechanism and enhance our understanding of this common respiratory presentation.

  10. Balloon kyphoplasty: an evidence-based analysis. (United States)


    are inserted bilaterally, into each fractured vertebral body. Kyphoplasty usually is done under general anesthesia in about 1.5 hours. Patients typically are observed for only a few hours after the surgery, but some may require an overnight hospital stay. Health Canada has licensed KyphX Xpander Inflatable Bone Tamp (Kyphon Inc., Sunnyvale, CA), for kyphoplasty in patients with VCFs. KyphX is the only commercially available device for percutaneous kyphoplasty. The KyphX kit uses a series of bone filler device tubes. Each bone filler device must be loaded manually with cement. The cement is injected into the cavity by pressing an inner stylet. In the United States, the Food and Drug Administration cleared the KyphX Inflatable Bone Tamp for marketing in July 1998. CE (Conformité European) marketing was obtained in February 2000 for the reduction of fracture and/or creation of a void in cancellous bone. The aim of this literature review was to evaluate the safety and effectiveness of balloon kyphoplasty in the treatment of painful VCFs. INAHTA, Cochrane CCTR (formerly Cochrane Controlled Trials Register), and DSR were searched for health technology assessment reports. In addition, MEDLINE, EMBASE, and MEDLINE In-Process & Other Non-Indexed Citations were searched from January 1, 2000 to September 21, 2004. The search was limited to English-language articles and human studies. The positive end points selected for this assessment were as follows: Reduction in pain scoresReduction in vertebral height lossReduction in kyphotic (Cobb) angleImprovement in quality of life scoresThe search did not yield any health technology assessments on balloon kyphoplasty. The search yielded 152 citations, including those for review articles. No randomized controlled trials (RCTs) on balloon kyphoplasty were identified. All of the published studies were either prospective cohort studies or retrospective studies with no controls. Eleven studies (all case series) met the inclusion criteria

  11. Ballonnen in zee = balloons as marine litter

    NARCIS (Netherlands)

    Franeker, van J.A.


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

  12. Complications of balloon packing in epistaxis

    NARCIS (Netherlands)

    Vermeeren, Lenka; Derks, Wynia; Fokkens, Wytske; Menger, Dirk Jan|info:eu-repo/dai/nl/396566170


    Although balloon packing appears to be efficient to control epistaxis, severe local complications can occur. We describe four patients with local lesions after balloon packing. Prolonged balloon packing can cause damage to nasal mucosa, septum and alar skin (nasal mucosa, the cartilaginous skeleton

  13. Maternal outcomes after uterine balloon tamponade for postpartum hemorrhage. (United States)

    Martin, Emmanuelle; Legendre, Guillaume; Bouet, Pierre-Emmanuel; Cheve, Marie-Therese; Multon, Olivier; Sentilhes, Loïc


    To evaluate maternal outcomes following uterine balloon tamponade in the management of postpartum hemorrhage. Retrospective case-series. Two French hospitals, a level 3 university referral center and a level 2 private hospital. All women who underwent balloon tamponade treatment for primary postpartum hemorrhage. Uterine tamponade was used after standard treatment of postpartum hemorrhage had failed. The study population was divided into two groups, successful cases where the bleeding stopped after the balloon tamponade, and failures requiring subsequent surgery or embolization. Success rates. Uterine tamponade was used in 49 women: 30 (61%) after vaginal delivery and 19 (39%) after cesarean section. Uterine atony was the main cause of hemorrhage (86%). The overall success rate was 65%. Of 17 failures, surgery was required in 16 cases, including hysterectomy in 11, and uterine artery embolization in one case. Demographic and obstetric characteristics did not differ significantly between the success and failure groups. No complications were directly attributed to the balloon tamponade in the postpartum period. Two women had a subsequent full-term pregnancy without recurrence of postpartum hemorrhage. Balloon tamponade is an effective, safe and readily available method for treating primary postpartum hemorrhage and could reduce the need for invasive procedures. © 2015 Nordic Federation of Societies of Obstetrics and Gynecology.

  14. Endoscopic Balloon Dilation of Esophageal Strictures in 9 Horses. (United States)

    Prutton, J S W; Marks, S L; Aleman, M


    Medical treatment of esophageal strictures in horses is limited and the use of balloon dilatation is described in few cases. Long-term follow up after balloon dilatation and the use of intralesional corticosteroids has not been evaluated. To describe the use of endoscopic guided, esophageal balloon dilatation in horses for cervical and thoracic esophageal strictures and administration of intralesional corticosteroids at the time of dilatation. Nine horses from the hospital population with benign esophageal strictures. Retrospective study: Medical records were reviewed from horses presented to the William R. Pritchard, Veterinary Medical Teaching Hospital at UC Davis from 2002 to 2013. Records were searched using the key words: equine, horse, balloon dilatation, bougienage, and esophageal stricture. Nine horses with esophageal strictures were treated with esophageal balloon dilatation. Five horses survived (survival at writing ranged from 2 to 11 years after discharge) and all nonsurvivors were dilatation. Intralesional corticosteroids might reduce the incidence of recurrent strictures. Copyright © 2015 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals, Inc. on behalf of the American College of Veterinary Internal Medicine.

  15. Meteorological Support in Scientific Ballooning (United States)

    Schwantes, Chris; Mullenax, Robert


    The weather affects every portion of a scientific balloon mission, from payload integration to launch, float, and impact and recovery. Forecasting for these missions is very specialized and unique in many aspects. CSBF Meteorology incorporates data from NWSNCEP, as well as several international meteorological organizations, and NCAR. This presentation will detail the tools used and specifics on how CSBF Meteorology produces its forecasts.

  16. Complex Coronary Interventions with the Novel Mozec™ CTO Balloon: The MOZART Registry. (United States)

    Lupi, Alessandro; Rognoni, Andrea; Schaffer, Alon; Secco, Gioel G; Bongo, Angelo S


    Mozec™ CTO is a novel semicompliant rapid-exchange PTCA balloon catheter with specific features dedicated to treat complex coronary lesions like chronic total occlusions (CTOs). However, no data have been reported about the performance of this device in an all-comers population with complex coronary lesions. We evaluated the safety and success rate of Mozec™ CTO balloon in 41 consecutive patients with chronic stable angina and complex coronary lesions (15 severe calcified coronary stenoses, 15 bifurcation lesions with planned two-stent intervention, and 11 CTOs). Safety was assessed reporting the balloon burst rate after inflation exceeding the rated burst pressure (RBP) according to the manufacturer's reference table. Success was defined as the possibility to advance the device further the target lesion. The Mozec™ CTO balloon showed an excellent performance with a 93.3% success in crossing tight and severely calcified lesions (14/15 pts), a 93.3% success in engaging jailed side branches after stent deployment across bifurcations (14/15 pts), and a 90.9% success in crossing CTO lesions (10/11 pts). The burst rate at RBP of the Mozec™ CTO balloon was 6.7% (1/15 balloons) in the tight and severely calcified lesions, 6.7% (1/15 balloons) when dilating jailed vessels, and 9.1% (1/11 balloons) in CTOs. The novel Mozec™ CTO balloon dilatation catheter showed promising results when employed to treat complex lesions in an all-comers population. Further studies should clarify if this kind of balloon might reduce the need of more costly devices like over-the-wire balloons and microcatheters for complex lesions treatment.

  17. Clinical evaluation of long-term safety and effectiveness of a third-generation thermal uterine balloon therapy system for heavy menstrual bleeding. (United States)

    Cash, Charles; Garza-Leal, Jose; Donovan, Arthur; Guidry, Cyrus; Romanowski, Christine; Patel, Bababhai


    To estimate the incidence of amenorrhea at 36 months after treatment using a third-generation thermal uterine balloon therapy (UBT) system and to compare it with the first-generation UBT system. The secondary objective was to estimate the effect of post-procedure curettage on patient outcomes at 36 months after endometrial ablation. Multicenter controlled study (Canadian Task Force classification I). Thirteen hospitals: 12 in the United States and 1 in Mexico. Two-hundred fifty premenopausal women aged at least 30 years with heavy menstrual bleeding not responsive to previous medical therapy for at least 3 months. After treatment with a third-generation thermal UBT system, patients were randomly assigned to receive post-procedure curettage (PPC) or no PPC. Amenorrhea was estimated at 12 months using individual success defined by a pictorial blood loss assessment chart score of 0, and at 24- and 36-month follow-up by patient response of amenorrhea on a 5-point scale (amenorrhea, spotting, and light, normal, or excessive bleeding). In the intention-to-treat population, at 36 months after ablation, the amenorrhea rate was 26.8% with the third-generation UBT system, and 13.0% with the first-generation UBT system. Results by assigned intervention were 29.8% in the no PPC group vs 23.8% in the PPC group. At extended 36-month follow-up, results were similar to the previously reported results at 1 year using prospectively defined matched-pair analysis, and demonstrated superiority in treating amenorrhea using the third-generation UBT system vs the first-generation UBT system. Copyright © 2012 AAGL. Published by Elsevier Inc. All rights reserved.

  18. High pressure balloon dilation for vesicourethral anastomotic strictures after radical prostatectomy. (United States)

    Ishii, Gen; Naruoka, Takehito; Kasai, Kanako; Hata, Kenichi; Omono, Hiroshi; Suzuki, Masayasu; Kimura, Takahiro; Egawa, Shin


    Vesicourethral anastomotic stricture (VAS) is a rare but serious complication following radical prostatectomy (RP), and various types of managements for VAS have been proposed. We investigated the efficacy of transurethral balloon dilation in the management of VAS after RP. A total of 128 consecutive patients underwent open RP at our hospital between 2008 and 2013; of these, 10 patients (7.8%) developed VAS. Transurethral balloon dilation was performed in all 10 patients, using a high pressure balloon catheter under fluoroscopic and endoscopic guidance. Follow-up endoscopy was performed, and patients in whom the stricture had recurred underwent repeat dilation. We retrospectively evaluated the management of VAS and short-term efficacy of high pressure balloon dilation. The mean time from RP to diagnosis of VAS was 9 months (2-40 months); eight patients (80%) were diagnosed within 6 months of RP. Balloon dilation of VAS was technically successful in all patients, and no perioperative complications were recorded. The median follow-up after balloon dilation was 24 months (7-67 months). There was no recurrence of VAS in eight patients (80%) after the first balloon dilation, and all patients were controlled within the twice. High pressure balloon dilation is a highly effective and minimally invasive procedure for treating VAS.

  19. Investigation Team Methodically Arrives at a Logical Conclusion for the NASA Ultra Long Duration Balloon Failure (United States)

    Seely, L.; Smith, M.; West, M.

    Continued development of the design and fabrication of National Aeronautics and Space Administration s Ultra Long Duration Balloon ULDB depends significantly on knowledge and experience gained from successful balloon flights but more importantly from anomalies or failures On February 4 2005 a 176 000 cu m 6 2 MCF ULDB balloon carrying a 1361 kg 3 000 lb payload was launched from Ft Sumner New Mexico The balloon successfully pressurized reached float altitude and deployed flawlessly Unfortunately the balloon catastrophically failed not long after it reached float Following the Flight 540 NT failure members of the scientific ballooning community were immediately pulled together to form a highly skilled and vastly diverse investigating working group The team was comprised of management scientists engineers quality auditors and balloon manufacturing assemblers and quality inspectors from NASA Wallops Flight Facility and Goddard Space Flight Center New Mexico State University s Physical Science Laboratory and the National Scientific Balloon Facility TENSYS Winzen Engineering and Aerostar International Inc This paper will present how the team progressed to a logical conclusion by methodically evaluating testing and analyzing intricate pieces of the design and fabrication processes that were previously not known Once understood changes and preventative measures were immediately implemented to prevent the kind of problems that caused the failure A brief overview of these changes will also be included in the paper

  20. Removal of fractured balloon catheter using another balloon inflation in coronary artery: case report. (United States)

    Soylu, Ahmet; Ozdemir, Kurtulus; Duzenli, M Akif


    In this report, a novel management to the problem of a fractured balloon catheter which is a very rarely seen complication and has not yet been reported in the nature as in our case during percutaneous transluminal coronary interventions is presented. We inserted a second balloon catheter to the space between the previous fractured balloon and the wall of right coronary artery, and then by inflating the second balloon catheter at low pressure, the guide-wire of fractured balloon catheter and the second sound balloon catheter gently and cautiously removed together into the guiding catheter. Subsequently, the whole system was taken out of the body without complication.

  1. Development of scientific ballooning in Japan (United States)

    Nishimura, Jun

    On the occasion of the 50th Anniversary Celebration of COSPAR of this year of 2008, it is worthwhile to summarize the results of the Scientific ballooning in early days in connection with the recent developments in various countries. Nishina Laboratories, Riken, had started the observations of cosmic rays with rubber balloons as early as 1942. However it was interrupted soon by the war II. After the war, new research group started in collaboration with several universities with nuclear emulsions put on the rubber balloons in 1950, and then soon after the group manufactured by themselves and launched the first plastic balloon in 1953. Based on additional technologies during a few years developed by these group, the Institute of Nuclear Study, INS, the University of Tokyo, organized the large campaign of 14 emulsion chambers and a pellicle stack with 8 plastic balloons in 1956. It is to be noted that the project was one of the largest in the world standard in those days. By the experience of this campaign, the importance of the balloon technologies was more recognized, and INS organized the group to study the balloon technologies, and had established some developments. The systematic study of scientific ballooning has started, when the scientific ballooning laboratory was founded in 1965, in the new Institute of ISAS, the University of Tokyo. The permanent balloon base of "Sanriku Balloon Center" was founded in 1971. This group has expended all efforts for the scientific ballooning, launching 10-20 balloons in each year with new inventions such as the studies of; Technologies to manufacture the reliable plastic balloons, New Balloon materials, New instrumentations for scientific ballooning, Systems of long duration flights including Antarctica flights, International collaboratiom, etc. Up to now almost 600 plastic balloons were launched during past 50 years. Then the scientific balloonings have played important and indispensable roles for the development of space

  2. Scientific ballooning in India: recent developments (United States)

    Joshi, M. N.; Damle, S. V.

    The National Scientific Balloon Facility (NBF) of the Tata Institute of Fundamental Research (TIFR) has been conducting regular balloon flights for various experiments in the areas of Space Astronomy and Atmospheric Sciences. A continuous improvement in all aspects of Scientific Ballooning through a sustained R and D programme ensures uptodate services and a better handle on the design specifications for the balloon. Recent developments in balloon grade films, continuous improvements in design specifications, balloon manufacturing methods, flight operational procedures and improved balloon flight capabilities have resulted in a greatly improved flight performance in the last five years. A launch capability upgradation programme in terms of new launch spool and new launch vehicle has been initiated to be able to safely launch balloons with gross lifts upto 3500 kg, balloon volumes upto 450,000 m^3 and payloads upto 1400 kg. A series of steps have been initiated to improve long duration flight capabilities. In this paper, we present details on some of these aspects of Scientific Ballooning in India.

  3. Rationale and design of the Edwards SAPIEN-3 periprosthetic leakage evaluation versus Medtronic CoreValve in transfemoral aortic valve implantation (ELECT) trial : A randomised comparison of balloon-expandable versus self-expanding transcatheter aortic valve prostheses. (United States)

    Abawi, M; Agostoni, P; Kooistra, N H M; Samim, M; Nijhoff, F; Voskuil, M; Nathoe, H; Doevendans, P A; Chamuleau, S A; Urgel, K; Hendrikse, J; Leiner, T; Abrahams, A C; van der Worp, B; Stella, P R


    Periprosthetic aortic regurgitation (PPR) after transcatheter aortic valve implantation (TAVI) remains an important issue associated with impaired long-term outcomes. The current randomised study aims to evaluate potential differences between the balloon-expandable Edwards SAPIEN-3 and the self-expanding Medtronic CoreValve system with the main focus on post-TAVI PPR by means of novel imaging endpoints, and an additional focus on other clinical endpoints. The primary endpoint of this study is quantitative assessment of the severity of post-procedural PPR using cardiac magnetic resonance imaging. Several other novel imaging modalities (X-ray contrast angiography, echocardiography) are used as secondary imaging modalities for the assessment of PPR following TAVI. Secondary objectives of the study include clinical outcomes such as cerebral and kidney injury related to TAVI, and quality of life. The ELECT study is a single-centre, prospective, two-armed randomised controlled trial. For the purpose of this study, 108 consecutive adult patients suitable for transfemoral TAVI will be randomly allocated to receive the SAPIEN-3 (n = 54) or the CoreValve system (n = 54). The ELECT trial is the first randomised controlled trial to quantitatively compare the extent of post-TAVI PPR between the SAPIEN-3 and CoreValve. Furthermore, it will evaluate potential differences between the two prostheses with regard to mid-term clinical outcome and quality of life.

  4. Transcatheter pulmonary valve perforation and balloon dilatation in neonates with pulmonary atresia and intact ventricular septum

    NARCIS (Netherlands)

    Gerestein, C.G.; Berger, R.M.F.; Dalinghaus, M.; Bogers, A.J.J.C.; Witsenburg, M.


    BACKGROUND: Pulmonary atresia and intact ventricular septum is characterised by a great morphological variety. Treatment is not uniform. OBJECTIVE: To evaluate our experience with transcatheter valvotomy and balloon dilatation in neonates with pulmonary atresia and intact ventricular septum. DESIGN:

  5. Abdominal cavity balloon for preventing a patient's bleeding


    Naber, E.E.H.; Rutten, H.J.T.; Jakimowicz, J.J.; Goossens, R.H.M.; Moes, C.C.M.; Buzink, S.N.


    The invention relates to an abdominal cavity balloon for preventing a haemorrhage in a patient's pelvic region, comprising an inflatable balloon, wherein the balloon is pro vided with a smooth surface and with a strip that is flex- urally stiff and formed to follow the balloon's shape for po sitioning the balloon.

  6. Adjustable continence balloons

    DEFF Research Database (Denmark)

    Kjær, Line; Fode, Mikkel; Nørgaard, Nis


    Abstract Objective. This study aimed to evaluate the results of the Danish experience with the ProACT urinary continence device inserted in men with stress urinary incontinence. Material and methods. The ProACT was inserted in 114 patients. Data were registered prospectively. The main endpoints...... to be a good alternative in the treatment of male urinary incontinence. Complications are mild and easily treated....... were complications, pad use per day and 24 h urinary leakage. A questionnaire evaluating symptoms and satisfaction was sent to the patients. Results. Data including preoperative and postoperative pad use and urinary leakage were available for 92 and 90 patients, respectively. A decrease in the median...

  7. Analysis of Reported Balloon Malfunctions and Proposed Rescue Strategy for Malfunction during Airway Dilation. (United States)

    Strong, E Brandon; Randall, Derrick R; Cates, Daniel J; Belafsky, Peter C


    Objective The rate of balloon dilator failure is unknown, and a rescue strategy for device malfunction has not been established. The purposes of this investigation were to determine the approximate number of balloon failures in the gastrointestinal tract and airway, evaluate the parameters required to rupture balloon dilators, and develop a rescue strategy to efficiently reestablish airway patency. Study Design Retrospective cohort and basic medical research. Setting Academic tertiary care medical center. Subjects and Methods The Manufacturer and User Facility Device Experience database was queried for adverse events associated with tracheal and esophageal dilators between January 1, 2014, and January 1, 2017. A bench-top model of airway stenosis was developed, and optimal conditions for the safe removal of a malfunctioning dilator were assessed (2, 4, 6 atm). Results There were 420 reported balloon malfunctions, including 104 cases with deflation/removal issues. The bench-top model determined that device rupture allowing for immediate removal occurs with needle puncture at balloon pressures ≥8 atm. Balloons inflated to 6 atm required a median of 17.5 seconds (range, 0-55.3) for removal, in comparison with 30.2 seconds (range, 7.1-87.5) at 2 atm ( P > .05). Conclusion Balloon dilator malfunction is a significant problem that practitioners must be prepared for. Pressure ≥8 atm (~33% overinflation) is required to consistently cause complete balloon dilator rupture via needle puncture. While counterintuitive, increasing the inflation pressure of a malfunctioning balloon (8-10 atm) may expedite rupture and safe removal. A rescue strategy for balloon malfunction is proposed.

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

    Directory of Open Access Journals (Sweden)

    Hee Young Cho

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

  9. Change in Imaging Findings on Angiography-Assisted CT During Balloon-Occluded Transcatheter Arterial Chemoembolization for Hepatocellular Carcinoma

    Energy Technology Data Exchange (ETDEWEB)

    Yoshimatsu, Rika [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences (Japan); Yamagami, Takuji, E-mail: [Kochi University, Department of Radiology (Japan); Ishikawa, Masaki; Kajiwara, Kenji [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences (Japan); Aikata, Hiroshi; Chayama, Kazuaki [Hiroshima University, Department of Gastroenterology and Metabolism, Institute of Biomedical and Health Sciences (Japan); Awai, Kazuo [Hiroshima University, Department of Diagnostic Radiology, Institute and Graduate School of Biomedical Sciences (Japan)


    PurposeTo evaluate changes in imaging findings on CT during hepatic arteriography (CTHA) and CT during arterial portography (CTAP) by balloon occlusion of the treated artery and their relationship with iodized oil accumulation in the tumor during balloon-occluded transcatheter arterial chemoembolization (B-TACE).MethodsBoth B-TACE and angiography-assisted CT were performed for 27 hepatocellular carcinomas. Tumor enhancement on selective CTHA with/without balloon occlusion and iodized oil accumulation after B-TACE were evaluated. Tumorous portal perfusion defect size on CTAP was compared with/without balloon occlusion. Factors influencing discrepancies between selective CTHA with/without balloon occlusion and the degree of iodized oil accumulation were investigated.ResultsAmong 27 tumors, tumor enhancement on selective CTHA changed after balloon occlusion in 14 (decreased, 11; increased, 3). In 18 tumors, there was a discrepancy between tumor enhancement on selective CTHA with balloon occlusion and the degree of accumulated iodized oil, which was higher than the tumor enhancement grade in all 18. The tumorous portal perfusion defect on CTAP significantly decreased after balloon occlusion in 18 of 20 tumors (mean decrease from 21.9 to 19.1 mm in diameter; p = 0.0001). No significant factors influenced discrepancies between selective CTHA with/without balloon occlusion. Central area tumor location, poor tumor enhancement on selective CTHA with balloon occlusion, and no decrease in the tumorous portal perfusion defect area on CTAP after balloon occlusion significantly influenced poor iodized oil accumulation in the tumor.ConclusionsTumor enhancement on selective CTHA frequently changed after balloon occlusion, which did not correspond to accumulated iodized oil in most cases.

  10. Blast Simulation with Balloons Containing Detonable Gas. (United States)


    to separate the gas components during the launch procedure for high altitude tests. The balloon is partially inflated at launch with methane in one...1 II LEONBL 24 irI GAS LOADING DU - GAS COMMUNICATION DUCT ACCESS DUCT DETONATOR SUPPORT L.INE \\. I ~~ GAS LOADING DUCT’’ BALLON E T BALLOON. Figure 2...rr DNA 3432F BLAST SIMULATION WITH BALLOONS CONTAINING DETONABLE GAS General American Research Division 7449 North Natchez Avenue Niles, Illinois

  11. Hyperspectral Polarimeter for Monitoring Balloon Strain Project (United States)

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

  12. Ultrasonic resonant modes of piezoelectric balloons under internal pressure. (United States)

    Denham, Lori Vidal; Rice, David A


    Properties of a piezoelectric polymeric angioplasty balloon that may decrease the problems of acute closure and restenosis are evaluated in this study. Polyvinylidene difluoride (PVDF), a piezoelectric and pyroelectric polymer, has sufficient strength to serve as a standard angioplasty balloon as well as functioning as an ultrasonic transmitter and/or receiver. These properties enable potential therapeutic applications using ultrasound such as plaque ablation and sonotherapy as well as vulnerable plaque diagnosis using thermography. This study investigates the resonant structure of the PVDF balloon catheter in the frequency range 5-100 kHz. Vibrations of the piezoelectric balloon are modeled using cylindrical shell theory and compared with the observed modal frequencies of PVDF cylinders with and without internal pressure. Modal frequencies are determined by measuring the near-field pressure response of the PVDF cylinders using a high frequency microphone. A rich nodal structure is observed between 5 and 100 kHz with peak relative amplitudes measured between 42 and 45 kHz. Higher order modes for cylinders with 9 μm and 28 μm wall thickness increase in frequency as the internal pressure is increased. Experimental measurements confirm theoretical models that predict both pressure-dependent and pressure-independent resonant frequencies. Frequencies of pressure-dependent modes are calculated within 2.2% of measured values at high pressure.

  13. Percutaneous balloon kyphoplasty for the treatment of vertebral compression fractures. (United States)

    Yu, Chia-Wei; Hsieh, Ming-Kai; Chen, Lih-Huei; Niu, Chi-Chien; Fu, Tsai-Sheng; Lai, Po-Liang; Chen, Wen-Jer; Chen, Wen-Chien; Lu, Meng-Ling


    Vertebral compression fractures (VCFs) constitute a major health care problem, not only because of their high incidence but also because of their direct and indirect negative impacts on both patients' health-related quality of life and costs to the health care system. Two minimally invasive surgical approaches were developed for the management of symptomatic VCFs: balloon kyphoplasty and vertebroplasty. The purpose of this study was to evaluate the effectiveness and safety of balloon kyphoplasty in the treatment of symptomatic VCFs. Between July 2011 and June 2012, one hundred and eighty-seven patients with two hundred and fifty-one vertebras received balloon kyphoplasty in our hospital. There were sixty-five male and one hundred and twenty-two female patients with an average age of 74.5 (range, 61 to 95 years). The pain symptoms and quality of life, were measured before operation and at one day, three months, six months and one year following kyphoplasty. Radiographic data including restoration of kyphotic angle, anterior vertebral height, and any leakage of cement were defined. The mean visual analog pain scale decreased from a preoperative value of 7.7 to 2.2 at one day (p kyphoplasty not only rapidly reduced pain and disability but also restored sagittal alignment in our patients at one-year follow-up. The treatment of osteoporotic vertebral compression fractures with balloon kyphoplasty is a safe, effective, and minimally invasive procedure that provides satisfactory clinical results.

  14. Balloon occlusion of the internal iliac arteries in the multidisciplinary management of placenta percreta

    DEFF Research Database (Denmark)

    Clausen, Caroline; Stensballe, Jakob; Albrechtsen, Charlotte K


    Objective. To evaluate our experience with prophylactic balloon occlusion of the internal iliac arteries as a part of a multidisciplinary algorithm for the management of placenta percreta. Design. Consecutive case series. Setting. Rigshospitalet, Copenhagen University Hospital, Denmark. Sample....... Prophylactic balloon occlusion of the internal iliac arteries as part of a multidisciplinary algorithm allowed for a safe management of all cases in our consecutive series of 17 women with placenta percreta. However, intraoperative blood loss and transfusion requirements were significant. We have therefore...... decided to modify our multidisciplinary algorithm to include balloon occlusion of the common iliac arteries rather than the internal iliac arteries....

  15. Impact of low-power red laser light on restenosis following balloon angioplasty (United States)

    Kipshidze, Nicholas; Horn, Joseph B.; Sahota, Harry; Zulich, Ahmet; Keane, Sean; Baker, John E.; Komorowski, Richard; Nikolaychik, Victor; Keelan, Michael H., Jr.


    Despite the widespread application of balloon angioplasty for the treatment of coronary artery disease, restenosis limits the clinical benefits of the procedure. Restenosis is a complex process and may be partly attributed to the inability of the vascular endothelium to regenerate and cover the denuded area at the site of arterial injury. We previously demonstrated that low power red laser light (LPRLL) stimulates endothelial cell proliferation in vitro and contributes to rapid endothelial regeneration following balloon injury in nonatherosclerotic rabbits. We evaluated the long term impact of intravascular LPRLL on restenosis in an atherosclerotic rabbit mode. Rabbit abdominal aortas were subjected to balloon dilatation and balloon dilatation plus laser illumination. Intravascular laser therapy was performed using a 3.0 mm laser-balloon catheter. All rabbits received a single dose of 10 mW for 3 minutes generated from a He-Ne laser. Angiography was performed before and after treatment, and repeated at 60 days prior to harvesting the aortas. Quantitative angiography, morphometric, and histologic analysis revealed that LPRLL treatment prevented balloon-induced adverse changes including intimal proliferation. We conclude that intravascular LPRLL reduces restenosis following balloon angioplasty.

  16. 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)


    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.)

  17. Effectiveness of a reusable low-cost balloon trocar dissection device in the creation of preperitoneal space during endoscopic surgery. An experimental study in swine. (United States)

    Nácul, Miguel Prestes; Cavazzola, Leandro Totti; Loureiro, Marcelo de Paula; Bonin, Eduardo Aimoré; Ferreira, Paulo Roberto Walter


    To evaluate a new, low-cost, reusable balloon trocar device for dissection of the preperitoneal space during endoscopic surgery. Twenty swine (weight: 15-37 kg) were randomized to two groups, according to whether the preperitoneal space was created with a new balloon device manufactured by Bhio-Supply (group B) or with the commercially available OMSPDB 1000® balloon device manufactured by Covidien (group C). Quality and size of the created preperitoneal space, identification of anatomic structures, balloon dissection time, total procedure time, balloon resistance and internal pressure after insufflation with 300 mL of ambient air, balloon-related complications, and procedure cost were assessed. No significant differences in dissection time, total procedure time, or size of the created preperitoneal space were found between the groups. Balloons in group B had a significantly higher internal pressure compared to balloons in group C. None of the balloons ruptured during the experiment. Three animals in group C had balloon-related peritoneal lacerations. Despite a higher individual device cost, group B had a lower procedure cost over the entire experiment. The new balloon device is not inferior to the commercially available device in terms of the safety and effectiveness for creating a preperitoneal space in swine.

  18. [Feasibility and safety of patient controlled analgesia technology in double-balloon endoscopy]. (United States)

    Wan, Pin; Guo, Qiang; He, Tian; Yue, Wei; Luo, Jing; Jing, Hua; Wang, Li; Zhao, Ling


    To evaluate the feasibility and safety of patient controlled analgesia (PCA) technology during double balloon endoscopy(DBE) inspection. According to the anesthesia, 120 patients with suspected intestinal disease were randomized into non-anaesthesia(Group A), propofol infusion with TCI vein pump(Group B), and remifentanil vein infusion with PCA pump(Group C), with 40 patients in each group. The feasibility and safety of the three methods in double balloon endoscopy(DBE) inspection were evaluated. The tolerance in groups B and C was good and the procedure success rate was 100%, significantly higher than Group A(80%, 12/40, Ptechnology in the double-balloon endoscopy inspection can meet the individualized analgesic needs of patients in different period, increase the tolerance and compliance of patients to the inspection, facilitate patient-operator communication and positions change, reduce the operation risk, and increase the success rate of double balloon endoscopy.

  19. Cryo-balloon catheter position planning using AFiT (United States)

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


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

  20. Basic development of a small balloon-mounted telemetry and its operation system by university students (United States)

    Yamamoto, Masa-yuki; Kakinami, Yoshihiro; Kono, Hiroki

    In Japan, the high altitude balloon for scientific observation has been continuously launched by JAXA. The balloon has a possibility to reach 50 km altitude without tight environmental condition for onboard equipments, operating with a cost lower than sounding rockets, however, development of the large-scale scientific observation balloons by university laboratories is still difficult. Being coupled with recent improvement of semiconductor sensors, laboratory-basis balloon experiments using small weather balloons has been becoming easily in these years. Owing to an advantage of wide land fields in continental regions, the launch of such small balloons has become to be carried out many times especially in continental countries (e.g. Near Space Ventures, Inc., 2013). Although the balloon is very small as its diameter of 6 feet, excluding its extra buoyancy and the weight of the balloon itself, it is expected that about 2 kg loading capacity is remained for payloads to send it up to about 35 km altitude. However, operation of such balloons in Japan is not in general because precise prediction of a landing area of the payload is difficult, thus high-risk situation for balloon releases is remained. In this study, we aim to achieve practical engineering experiments of weather balloons in Japan to be used for scientific observation within university laboratory level as an educational context. Here we report an approach of developing many devices for a small tethered balloon currently in progress. We evaluated an accuracy of altitude measurement by using a laboratory developed altitude data logger system that consists of a GPS-module and a barometric altimeter. Diameter of the balloon was about 1.4 m. Being fulfilled with about 1440 L helium, it produced buoyancy of about 15.7 N. Taking into account of total weight including the mooring equipments, available payload mass becomes to be about 1100 g. Applying an advantage of a 3D printer of FDM (Fused Deposition Modeling

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

    DEFF Research Database (Denmark)

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


    The long-term results of simple high-pressure balloon dilation in the treatment of ureteropelvic junction obstruction (UPJO) and ureteral strictures were evaluated. A total of 77 consecutive patients were treated: 40 had UPJO and 37 ureteral strictures. The etiology of the obstruction included......%, and in strictures secondary to reconstructive and ureteroscopic surgery, with a success rate of 91%. In congenital UPJO, the results were less encouraging: in patients with a symptom debut after the age of 18 years, balloon dilation was successful in 57% of cases; in patients with symptom debut before the age of 18...... years, success was achieved in only 25% of cases. There were no major complications. It was concluded that simple high-pressure balloon dilation is a safe and reasonably effective technique for the management of most ureteral strictures and congenital UPJO with symptom debut in adult life. Balloon...

  2. A refined understanding of compressibility effects on the stability of drift ballooning modes (United States)

    Rhee, T.; Park, G. Y.; Jhang, Hogun; Kim, S. S.; Singh, R.


    A study is conducted on the impact of plasma compressibility on the stability of drift ballooning modes. The two-fluid and four-field model developed by Hazeltine et al. [Phys. Fluids 28, 2466 (1985)] is employed in this study. Results of linear numerical simulations show that finite compressibility destabilizes ballooning modes which are otherwise stable due to the ion diamagnetic drift effect. A systematic study reveals that the parallel compressibility originating from the two-fluid effect, rather than the drift-acoustic wave coupling suggested by Hastie et al. [Phys. Plasmas 10, 4405 (2003)], plays the most important role in destabilizing the ballooning modes. An analytic evaluation of the dispersion relation underpins the strong sensitivity of this parallel compressibility term in the ballooning mode stability. The potential impact of this new understanding on the physics of small edge localized modes is discussed.

  3. Heat Transfer Model for Hot Air Balloons (United States)

    Llado-Gambin, Adriana

    A heat transfer model and analysis for hot air balloons is presented in this work, backed with a flow simulation using SolidWorks. The objective is to understand the major heat losses in the balloon and to identify the parameters that affect most its flight performance. Results show that more than 70% of the heat losses are due to the emitted radiation from the balloon envelope and that convection losses represent around 20% of the total. A simulated heating source is also included in the modeling based on typical thermal input from a balloon propane burner. The burner duty cycle to keep a constant altitude can vary from 10% to 28% depending on the atmospheric conditions, and the ambient temperature is the parameter that most affects the total thermal input needed. The simulation and analysis also predict that the gas temperature inside the balloon decreases at a rate of -0.25 K/s when there is no burner activity, and it increases at a rate of +1 K/s when the balloon pilot operates the burner. The results were compared to actual flight data and they show very good agreement indicating that the major physical processes responsible for balloon performance aloft are accurately captured in the simulation.

  4. Trajectory Control For High Altitude Balloons (United States)

    Aaron, K.; Nock, K.; Heun, M.; Wyszkowski, C.

    We will discuss the continuing development of the StratoSailTM Balloon Trajectory Control System presented at the 33rd COSPAR in 2000. A vertical wing suspended on a 15-km tether from a high altitude balloon uses the difference in wind velocity between the altitude of the balloon and the altitude of the wing to create an aerodynamic sideforce. This sideforce, transmitted to the balloon gondola via the tether, causes the balloon to move laterally. Although the balloon's resultant drift velocity is quite small (a few meters per second), the effect becomes significant over long periods of time (hours to days). Recently, a full-scale wing, rudder and boom assembly has been fabricated, a winch system testbed has been completed, and a lightweight tether with reduced susceptibility to ultraviolet damage has been developed. The development effort for this invention, with pending international patents, has been funded by the NASA/SBIR program in support of the Ultra Long Duration Balloon (ULDB) program.

  5. Abdominal cavity balloon for preventing a patient's bleeding

    NARCIS (Netherlands)

    Naber, E.E.H.; Rutten, H.J.T.; Jakimowicz, J.J.; Goossens, R.H.M.; Moes, C.C.M.; Buzink, S.N.


    The invention relates to an abdominal cavity balloon for preventing a haemorrhage in a patient's pelvic region, comprising an inflatable balloon, wherein the balloon is pro vided with a smooth surface and with a strip that is flex- urally stiff and formed to follow the balloon's shape for po

  6. Accurate Determination of the Volume of an Irregular Helium Balloon (United States)

    Blumenthal, Jack; Bradvica, Rafaela; Karl, Katherine


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

  7. The natural shape balloon and related models (United States)

    Baginski, F.; Winker, J.

    Typically, the design shape of a large scientific balloon is an axisymmetric stat- ically determinate shape in which only the weight of the balloon system and the lifting gas are taken into consideration. These equations were originally developed in the 1950s at the University of Minnesota, and in the special case when the circumferential stress is zero, have come to be known as the natural shape equations. Over the years, variants of these equations have been redis- covered and their relation to the general framework sometimes obscured. We will present a brief exposition of the natural shape equations, and show how a number of balloon models follow from it.

  8. Looners: Inside the world of balloon fetishism


    McIntyre, Karen E


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

  9. Stenting for curved lesions using a novel curved balloon: Preliminary experimental study. (United States)

    Tomita, Hideshi; Higaki, Takashi; Kobayashi, Toshiki; Fujii, Takanari; Fujimoto, Kazuto


    Stenting may be a compelling approach to dilating curved lesions in congenital heart diseases. However, balloon-expandable stents, which are commonly used for congenital heart diseases, are usually deployed in a straight orientation. In this study, we evaluated the effect of stenting with a novel curved balloon considered to provide better conformability to the curved-angled lesion. In vitro experiments: A Palmaz Genesis(®) stent (Johnson & Johnson, Cordis Co, Bridgewater, NJ, USA) mounted on the Goku(®) curve (Tokai Medical Co. Nagoya, Japan) was dilated in vitro to observe directly the behavior of the stent and balloon assembly during expansion. Animal experiment: A short Express(®) Vascular SD (Boston Scientific Co, Marlborough, MA, USA) stent and a long Express(®) Vascular LD stent (Boston Scientific) mounted on the curved balloon were deployed in the curved vessel of a pig to observe the effect of stenting in vivo. In vitro experiments: Although the stent was dilated in a curved fashion, stent and balloon assembly also rotated conjointly during expansion of its curved portion. In the primary stenting of the short stent, the stent was dilated with rotation of the curved portion. The excised stent conformed to the curved vessel. As the long stent could not be negotiated across the mid-portion with the balloon in expansion when it started curving, the mid-portion of the stent failed to expand fully. Furthermore, the balloon, which became entangled with the stent strut, could not be retrieved even after complete deflation. This novel curved balloon catheter might be used for implantation of the short stent in a curved lesion; however, it should not be used for primary stenting of the long stent. Post-dilation to conform the stent to the angled vessel would be safer than primary stenting irrespective of stent length. Copyright © 2014 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  10. Magnetometer for Balloons and UAVs Project (United States)

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

  11. Shielded Mars Balloon Launcher (SMBL) Project (United States)

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

  12. Apical ballooning syndrome: a case report (United States)


    Background Apical ballooning syndrome mimics acute coronary syndromes and it is characterized by reversible left ventricular apical ballooning in the absence of angiographically significant coronary artery stenosis. Case presentation This is a case of a 40-year-old Caucasian male without any health related problems that was submitted to an urgent coronary angiography because of acute chest pain and marked precordial T-wave inversions suggestive of acute myocardial ischemia. Coronary angiography showed no significant stenosis of the coronary arteries. Left ventriculography showed systolic apical ballooning with mild basal hypercontraction. Conclusion Physicians should be aware of the presentation of apical ballooning syndrome, and the chest pain after following acute stress should not be readily attributed to anxiety. PMID:23270409

  13. Retrieving Balloon Data in Flight Project (United States)

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

  14. Results of balloon dilatation of stenotic homografts in pulmonary position in children and young adults. (United States)

    Bertels, Robin A; Dalinghaus, Michiel; Witsenburg, Maarten; Nijveld, Aagje; Bogers, Ad J J C; Meijboom, Folkert; van Oort, Anton; Tanke, Ronald


    To evaluate the results of balloon dilatation of stenotic homografts in children, adolescents, and young adults and to identify factors that might influence or predict the effect of the dilatation. Homografts are widely used in congenital cardiac surgery; however, the longevity remains a problem mostly because of stenosis in the homograft. The effect of treatment by balloon dilatation is unclear. In a retrospective study, the effect of balloon dilatation was determined by the percentage of reduction of the peak systolic pressure gradient over the homograft during catheterisation and the postponement of re-intervention or replacement of the homograft in months. Successful dilatations - defined in this study as a reduction of more than 33% and postponement of more than 18 months - were compared with unsuccessful dilatations in search of factors influencing or predicting the results. The mean reduction of the peak systolic pressure gradient was 30% in 40 procedures. Re-intervention or replacement of the homograft was postponed by a mean of 19 months. In all, 14 balloon dilatations (35%) were successful; the mean reduction was 49% and the mean postponement was 34 months. The time since homograft implantation, the presence of calcification, the homograft/balloon ratio, and the pressure applied during dilatation all tended to correlate with outcome, but were not statistically significant. Balloon dilatation is able to reduce the peak systolic pressure gradient over homografts in a subgroup of patients and can be of clinical significance to postpone re-intervention or pulmonary valve replacement.

  15. Endoscopic minor papilla balloon dilation for the treatment of symptomatic pancreas divisum. (United States)

    Yamamoto, Natsuyo; Isayama, Hiroyuki; Sasahira, Naoki; Tsujino, Takeshi; Nakai, Yousuke; Miyabayashi, Koji; Mizuno, Suguru; Kogure, Hirofumi; Sasaki, Takashi; Hirano, Kenji; Tada, Minoru; Koike, Kazuhiko


    A subpopulation of patients with pancreas divisum experience symptomatic events such as recurrent acute pancreatitis and chronic pancreatitis. Minor papilla sphincterotomy has been reported as being an effective treatment. The aim of this study was to evaluate the safety and efficacy of endoscopic balloon dilation for the minor papilla. Between 2000 and 2012, 16 patients were retrospectively included in this study. After endoscopic balloon dilation for the minor papilla was received, a pancreatic stent or a nasal pancreatic drainage catheter was placed for 1 week. If a stricture or obstruction was evident, it was treated with balloon dilation followed by long-term stent placement (1 year). When an outflow of pancreatic juice was disturbed by a pancreatic stone, endoscopic stone extraction was performed. Balloon dilation and stent placement were achieved and were successful in all the cases (16/16; 100%). Clinical improvement was achieved in 7 (84.7%) of the 9 patients with recurrent acute pancreatitis and in 6 (85.7%) of the 7 patients with chronic pancreatitis. Early complications were observed in 1 (6.3%) patient. Pancreatitis or bleeding related to balloon dilation was not observed. Endoscopic balloon dilation for the minor papilla is feasible for the management of symptomatic pancreas divisum.

  16. Power Systems Design for Long Duration Ballooning (United States)

    Stilwell, Bryan; Chuzel, Alain


    The Columbia Scientific Balloon Facility has been designing and building high-altitude balloon power systems for over 26 years. With that experience, we have found certain types of PV panels, batteries, and charge controllers that are reliable in stratospheric environments. The ultimate goal is to ensure that power systems will provide power reliably throughout the duration of an LDB flight. The purpose of this presentation is to provide some general guidelines and best practices for power system design.

  17. Residual plaque burden, delivered dose, and tissue composition predict 6-month outcome after balloon angioplasty and beta-radiation therapy

    NARCIS (Netherlands)

    M. Sabaté (Manel); J.P. Marijnissen (Johannes); S.G. Carlier (Stephan); I.P. Kay (Ian Patrick); V.L.M.A. Coen (Veronique); J.M.R. Ligthart (Jürgen); M.A. Costa (Marco); P.W.J.C. Serruys (Patrick); P.C. Levendag (Peter); W.J. van der Giessen (Wim); H. Boersma (Eric)


    textabstractBACKGROUND: Inhomogeneity of dose distribution and anatomic aspects of the atherosclerotic plaque may influence the outcome of irradiated lesions after balloon angioplasty (BA). We evaluated the influence of delivered dose and morphological characteristics of coronary

  18. Temporary balloon occlusion of the internal iliac arteries to prevent massive hemorrhage during cesarean delivery among patients with placenta previa

    NARCIS (Netherlands)

    Broekman, Evelien A.; Versteeg, Henneke; Vos, Louwerens D.; Dijksterhuis, Marja G.; Papatsonis, Dimitri N.


    Objective To evaluate the effectiveness of temporary balloon occlusion of the internal iliac artery before uterine incision to prevent massive obstetric hemorrhage during cesarean delivery among patients with anterior placenta previa. Methods In a retrospective cohort study conducted at Amphia

  19. Percutaneous transhepatic balloon dilation of biliary-enteric anastomotic strictures after surgical repair of iatrogenic bile duct injuries.

    Directory of Open Access Journals (Sweden)

    Andrew Y Lee

    Full Text Available PURPOSE: To evaluate the efficacy of percutaneous balloon dilation of biliary-enteric anastomotic strictures resulting from surgical repair of laparoscopic cholecystectomy-related bile duct injuries. MATERIAL AND METHODS: A total of 61 patients were referred to our institution from 1995 to 2010 for treatment of obstruction at the biliary-enteric anastomosis following surgical repair of laparoscopic cholecystectomy-related bile duct injuries. Of these 61 patients, 27 underwent surgical revision upon stricture diagnosis, and 34 patients were managed using balloon dilation. Of these 34 patients, 2 were lost to follow up, leaving 32 patients for analysis. The primary study objective was to determine the clinical success rate of balloon dilation of biliary-enteric anastomotic strictures. Secondary study objectives included determining anastomosis patency, rates of stricture recurrence following treatment, and morbidity. RESULTS: Balloon dilation of biliary-enteric anastomotic strictures was clinically successful in 21 of 32 patients (66%. Anastomotic stricture recurred in one of 21 patients (5% after an average of 13.1 years of follow-up. Patients who were unsuccessfully managed with balloon dilation required significantly more invasive procedures (6.8 v. 3.4; p = 0.02 and were left with an indwelling biliary catheter for a significantly longer period of time (8.8 v. 2.0 months; p = 0.02 than patients whose strictures could be resolved by balloon dilation. No significant differences in the number of balloon dilations performed (p = 0.17 or in the maximum balloon diameter used (p = 0.99 were demonstrated for patients with successful or unsuccessful balloon dilation outcomes. CONCLUSION: Percutaneous balloon dilation of anastomotic biliary strictures following surgical repair of laparoscopic cholecystectomy-related injuries may result in lasting patency of the biliary-enteric anastomosis.

  20. [Coronary angioplasty using double balloon in artery of large calibre (hugging balloons)]. (United States)

    Centemero, M P; Cano, M N; Maldonado, G; de Almeida, J D; Sousa, A G; Sousa, J E


    In this case report the transluminal coronary angioplasty was performed in a oversized right coronary artery with a severe lesion with thrombus inside, using the Hugging balloon technique (two dilatation balloon catheters used simultaneously). This technique achieved minimal residual lesion and had a favorable clinical outcome of the patient.

  1. REMODEL larger cohort with long‐term outcomes and meta‐analysis of standalone balloon dilation studies (United States)

    Kern, Robert C.; Cutler, Jeffrey L.; Welch, Kevin C.; Russell, Paul T.


    Objectives/Hypothesis To provide the final results from the REMODEL (randomized evaluation of maxillary antrostomy versus ostial dilation efficacy through long‐term follow‐up) full‐study cohorts and perform meta‐analyses of standalone balloon sinus dilation studies to explore long‐term outcomes in a large patient sample. Study Design Randomized controlled trial and meta‐analysis. Methods Final outcomes from the REMODEL randomized trial, including a larger cohort of 135 patients treated with functional endoscopic sinus surgery (FESS) or in‐office balloon dilation, were evaluated. One hundred thirty patients had 12‐month data, 66 had 18‐month data, and 25 had 24‐month data. In addition, a meta‐analysis evaluated outcomes from six studies including 358 standalone balloon dilation patients with up to 24 months follow‐up. Results Outcomes out to 2 years from the REMODEL full‐study cohort are consistent with 6‐month and 12‐month outcomes. In the meta‐analysis of standalone balloon dilation studies, technical success is 97.5%, and mean 20‐item Sino‐Nasal Outcomes Test scores are significantly and clinically improved at all time points (P time is 1.4 days. Comparison of 12‐month symptom improvements and revision rates between the REMODEL FESS arm (n = 59), REMODEL balloon dilation arm (n = 71), and pooled single‐arm standalone balloon dilation studies (n = 243) demonstrated no statistical difference. Conclusions All outcomes are comparable between FESS and balloon dilation at all time points from 6 months to 24 months. Balloon dilation produces faster recovery, less postoperative pain, and fewer debridements than FESS. There is significant, durable benefit in a large series of 358 patients undergoing standalone balloon dilation. Level of Evidence 1b. Laryngoscope, 126:44–50, 2016 PMID:26228589

  2. Oesophageal strictures caused by the ingestion of corrosive agents: effectiveness of balloon dilatation in children

    Energy Technology Data Exchange (ETDEWEB)

    Doo, E.-Y. [Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center (Korea, Republic of); Shin, J.H. [Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center (Korea, Republic of)], E-mail:; Kim, J.H.; Song, H.-Y. [Department of Radiology, Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center (Korea, Republic of)


    Aim: To evaluate the safety and clinical effectiveness of balloon dilatation in children for oesophageal strictures caused by the ingestion of corrosive agents. Materials and methods: The study comprised 11 children (median age 6 years; range 1-14 years) with oesophageal strictures caused by corrosive agents, who underwent a total of 36 balloon dilatation sessions. The technical and clinical success, recurrence of dysphagia, complications, and primary and secondary patency rates were retrospectively evaluated. Results: Technical success was achieved in 91% of patients and in 97% of balloon dilatation sessions. Clinical success (defined as improved food intake and reduced dysphagia within 1 month of the first balloon dilatation session) was achieved in 64% of patients (7/11). During the mean 35-month follow-up period (range 1-89 months), 10 (91%) patients experienced recurrence. Oesophageal rupture (types 1 or 2) occurred in 45% of patients and in 31% of balloon dilatation sessions. Primary patency rates at 6 months and 1, 2, 3, 4, and 5 years were 36, 27, 14, 14, 14, and 14%, respectively. Secondary patency rates at 6 months and 1, 2, 3, 4, and 5 years were 82, 82, 82, 56, 42, and 42%, respectively. The secondary patency rate was higher than the primary patency rate (p < 0.05). Conclusion: The present study examined oesophageal balloon dilatation for paediatric oesophageal strictures caused by the ingestion of corrosive agents. Although the technical success rate was high and there were no deaths, the clinical success rate was low owing to a high recurrence rate. However, repeated balloon dilatations resulted in an acceptable secondary patency rate.

  3. Clinical outcomes after final kissing balloon inflation compared with no final kissing balloon inflation in bifurcation lesions treated with a dedicated coronary bifurcation stent

    NARCIS (Netherlands)

    M.J. Grundeken (Maik); M. Lesiak (MacIej); S. Asgedom (Solomon); E. Garcia (Eulogio); A. Bethencourt (Armando); M.S. Norell (Michael); K. Damman (Kevin); E. Woudstra (Evert); K. Koch (Karel); M.M. Vis (Marije); J.P.S. Henriques (Jose); J.G.P. Tijssen (Jan); Y. Onuma (Yoshinobu); D.P. Foley (David); A. Bartorelli (Antonio); P.R. Stella (Pieter); R.J. de Winter (Robbert); J.J. Wykrzykowska (Joanna)


    textabstractObjective We evaluated differences in clinical outcomes between patients who underwent final kissing balloon inflation (FKBI) and patients who did not undergo FKBI in bifurcation treatment using the Tryton Side Branch Stent (Tryton Medical, Durham, North Carolina, USA). Methods Clinical

  4. Clinical outcomes after final kissing balloon inflation compared with no final kissing balloon inflation in bifurcation lesions treated with a dedicated coronary bifurcation stent

    NARCIS (Netherlands)

    Grundeken, Maik J.; Lesiak, Maciej; Asgedom, Solomon; Garcia, Eulogio; Bethencourt, Armando; Norell, Michael S.; Damman, Peter; Woudstra, Pier; Koch, Karel T.; Vis, M. Marije; Henriques, Jose P.; Tijssen, Jan G.; Onuma, Yoshinobu; Foley, David P.; Bartorelli, Antonio L.; Stella, Pieter R.; de Winter, Robbert J.; Wykrzykowska, Joanna J.


    We evaluated differences in clinical outcomes between patients who underwent final kissing balloon inflation (FKBI) and patients who did not undergo FKBI in bifurcation treatment using the Tryton Side Branch Stent (Tryton Medical, Durham, North Carolina, USA). Clinical outcomes were defined as

  5. Foley balloon catheter to prevent or manage bleeding during treatment for cervical and Cesarean scar pregnancy. (United States)

    Timor-Tritsch, I E; Cali, G; Monteagudo, A; Khatib, N; Berg, R E; Forlani, F; Avizova, E


    To demonstrate the efficacy of placement and inflation of Foley balloon catheters prophylactically to prevent, or as an adjuvant therapy to control, bleeding in women undergoing treatment for Cesarean scar pregnancy (CSP) or cervical pregnancy (CxP). This was a retrospective study of 18 women with either CSP (n = 16) or CxP (n = 2), who underwent Foley balloon catheter placement under continuous transvaginal or transabdominal ultrasound guidance to prevent or manage bleeding following treatment, which in most cases comprised local (intragestational sac) and intramuscular (IM) methotrexate (MTX) injections. In eight cases, the balloon catheter was placed immediately following local and/or IM MTX treatment, either because of bleeding or prophylactically; in eight cases, the catheter was placed as part of a two-step protocol, with patients first treated with local and IM MTX injection, then suction aspiration on Day 4 or 5, followed by planned insertion of a balloon catheter; in one patient the balloon was placed on Day 21 after local and IM MTX treatment, due to sudden bleeding; and in one case of a heterotopic pregnancy, one intrauterine and one cervical, the balloon was placed due to severe bleeding. Human chorionic gonadotropin (hCG) levels were evaluated weekly following MTX injection. Gestational ages at balloon placement ranged between 5 and 12 + 2 weeks. All embryos/fetuses, with the exception of the cervical heterotopic one, had heart activity and catheter placement was well-tolerated by all women. The balloon tamponade effectively reduced or prevented maternal vaginal bleeding in all except one patient; this woman had a heterotopic CxP and required abdominal robotic cerclage to control the bleeding. Catheters were kept in place for a mean of 3.6 (range, 1-6) days. hCG levels returned to low or zero levels within 19-82 days following MTX injection. Fifteen women required antibiotic treatment following the procedure. One woman with CSP developed an

  6. Early clinical outcome and complications related to balloon kyphoplasty

    Directory of Open Access Journals (Sweden)

    Martin Bergmann


    Full Text Available The treatment of painful osteoporotic vertebral compression fractures using transpedicular cement augmentation has grown significantly over the last two decades. The benefits of balloon kyphoplasty compared to conservative treatment remain controversial and are discussed in the literature. The complication rates of vertebroplasty and kyphoplasty are considered to be low. The focus of this study was the analysis of acute and clinically relevant complications related to this procedure. In our department, all patients treated between February 2002 and February 2011 with percutaneous cement augmentation (372 patients, 522 augmented vertebral bodies were prospectively recorded. Demographic data, comorbidities, fracture types, intraoperative data and all complications were documented. The pre- and postoperative pain-level and neurological status (Frankel-Score were evaluated. All patients underwent a standardized surgical procedure. Two hundred and ninety-seven patients were treated solely by balloon kyphoplasty; 216 females (72.7% and 81 males (27.3%. Average patient age was 76.21 years (±10.71, range 35-98 years. Average American Society Anestesiologists score was 3.02. According to the Orthopedic Trauma Association classification, there were 69 A 1.1 fractures, 177 A 1.2 fractures, 178 A 3.1.1 fractures and 3 A 3.1.3 fractures. Complications were divided into preoperative, intraoperative and postoperative events. There were 4 pre-operative complications: 3 patients experienced persistent pain after the procedure. In one case, the pedicles could not be visualized during the procedure and the surgery was terminated. One hundred and twenty-nine (40.06% of the patients showed intraoperative cement leaking outside the vertebras, one severe hypotension and tachycardia as reaction to the inflation of the balloons, and there was one cardiac arrest during surgery. Postoperative subcutaneous hematomas were observed in 3 cases, 13 patients developed a

  7. [Balloon valvuloplasty for congenital aortic valve stenosis in children]. (United States)

    Wu, Lin; Qi, Chunhua; He, Lan; Liu, Fang; Lu, Ying; Huang, Guoying


    To evaluate the efficacy and safety of percutaneous balloon aortic valvuloplasty (PBAV) for congenital aortic valve stenosis in children. This is a retrospective clinical study including 14 children treated with PBAV for congenital aortic valve stenosis from October 2006 to December 2012 in our institute. During clinical follow-up, aortic residual stenosis and restenosis, left ventricular function and the procedure-related complications, including the approach artery injury, and aortic regurgitation were particularly assessed. A total of 14 patients consisting of 12 boys and 2 girls underwent the procedure, with mean age (17.1 ± 10.5) months (range from 8 days to 6 years) and the mean body weight (8.9 ± 5.5) kg (range from 1.9 kg to 23.0 kg). The indication for PBAV was a Doppler-derived peak instaneous gradient of ≥ 75 mmHg(1 mmHg = 0.133 kPa) or a smaller gradient with signs of severe left ventricular dysfunction or left ventricular strain on the ECG. The mean ratio of balloon-annulus was 0.92 ± 0.09 (range from 0.75 to 1.09). The catheter-measured peak systolic valve gradient was successfully relieved in all the patients, decreasing from (69 ± 26) mmHg to (29 ± 13) mmHg immediately after balloon valvuloplasty (t = 7.628, P = 0.000). The Doppler-derived peak and mean gradient decreased from (95 ± 21) mmHg and (50 ± 7) mmHg to (49 ± 16) mmHg and (24 ± 11) mmHg, respectively (t = 7.630, 10.401; P = 0.000, 0.000) . The mean follow-up period was 1 day to 61 months. At follow-up, 2 patients (2/14, 14%) underwent the second balloon valvuloplasty for the significant restenosis, and both showed successful relief of restenosis, however 1 patient required surgical Ross procedure due to significant recurrent systolic pressure gradient and moderate aortic regurgitation 4 years after the second balloon valvuloplasty. Among the 3 young infants who presented with congestive heart failure before intervention, 1 died 1 day after the procedure, the other 2 patients had

  8. Balloon catheter vs. cervical vacuum cup for hysterosalpingography: a prospective, randomized, single-blinded study. (United States)

    Ricci, Giuseppe; Guastalla, Pierpaolo; Ammar, Lydie; Cervi, Gina; Guarnieri, Silvia; Sartore, Andrea


    To compare the use of a balloon catheter device with the use of a cervical vacuum cup device in performing hysterosalpingography (HSG). Prospective, randomized, single-blinded study. Tertiary infertility center. Two hundred twenty-nine infertile women undergoing HSG. Subjects were randomized to undergo HSG using a cervical vacuum cup (n = 115) or a balloon catheter (n = 114). Randomization was performed according to Consolidated Standard of Reporting Trials (CONSORT) guidelines. The degree of pain experienced during and after the HSG, evaluated using a 100-mm visual analogue scale. The length of the procedure, the fluoroscopic time, the volume of contrast used, the difficulty of performing HSG, and the percentage of complications were also evaluated. Women in the cervical-cup group experienced more pain than those in the balloon catheter group during the contrast injection (median visual analogue scale pain scores, 13.0 vs. 6.5). The placement of the balloon catheter in comparison with the cervical cup was slightly easier to perform, although it required a somewhat longer time. The HSG using the cervical cup required less fluoroscopic time (median, 0.6 vs. 0.8 min). The balloon catheter appears to be better tolerated than the cervical cup, but the difference is minimal. The use of the cervical cup allows shortening of the patient radiation exposure.

  9. Combined CT and fluoroscopic guidance of balloon kyphoplasty versus fluoroscopy-only procedures

    Energy Technology Data Exchange (ETDEWEB)

    Amoretti, Nicolas; Marcy, Pierre-Yves; Lesbats-Jacquot, Virginie; Fonquerne, Marie-Eve; Hericord, Olivier; Maratos, Yvonne [Centre Hospitalier Universitaire de Nice, Service de Radiologie, Nice (France); Hovorka, Istvan [Centre Hospitalier Universitaire de Nice, Spine Surgery Department, Nice (France); Roux, Christian; Euller-Ziegler, Liana [Centre Hospitalier Universitaire de Nice, Rheumatology Department, Nice (France)


    To evaluate the performance of combined (computed tomography (CT) and fluoroscopic) guidance of balloon kyphoplasty in comparison to fluoroscopic guidance alone. Forty-one kyphoplasties were performed between January 2005 and March 2006 according to two different protocols. Study group 1 consisted of 20 consecutive patients with 20 balloon kyphoplasty procedures under dual guidance (CT scan and fluoroscopy) for osteoporotic or traumatic vertebral fractures. Study group 2 consisted of 21 consecutive patients in whom kyphoplasty was performed with fluoroscopy alone. Visualization of the pedicles, the final of the balloon position, and cement distribution were evaluated(1 - poor, 2 - intermediate, 3 - good). Combined use of CT and fluoroscopy (group 1) was superior in identifying the pedicles (100% versus 66.7%, p = 0.009) and balloon placement (100% versus 71.4%, p = 0.02) but not in monitoring of cement distribution within the vertebral body (100% versus 90.5%, p = 0.49). The difference between the two groups was more pronounced in the thoracic spine than in the lumbar spine. CT/fluoroscopic guidance of kyphoplasty combines safe CT-guided insertion of the osteointroducers and balloons as well as fluoroscopic real-time monitoring of polymethylmethacrylate injection. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Roland Fiszer


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

  11. Endovascular stent placement of juxtaanastomotic stenosis in native arteriovenous fistula after unsuccessful balloon angioplasty. (United States)

    Ozkan, Burak; Güngör, Durmus; Yıldırım, Utku Mahir; Harman, Ali; Ozen, Ozgur; Aytekin, Cüneyt


    In hemodialysis patients, the most common problem in arteriovenous fistulas, as the best functional vascular access, is the juxtaanastomotic located lesions. Percutaneous transluminal angioplasty is accepted as the treatment method for juxtanastomotic lesions. To assess juxtaanastomotic stent placement after insufficient balloon angioplasty in the treatment of autogenous radiocephalic or brachiocephalic fistula dysfunction. Between July 2003 and June 2010, 20 hemodialysis patients with autogenous radiocephalic or brachiocephalic fistula dysfunction underwent stent placement for the lesion located at the juxtaanastomotic region. Indications for stent placement were insufficient balloon dilatation, early recurring stenosis, chronic organizing thrombus and vessel rupture. The Kaplan-Meier method was used to calculate the stent patency rates. All patients who had fistula dysfunction (thrombosis of hemodialysis access, difficult access cannulation, extremity pain due to thrombosis or decreased arterial access blood flow) were evaluated by color Doppler ultrasound. The stenoses were initially dilated with standard noncompliant balloons (3 to 10-mm in diameter). Dilatation was followed by high pressure (Blue Max, Boston Scientific) or cutting balloons (Boston Scientific), if the standard balloon failed to dilate the stenotic segment. Twenty-one stents were applied. The anatomical and clinical success rate was 100%. Seventeen additional interventions were done for 11 (55%) patients due to stent thrombosis or stenosis during follow-up. Our 1- and 2-year secondary patency rates were 76.2% and 65.5%, respectively and were comparable to those after balloon angioplasty and surgical shunt revision. Metallic stent placement is a safe and effective procedure for salvage of native hemodialysis fistula after unsuccessful balloon angioplasty.

  12. Wind-Based Navigation of a Hot-air Balloon on Titan: A Feasibility Study (United States)

    Furfaro, Roberto; Lunine, Jonathan I.; Elfes, Alberto; Reh, Kim


    Current analysis of data streamed back to Earth by the Cassini spacecraft features Titan as one of the most exciting places in the solar system. NASA centers and universities around the US, as well as the European Space Agency, are studying the possibility of sending, as part of the next mission to this giant moon of Saturn, a hot-air balloon (Montgolfier-type) for further and more in-depth exploration. The basic idea would be to design a reliable, semi-autonomous, and yet cheap Montgolfier capable of using continuous flow of waste heat from a power source to lift the balloon and sustain its altitude in the Titan environment. In this paper we study the problem of locally navigating a hot-air balloon in the nitrogen-based Titan atmosphere. The basic idea is to define a strategy (i.e. design of a suitable guidance system) that allows autonomous and semi-autonomous navigation of the balloon using the available (and partial) knowledge of the wind structure blowing on the saturnian satellite surface. Starting from first principles we determined the appropriate thermal and dynamical models describing (a) the vertical dynamics of the balloon and (b) the dynamics of the balloon moving on a vertical plane (2-D motion). Next, various non-linear fuzzy-based control strategies have been evaluated, analyzed and implemented in MATLAB to numerically simulate the capability of the system to simultaneously maintain altitude, as well as a scientifically desirable trajectory. We also looked at the ability of the balloon to perform station keeping. The results of the simulation are encouraging and show the effectiveness of such a system to cheaply and effectively perform semiautonomous exploration of Titan.

  13. Balloon dilatation of the prostatic urethra

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yeon Soo; Shim, Hyung Jin; Cha, Kyung Soo; Hong, Ju Hee; Lim, Myung Ah; Kim, Cheol Soo [Sung Ae General Hospital, Seoul (Korea, Republic of)


    We analyzed the result of transurethral balloon dilatation in 11 patients with benign prostatic hypertrophy. The procedures were performed under intravenous sedation and local anesthesia with double lumen balloon catheter at 4 atmosphere for 10 minutes. After dilatation, the prostatism symptom scores improved in 10 out of 11 patients and the mean diameter of the prostatic urethra significantly increased form 4.3 mm to 10.2 mm ({rho} < 0.005). The procedures were successful not only in lateral lobe hypertrophy but also in median lobe hypertrophy of the prostate. Postdilatation MRI of 1 patient showed an intact prostatic capsule and no periprostatic hematoma. Complications did not develop except in 1 patient with mild hematuria and incontinence. These preliminary results suggest that transurethral balloon dilatation can be an effective and safe treatment modality for benign prostatic hypertrophy.

  14. [Intragastric balloons--the new hope in bariatry?]. (United States)

    Rydzewska, Grazyna; Milewski, Janusz


    The concept of intragastric space-occupying balloon developed from observations in psychiatric patients with gastric bezoars. Several gastric balloons consisting of different materials were developed. The BioEnterics Intagastric Balloon System (BIB) is a smooth, spherical, silicone elastomer balloon inducing satiety and restricting food intake. The balloon is indicated to induce weight loss in patients before surgery, to reduce the surgical risk, to select the patients for gastric restrictive surgery. Our experience showed that patients who had good results with the balloon they are good candidates for gastric restrictive surgical procedures. There were few complications: balloon intolerance, spontaneous deflation, oesophagitis, gastritis and rarely gastric ulcers. Conclusion is that in selected patients intragastric balloon can be used as effective and safe approach and could be a great help to induce weight loss and to prepare for surgery.

  15. Mechanics of stretchable electronics on balloon catheter under extreme deformation

    National Research Council Canada - National Science Library

    Su, Yewang; Liu, Zhuangjian; Wang, Shuodao; Ghaffari, Roozbeh; Kim, Dae-Hyeong; Hwang, Keh-Chih; Rogers, John A; Huang, Yonggang


    ... ([approximately equal to]vacuum) and outside of the balloon (pressure [approximately equal to]1atm). The balloon catheter, on which microelectrodes and interconnects are printed, undergoes extreme mechanical deformation during its inflation and deflation...

  16. Pointing system for the balloon-borne astronomical payloads (United States)

    Nirmal, Kaipacheri; Sreejith, Aickara Gopinathan; Mathew, Joice; Sarpotdar, Mayuresh; Ambily, Suresh; Prakash, Ajin; Safonova, Margarita; Murthy, Jayant


    We describe the development and implementation of a light-weight, fully autonomous 2-axis pointing and stabilization system designed for balloon-borne astronomical payloads. The system is developed using off-the-shelf components such as Arduino Uno controller, HMC 5883L magnetometer, MPU-9150 inertial measurement unit, and iWave GPS receiver unit. It is a compact and rugged system which can also be used to take images/video in a moving vehicle or in real photography. The system performance is evaluated from the ground, as well as in conditions simulated to imitate the actual flight by using a tethered launch.

  17. Radial dilation of nephrostomy balloons: a comparative analysis


    Kari Hendlin; Manoj Monga


    PURPOSE: The dynamics of percutaneous balloon expansion may differ with increasing extrinsic compressive forces and increasing inflation pressures. This study compares the ability of percutaneous balloons to expand under different radial constrictive forces. MATERIALS AND METHODS: Three 30F nephrostomy balloons were tested: Bard X-Force™, Boston Scientific Microvasive Amplatz Tractmaster™, and Cook Ultraxx™. With a super stiff guidewire in place, the balloon tip was secured ...

  18. 21 CFR 884.5050 - Metreurynter-balloon abortion system. (United States)


    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Metreurynter-balloon abortion system. 884.5050... Devices § 884.5050 Metreurynter-balloon abortion system. (a) Identification. A metreurynter-balloon abortion system is a device used to induce abortion. The device is inserted into the uterine cavity...

  19. Ballooning behavior in the golden orbweb spider Nephilapilipes (Araneae: Nephilidae

    Directory of Open Access Journals (Sweden)

    Vanessa M.J. Lee


    Full Text Available Ballooning, a mode of aerial dispersal in spiders, is an innate behavior that requires appropriate physiological and meteorological conditions. Although only rarely reported in the golden orbweb spiders, family Nephilidae, the large geographic distributions of most nephilids—in particular of Nephila species—would imply that these spiders likely routinely disperse by ballooning in spite of giant female sizes. Here we study ballooning behavior in the golden orbweb spider Nephila pilipes (Fabricius, 1793. Specifically, we test for the propensity of spiderlings to deploy ballooning as a dispersal mechanism. We subjected a total of 59 first-instar spiderlings to a wind experiment at two wind speeds (2.17 ± 0.02 m s-1 and 3.17 ± 0.02 m s-1 under laboratory conditions. Under an average wind speed of 3.17 m s-1, none of the spiderlings exhibited pre-ballooning or ballooning behavior. However, at an average wind speed of 2.17 m s-1, 53 (89.8% spiderlings showed pre-ballooning behavior, and 17 (32.1% of the pre-ballooners ultimately ballooned. Our results concur with prior reports on spiderlings of other families that pre-ballooning behavior is a requirement for ballooning to occur. Furthermore, although we cannot rule out other dispersal mechanisms such as synanthropic spread, our findings suggest that the widespread N. pilipes uses ballooning to colonize remote oceanic islands.

  20. Outcomes of intragastric balloon placements in a private practice setting

    NARCIS (Netherlands)

    Mathus-Vliegen, Elisabeth M. H.; Alders, Peter R. H.; Chuttani, Ram; Scherpenisse, Joost


    Intragastric balloons are used as a treatment for obesity. Much of the data collected on balloons has been in the context of clinical trials in academic medical centers or as a bridge to bariatric surgery in obesity centers. The aim of this study was to investigate the efficacy and safety of balloon

  1. Efficacy and safety of circumferential pulmonary vein isolation using a novel cryothermal balloon ablation system. (United States)

    Sarabanda, Alvaro V; Bunch, T Jared; Johnson, Susan B; Mahapatra, Srijoy; Milton, Mark A; Leite, Luiz R; Bruce, G Keith; Packer, Douglas L


    We sought to evaluate the efficacy and safety of a novel cryothermal balloon ablation system in creating pulmonary vein (PV) isolation. Pulmonary vein isolation using standard radiofrequency ablation techniques is limited by procedure-related complications, such as thrombus formation and PV stenosis. Cryothermal ablation may reduce the risk of such complications. Eight dogs underwent circumferential ablation of both superior PVs for either 4 or 8 min using a cryothermal balloon catheter (CryoCath Technologies Inc., Kirkland, Canada). Both fluoroscopy and intracardiac ultrasound (ICE)-guided balloon and Lasso catheter positioning at the PV ostia assessed short-term PV integrity. In six additional dogs, long-term PV integrity was assessed by computed tomography at 16 weeks after ablation. Successful electrical isolation was achieved acutely in 14 of 16 (87.5%) PVs and was confirmed in one-week survival studies in 10 of 12 (83%) PVs. Successful isolation was higher in the absence of any peri-balloon flow leak as seen by ICE (p = 0.015), and with balloon temperatures ablation system is effective for isolating PVs, but injury to the right phrenic nerve was noted in this early experience. Further studies are needed to assess the long-term efficacy and safety of this technique.

  2. Assessment of risk of carotid occlusion with balloon Matas testing and dynamic computed tomography

    Energy Technology Data Exchange (ETDEWEB)

    Terada, Tomoaki; Okuno, Takashi; Moriwaki, Hiroshi; Nakai, Ekini; Nishiguchi, Takashi; Hayashi, Seiji; Komai, Norihiko.


    Temporary occlusion of the internal carotid artery with a balloon catheter (balloon Matas test) and simultaneous dynamic computed tomographic scanning (DCT) were performed in four patients with intracranial aneurysms to determine their tolerance for permanent carotid occlusion. Five DCT parameters were evaluated: appearance time, peak time, peak height fitting, first effective moment, and transit time. The patients were characterized into three types: type I (2 patients) - lack of neurological deficit during the balloon Matas test and equally preserved cerebral blood flow (CBF) in the two hemispheres on DCT during carotid occlusion, type II (one patient) - a decreased CBF on the occluded side on DCT despite the lack of neurological deficit; type III (one patient) - neurological signs, such as disturbance of consciousness, aphasia, and right hemiparesis occuring immediately after the start of the balloon Matas test, and a decreased CBF in the region of the middle and anterior cerebral arteries on the occluded side. In the type III patient, occlusion of the internal carotid artery is contraindicated unless an EC-IC bypass procedure that can rapidly provide a large supply of blood is performed. It can be concluded that the balloon Matas/DCT method offers a reliable means of predicting the risk of carotid ligation. (Namekawa, K.).

  3. Balloon Coating with Rapamycin Using an On-site Coating Device

    Energy Technology Data Exchange (ETDEWEB)

    Schmehl, Joerg, E-mail: [Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen (Germany); Ruhr, Juergen von der [Institute of Anatomy, University of Tuebingen (Germany); Dobratz, Markus; Kehlbach, Rainer [Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen (Germany); Braun, Isabelle [Translumina GmbH (Germany); Greiner, Tim-Oliver [Clinic of Thoracic and Cardiovascular Surgery, University Hospital of Tuebingen (Germany); Claussen, Claus D. [Department of Diagnostic and Interventional Radiology, University Hospital of Tuebingen (Germany); Behnisch, Boris [Translumina GmbH (Germany)


    Purpose. The efficacy of drug-eluting balloons has been demonstrated in clinical trials. The drug predominantly used is paclitaxel because of its lipophilic properties and the rapid onset of action. The aim of the investigation was to evaluate the feasibility and efficacy of an alternative balloon coating with rapamycin that can be applied on site.MethodsThe balloon coating (3.0/18 and 3.0/12 mm, Cathy No. 4, Translumina GmbH) with rapamycin was conducted with a coating machine (Translumina GmbH). Concentrations were 2, 2 Multiplication-Sign 2, 3, and 4 %. Measurements regarding the amount of substance released to the vessel wall were carried out on explanted porcine coronaries by means of ultraviolet and visible-light spectroscopy. Inflation time varied between 30 and 120 s. The biological effect of the coating was evaluated in a porcine peripheral overstretch and stent implantation model. Results. The amount of rapamycin on the balloon surface ranged from 558 {+-} 108 {mu}g for the 2 % solution to 1,441 {+-} 228 {mu}g in the 4 % solution. An amount of 95 {+-} 63-193 {+-} 113 {mu}g was released into the vessel wall. The quantitative measurements of the angiographic examinations 4 weeks after treatment revealed a reduction of diameter stenosis from 20.6 {+-} 17.4 % in the control group to 11.6 {+-} 5.5 % in the drug-eluting balloon group. Conclusion. A balloon coating with rapamycin omitting an excipient is possible with a dose-adjustable coating machine. However, the biological effects are moderate, which make further optimization of the coating process and evaluation of appropriate excipients necessary.

  4. Fasting and meal-suppressed ghrelin levels before and after intragastric balloons and balloon-induced weight loss

    NARCIS (Netherlands)

    Mathus-Vliegen, E. M. H.; Eichenberger, R. I.


    Intragastric balloons may be an option for obese patients with weight loss failure. Its mode of action remains enigmatic. We hypothesised depressed fasting ghrelin concentrations and enhanced meal suppression of ghrelin secretion by the gastric fundus through balloon contact and balloon-induced

  5. Optimal patient positioning for ligamentotaxis during balloon kyphoplasty of the thoracolumbar and lumbar spine.

    LENUS (Irish Health Repository)

    Cawley, D T


    Percutaneous balloon kyphoplasty aims to restore vertebral height, correct angular deformity and stabilize the spine in the setting of vertebral compression fractures. The patient is positioned prone with supports under the iliac crests and upper thorax to allow gravity to extend the spine. In the treatment of lumbar fractures, we evaluated patient positioning with the contribution of hip extension to increase anterior ligamentotaxis, thus facilitating restoration of vertebral height. Our positioning technique created a mean anterior height increase from 72% to 78% of the average height of the cranial and caudal vertebrae (p=0.037). Balloon inflation did not significantly further increase anterior or posterior vertebral height, or Cobb angle.

  6. Space and Earth Observations from Stratospheric Balloons (United States)

    Peterzen, Steven; Ubertini, Pietro; Masi, Silvia; Ibba, Roberto; Ivano, Musso; Cardillo, Andrea; Romeo, Giovanni; Dragøy, Petter; Spoto, Domenico

    Stratospheric balloons are rapidly becoming the vehicle of choice for near space investigations and earth observations by a variety of science disciplines. With the ever increasing research into climatic change, instruments suspended from stratospheric balloons offer the science team a unique, stable and reusable platform that can circle the Earth in the polar region or equatorial zone for thirty days or more. The Italian Space Agency (ASI) in collaboration with Andoya Rocket Range (Andenes, Norway) has opened access in the far northern latitudes above 78o N from Longyearbyen, Svalbard. In 2006 the first Italian UltraLite Long Duration Balloon was launched from Baia Terra Nova, Mario Zuchelli station in Antarctica and now ASI is setting up for the their first equatorial stratospheric launch from their satellite receiving station and rocket launch site in Malindi, Kenya. For the equatorial missions we have analysed the statistical properties of trajectories considering the biennal oscillation and the seasonal effects of the stratospheric winds. Maintaining these launch sites offer the science community 3 point world coverage for heavy lift balloons as well as the rapidly deployed Ultralight payloads and TM system ASI developed to use for test platforms, micro experiments, as well as a comprehensive student pilot program

  7. Low dose intravaginal misoprostol versus intracervical balloon ...

    African Journals Online (AJOL)

    Need for oxytocin augmentation was less in the misoprostol group (RR 0.76, 95% CI 0.64 to 0.91). No significant differences existed in rates for uterine hyperstimulation, Caesarean section, maternal and neonatal morbidity. Conclusion:Intravaginal misoprostol in a low dose was compared to intracervical balloon catheter for ...

  8. MHD Ballooning Instability in the Plasma Sheet

    Energy Technology Data Exchange (ETDEWEB)

    C.Z. Cheng; S. Zaharia


    Based on the ideal-MHD model the stability of ballooning modes is investigated by employing realistic 3D magnetospheric equilibria, in particular for the substorm growth phase. Previous MHD ballooning stability calculations making use of approximations on the plasma compressibility can give rise to erroneous conclusions. Our results show that without making approximations on the plasma compressibility the MHD ballooning modes are unstable for the entire plasma sheet where beta (sub)eq is greater than or equal to 1, and the most unstable modes are located in the strong cross-tail current sheet region in the near-Earth plasma sheet, which maps to the initial brightening location of the breakup arc in the ionosphere. However, the MHD beq threshold is too low in comparison with observations by AMPTE/CCE at X = -(8 - 9)R(sub)E, which show that a low-frequency instability is excited only when beq increases over 50. The difficulty is mitigated by considering the kinetic effects of ion gyrorad ii and trapped electron dynamics, which can greatly increase the stabilizing effects of field line tension and thus enhance the beta(sub)eq threshold [Cheng and Lui, 1998]. The consequence is to reduce the equatorial region of the unstable ballooning modes to the strong cross-tail current sheet region where the free energy associated with the plasma pressure gradient and magnetic field curvature is maximum.

  9. There is a Text in 'The Balloon'

    DEFF Research Database (Denmark)

    Elias, Camelia


    From the Introduction: Camelia Elias' "There is a Text in 'The Balloon': Donald Barthelme's Allegorical Flights" provides its reader with a much-need and useful distinction between fantasy and the fantastic: "whereas fantasy in critical discourse can be aligned with allegory, in which a supernatu......From the Introduction: Camelia Elias' "There is a Text in 'The Balloon': Donald Barthelme's Allegorical Flights" provides its reader with a much-need and useful distinction between fantasy and the fantastic: "whereas fantasy in critical discourse can be aligned with allegory, in which....... The concept of knowledge and story-telling is exemplified in the Biblical Fall-myth and in Scheherazade. Here Camelia Elias' gendered and witty point is that man knows (or rather wishes to know) and that woman knows (but does not tell). Finally, the meaning of a giant balloon appearing in the sky over New...... York in Donald Barthelme's short story  "The Balloon" from 1968 is discussed in the light of the chapter's epistemological understanding of fantasy....

  10. Low dose intravaginal misoprostol versus intracervical balloon ...

    African Journals Online (AJOL)

    Background:The efficacy and safety of low dose misoprostol as a ripening agent compared to the widely used balloon catheter in developing countries is undetermined. Objective:To compare the safety and efficacy of a low dose intravaginal misoprostol and intracervical Foley's catheter for cervical ripening. Design:A ...

  11. Double-balloon endoscopy: Who needs it?

    DEFF Research Database (Denmark)

    Hendel, J.W.; Vilmann, P.; Jensen, T.


    Objective. Double-balloon endoscopy (DBE) made the small bowel accessible to inspection and therapy in its entirety. However, DBE is a time-consuming procedure that requires a highly skilled endoscopist, several nurses and - more often than not - anesthesiological support. This makes the selection...

  12. The ATIC Long Duration Balloon Project (United States)

    Guzik, T.

    Long Duration Balloon (LDB) scientific experiments, launched to circumnavigate the south pole over Antarctica, have particular advantages compared to Shuttle or other Low Earth Orbit (LEO) missions in terms of cost, weight, scientific "duty factor" and work force development. The Advanced Thin Ionization Calorimeter (ATIC) cosmic ray astrophysics experiment is a good example of a university-based project that takes full advantage of current LDB capability and could effectively use future expansion in launch weight and flight duration. The ATIC experiment is currently being shipped to Antarctica in preparation for its first LDB science flight that will investigate the charge composition and energy spectra of primary cosmic rays over the energy range from about 101 0 to 10 1 4 eV. The instrument is built around a fully active, Bismuth Germanate (BGO) ionization calorimeter to measure the energy deposited by the cascades formed by particles interacting in a thick carbon target. A highly segmented silicon matrix, located above the target, provides good incident charge resolution plus rejection of the "backscattered" particles from the interaction. Trajectory reconstruction is based on the cascade profile in the BGO calorimeter, plus information from the three scintillator hodoscope layers in the target section above it. The hodoscope planes also provide the primary event trigger to initiate the detector readout, another measure of the incident particle charge and an indicator of the interaction point in the carbon material. The scientific payload weighs ~1,540 kg and consumes ~300 Watts of power supplied by a ~580 Watt solar array system. A full evaluation of the experiment was performed during a test flight occurring between 28 December 2000 and 13 January 2001 where ATIC was carried3 to an altitude of ~37 km above Antarctica by a ~850,000 m helium filled balloon for one circumnavigation of the continent. All systems behaved well, the detectors performed as expected

  13. Stratospheric Balloon Platforms for Near Space Access (United States)

    Dewey, R. G.


    For over five decades, high altitude aerospace balloon platforms have provided a unique vantage point for space and geophysical research by exposing scientific instrument packages and experiments to space-like conditions above 99% of Earth's atmosphere. Reaching altitudes in excess of 30 km for durations ranging from hours to weeks, high altitude balloons offer longer flight durations than both traditional sounding rockets and emerging suborbital reusable launch vehicles. For instruments and experiments requiring access to high altitudes, engineered balloon systems provide a timely, responsive, flexible, and cost-effective vehicle for reaching near space conditions. Moreover, high altitude balloon platforms serve as an early means of testing and validating hardware bound for suborbital or orbital space without imposing space vehicle qualifications and certification requirements on hardware in development. From float altitudes above 30 km visible obscuration of the sky is greatly reduced and telescopes and other sensors function in an orbit-like environment, but in 1g. Down-facing sensors can take long-exposure atmospheric measurements and images of Earth's surface from oblique and nadir perspectives. Payload support subsystems such as telemetry equipment and command, control, and communication (C3) interfaces can also be tested and operationally verified in this space-analog environment. For scientific payloads requiring over-flight of specific areas of interests, such as an active volcano or forest region, advanced mission planning software allows flight trajectories to be accurately modeled. Using both line-of-sight and satellite-based communication systems, payloads can be tracked and controlled throughout the entire mission duration. Under NASA's Flight Opportunities Program, NSC can provide a range of high altitude flight options to support space and geophysical research: High Altitude Shuttle System (HASS) - A balloon-borne semi-autonomous glider carries

  14. Single-balloon compared with double-balloon catheters for induction of labor: a randomized controlled trial. (United States)

    Salim, Raed; Zafran, Noah; Nachum, Zohar; Garmi, Gali; Kraiem, Nazik; Shalev, Eliezer


    To estimate the efficacy of a single-balloon catheter compared with a double-balloon catheter among women with unfavorable cervices undergoing induction of labor. This prospective randomized study was conducted at a university teaching medical center between June 2008 and December 2010. Pregnant women admitted for induction of labor with a live singleton gestation in cephalic presentation with intact membranes and a Bishop score of 6 or less were randomly assigned for cervical ripening by a single-balloon catheter or a double-balloon catheter. The primary outcome was the length of time from catheter insertion until delivery. The secondary outcome was mode of delivery. Of 368 eligible women screened during the study period, 293 were included in the final analysis; 145 were randomly assigned to receive a single-balloon catheter and 148 received a double-balloon catheter. Demographic and obstetric parameters were comparable between the two groups. Length of time from catheter insertion until delivery was 19.4 (±6.0) and 19.1 (±6.8) hours among the single-balloon and the double-balloon catheter groups, respectively (P=.80). Length of time did not differ when primiparous women were analyzed separately. Incidence of cesarean delivery was 10.3% and 17.6% among the single-balloon and double-balloon catheter groups, respectively (P=.09). The incidence of either vacuum deliveries or cesarean deliveries was significantly lower among the single-balloon group (14.4%) compared with the double-balloon catheter group (25.7%; odds ratio 0.49, 95% confidence interval 0.26-0.92; P=.02). Both the single-balloon and double-balloon catheters are equally efficacious for inducing labor. The double-balloon catheter may be associated with more operative deliveries.

  15. Balloons in endovascular neurosurgery: history and current applications. (United States)

    Alaraj, Ali; Wallace, Adam; Dashti, Reza; Patel, Prasad; Aletich, Victor


    The use of balloons in the field of neurosurgery is currently an essential part of our clinical practice. The field has evolved over the last 40 years since Serbinenko used balloons to test the feasibility of occluding cervical vessels for intracranial pathologies. Since that time, indications have expanded to include sacrificing cervical and intracranial vessels with detachable balloons, supporting the coil mass in wide-necked aneurysms (balloon remodeling technique), and performing intracranial and cervical angioplasty for atherosclerotic disease, as well as an adjunct to treat arteriovenous malformations. With the rapid expansion of endovascular technologies, it appears that the indications and uses for balloons will continue to expand. In this article, we review the history of balloons, the initial applications, the types of balloons available, and the current applications available for endovascular neurosurgeons.

  16. Cortical evoked potentials in response to rapid balloon distension of the rectum and anal canal

    DEFF Research Database (Denmark)

    Haas, S; Brock, C; Krogh, K


    BACKGROUND: Neurophysiological evaluation of anorectal sensory function is hampered by a paucity of methods. Rapid balloon distension (RBD) has been introduced to describe the cerebral response to rectal distension, but it has not successfully been applied to the anal canal. METHODS: Nineteen...

  17. Percutaneous Mitral Valve Dilatation: Single Balloon versus Double Balloon - A Finite Element Study

    Energy Technology Data Exchange (ETDEWEB)

    Schievano, Silvia; Kunzelman, Karyn; Nicosia, Mark; Cochran, R. P.; Einstein, Daniel R.; Khambadkone, Sachin; Bonheoffer, Philipp


    Background: Percutaneous mitral valve (MV) dilatation is performed with either a single balloon (SB) or double balloon (DB) technique. The aim of this study was to compare the two balloon system results using the finite element (FE) method. Methods and Results: An established FE model of the MV was modified by fusing the MV leaflet edges at commissure level to simulate a stenotic valve (orifice area=180mm2). A FE model of a 30mm SB (low-pressure, elastomeric balloon) and an 18mm DB system (high-pressure, non-elastic balloon) was created. Both SB and DB simulations resulted in splitting of the commissures and subsequent stenosis dilatation (final MV area=610mm2 and 560mm2 respectively). Stresses induced by the two balloon systems varied across the valve. At the end of inflation, SB showed higher stresses in the central part of the leaflets and at the commissures compared to DB simulation, which demonstrated a more uniform stress distribution. The higher stresses in the SB analysis were due to the mismatch of the round balloon shape with the oval mitral orifice. The commissural split was not easily accomplished with the SB due to its high compliance. The high pressure applied to the DB guaranteed the commissural split even when high forces were required to break the commissure welds. Conclusions: The FE model demonstrated that MV dilatation can be accomplished by both SB and DB techniques. However, the DB method resulted in higher probability of splitting of the fused commissures and less damage caused to the MV leaflets by overstretching.

  18. Randomized controlled trial: hybrid technique using balloon dilation of the frontal sinus drainage pathway. (United States)

    Hathorn, Iain F; Pace-Asciak, Pia; Habib, Al-Rahim R; Sunkaraneni, Vishnu; Javer, Amin R


    The objectives of this study were as follows: (1) to evaluate frontal sinus ostial patency following balloon dilation with the Ventera Sinus Dilation System, compared with frontal sinusotomy (Draf 2a); and (2) to compare mean blood loss and mean surgical time for frontal sinusotomy using balloon dilation compared with traditional surgical methods. A single blinded, randomized, controlled, prospective study was performed at St. Paul's Sinus Center, Vancouver, a tertiary referral rhinology center. Thirty patients undergoing functional endoscopic sinus surgery (FESS) for chronic rhinosinusitis (CRS) were randomized to a hybrid approach with exposure of the frontal recess using standard instrumentation and then balloon dilation of 1 frontal sinus drainage pathway and traditional frontal sinusotomy for the opposite side. Blood loss and surgical time for opening the frontal sinus drainage pathway was recorded for each side. Patients acted as their own controls. Ostial patency and size were assessed 5 weeks and 3 months postoperatively using endoscopy. Ostial patency was also recorded at 1 year following surgery. All frontal sinus ostia in both groups (n = 30) were successfully opened and were patent with both techniques 3 months postoperatively. All frontal sinus ostia assessed at 1 year (73%) remained patent and none required revision frontal surgery. Balloon dilation showed a mean surgical time of 655 seconds compared to 898 seconds for traditional FESS (p = 0.03). Mean blood loss was less with balloon dilation (58 mL vs 91 mL; p = 0.008). A hybrid balloon technique successfully dilates the frontal sinus drainage pathway with reduced blood loss. Also, short-term patency appears to be comparable to traditional frontal sinusotomy. © 2014 ARS-AAOA, LLC.

  19. Cutting Balloon Angioplasty in the Treatment of Short Infrapopliteal Bifurcation Disease. (United States)

    Iezzi, Roberto; Posa, Alessandro; Santoro, Marco; Nestola, Massimiliano; Contegiacomo, Andrea; Tinelli, Giovanni; Paolini, Alessandra; Flex, Andrea; Pitocco, Dario; Snider, Francesco; Bonomo, Lorenzo


    To evaluate the safety, feasibility, and effectiveness of cutting balloon angioplasty in the management of infrapopliteal bifurcation disease. Between November 2010 and March 2013, 23 patients (mean age 69.6±9.01 years, range 56-89; 16 men) suffering from critical limb ischemia were treated using cutting balloon angioplasty (single cutting balloon, T-shaped double cutting balloon, or double kissing cutting balloon technique) for 47 infrapopliteal artery bifurcation lesions (16 popliteal bifurcation and 9 tibioperoneal bifurcation) in 25 limbs. Follow-up consisted of clinical examination and duplex ultrasonography at 1 month and every 3 months thereafter. All treatments were technically successful. No 30-day death or adverse events needing treatment were registered. No flow-limiting dissection was observed, so no stent implantation was necessary. The mean postprocedure minimum lumen diameter and acute gain were 0.28±0.04 and 0.20±0.06 cm, respectively, with a residual stenosis of 0.04±0.02 cm. Primary and secondary patency rates were estimated as 89.3% and 93.5% at 6 months and 77.7% and 88.8% at 12 months, respectively; 1-year primary and secondary patency rates of the treated bifurcation were 74.2% and 87.0%, respectively. The survival rate estimated by Kaplan-Meier analysis was 82.5% at 1 year. Cutting balloon angioplasty seems to be a safe and effective tool in the routine treatment of short/ostial infrapopliteal bifurcation lesions, avoiding procedure-related complications, overcoming the limitations of conventional angioplasty, and improving the outcome of catheter-based therapy. © The Author(s) 2015.

  20. The predictive power of balloon shape and change of sensory functions on outcome of percutaneous balloon compression for trigeminal neuralgia. (United States)

    Asplund, Pär; Linderoth, Bengt; Bergenheim, A Tommy


    Percutaneous balloon compression is a simple and effective treatment of trigeminal neuralgia. However, results between and within different series are varying. To further improve the results in terms of pain relief, the authors believe that a careful study of the surgical procedure is important. The object of this study was to analyze the impact of balloon shape, balloon position, balloon volume, and compression time on duration of the therapeutic effect following percutaneous balloon compression. Furthermore, they analyzed the sensory side effects associated with this treatment, and how these relate to surgical parameters. Medical records and intraoperative radiographs from 87 balloon compressions were reviewed, and different surgical parameters were categorized. Univariate and multivariate analyses were performed to correlate surgical parameters to pain relief. Sensory testing with a transcutaneous electrical stimulation technique and clinical examination data were reviewed to analyze changes in sensory function. The balloon shape had a significant impact on time to recurrence of pain. A pear-shaped balloon resulted in a far better surgical result than a non-pear-shaped balloon (p pear shape was not significant (p = 0.14). Statistical significance was not reached for any of the other parameters in relation to duration of therapeutic effect. A pear-shaped balloon was also significantly associated with increased thresholds for percutaneous electrical stimulation in the immediate postoperative period, but the perception thresholds were normalized at the late follow-up at 3-9 months. A similar outcome was found for clinical testing with light touch and pinprick. The authors have demonstrated that using a pear-shaped balloon when performing percutaneous balloon compression for trigeminal neuralgia results in longer pain relief than non-pear-shaped balloons. Other surgical parameters seemed less important with respect to pain relief. Balloon compression also, in many

  1. Balloon dilatation biopsy of the biliary stricture through the percutaneous transhepatic biliary drainage tract: Feasibility and diagnostic accuracy

    Energy Technology Data Exchange (ETDEWEB)

    Hong, Ji Hoon; Ryeom, Hun Kyu; Jang, Yun Jin; Kim, Gab Chul; Cho, Seung Hyun; Song, Jung Hup [Kyungpook National University Hospital, Daegu (Korea, Republic of)


    To evaluate the feasibility and diagnostic accuracy of the balloon dilatation biopsy for the biliary stricture through the percutaneous transhepatic biliary drainage (PTBD) tract. The study included 35 patients who underwent balloon dilatation biopsy for the biliary stricture through the PTBD tract. Balloon dilatation was done with a balloon catheter of 10-mm or 12-mm diameter. Soft tissue adherent to the retrieved balloon catheter and soft tissue components separated by gauze filtration of evacuated bile were sampled for histopathologic examination. The results were compared with the final diagnosis which was made by clinical and imaging follow-up for mean 989 days (n = 34) and surgery with histopathologic examination (n = 1). Procedure-related complications and diagnostic accuracy were assessed. Tissues suitable for histopathologic examination were obtained in 31 out of 35 patients (88.6%). In 3 patients, self-limiting hemobilia was noted. No major complication was noted. The sensitivity, specificity, diagnostic accuracy, positive and negative predictive values for diagnosis of malignant stricture were 70.0%, 100%, 90.3%, 100%, and 87.5%, respectively. Balloon dilatation biopsy of the biliary stricture through the PTBD tract is a feasible and accurate diagnostic method. It can be a safe alternative to the endoscopic retrograde cholangiography biopsy or forceps biopsy through the PTBD tract.

  2. Certification and safety aspects relating to the transport of passengers on high altitude balloons in Europe (United States)

    Schoenmaker, Annelie


    High-altitude balloons typically fly between 25 and 50 km in altitude, which, while below the Karman line of 100 km, is yet far above the altitudes typically flown by aircraft. For example, the highest-flying commercial aircraft - the Concorde - had a maximum cruising altitude of only 18 km. zero2infinity, a Spanish company, is currently developing a pressurized pod named “bloon” which will be capable of lifting six people, including two pilot crew members and four paying passengers, to an altitude of 36 km through the use of high-altitude balloons. The boundary between Airspace and Outer Space has never been legally defined, mostly because of the lack of activities taking place between the altitude where airplanes fly and the lowest orbiting spacecraft. High-altitude balloons do fly at these in-between altitudes and the prospect of commercializing access to these parts of the stratosphere poses some questions in a new light. Given the relatively low altitude at which they fly, it may well be that these types of balloons would be considered to operate exclusively within air space. However, given the technology involved in crewed high altitude balloon flights, which is more similar to spacecraft engineering than to traditional hot-air or gas ballooning, it is necessary to evaluate the various legal regimes, codes, and regulations that would apply to such flights, especially regarding licenses and liabilities. For high altitude balloon flights commencing in Europe, the European Aviation Safety Agency (EASA) would very likely be the competent certification or licensing agency for these flights, although there would likely be input from various national aviation authorities as well. However, because the European Commission (EC) has not yet issued regulations regarding commercial spaceflight, particularly the use of high altitude balloons, new rules and regulations governing such flights may still need to be drafted and promulgated. With the development of

  3. Unconventional Ballooning Structures for Toroidal Drift Waves


    Xie, H. S.; Xiao, Y.


    With strong gradients in the pedestal of high confinement mode (H-mode) fusion plasmas, gyrokinetic simulations are carried out for the trapped electron and ion temperature gradient modes. A broad class of unconventional mode structures is found to localize at arbitrary poloidal positions or with multiple peaks. It is found that these unconventional ballooning structures are associated with different eigen states for the most unstable mode. At weak gradient (low confinement mode or L-mode), t...

  4. Report on the Brazilian Scientific Balloon Program (United States)

    Braga, Joao


    We report on the recent scientific ballooning activities in Brazil, and present the plans for the next few years. Recent technological developments, especially on telecommunications and gondola attitude control systems will be reported. We also present the recent progress achieved in the development of the protoMIRAX balloon experiment. protoMIRAX is a balloon-borne hard X-ray imaging telescope under development at INPE as a pathfinder for the MIRAX (Monitor e Imageador de Raios X) satellite mission. The experiment consists essentially in a hard X-ray coded-aperture imager to operate in the 20-200 keV energy range. The detector plane is a square array of 196 10mm x 10mm x 2mm CdZnTe (CZT) planar detectors. A collimator defines a fully-coded field-of-view of 20 x 20 degrees, with 7 x 7 degrees of full sensitivity and an angular resolution of 1.7 degrees. We describe the final stages of development and testing of the front-end electronics, with charge preamplifiers, LNAs, shapers and Wilkinson-type ADCs customized for these detectors. We also show detailed Monte Carlo simulations of the flight background and the expected flight images of bright sources performed with the use of GEANT4.

  5. Kissing balloon or sequential dilation of the side branch and main vessel for provisional stenting of bifurcations: lessons from micro-computed tomography and computational simulations

    National Research Council Canada - National Science Library

    Foin, Nicolas; Torii, Ryo; Mortier, Peter; De Beule, Mathieu; Viceconte, Nicola; Chan, Pak Hei; Davies, Justin E; Xu, Xiao Yun; Krams, Rob; Di Mario, Carlo


    This study sought to evaluate post-dilation strategies in bifurcation stenting. In bifurcation stenting practice, it is still controversial how post-dilation should be performed and whether the kissing balloon (KB...

  6. Intragastric balloon for treatment-resistant obesity: safety, tolerance, and efficacy of 1-year balloon treatment followed by a 1-year balloon-free follow-up

    NARCIS (Netherlands)

    Mathus-Vliegen, Elisabeth M. H.; Tytgat, Guido N. J.


    Background: Prior efforts to treat obesity with intragastric balloons were thwarted by high complication rates. Therefore, fundamental requirements for optimal balloon designs were defined. The aim of the present study was to investigate the effectiveness, the safety; and the tolerance of a new

  7. ISBA system for CNES operations of stratospheric balloons (United States)

    Vargas, André; Cocquerez, Philippe; Escarnot, Jean-Pierre; Sosa-Sesma, Sergio; Ragazzo, Patrick; Spel, Martin

    For long duration flights of stratospheric balloons, the CNES has developed the ISBA Tracking, Telemetry Command system (TT and C), which comprises a house-keeping gondola (on board aerostat) and associated ground segments. The ISBA TT and C system permits to control and to monitor stratospheric balloons for long duration flights lasting a few days (zero-pressure balloon) to several months (superpressure balloon), flying anywhere in the world. This system has been implemented for scientific balloon campaigns : African Monsoon Multidisciplinary Analyzes (AMMA 2006) and Pacific Asian Regional Campaign (PARC 2008). The next balloon campaign with this system will be Concordiasi (2010 ), during which 20 superpressure balloons will be launched from the U.S. MacMurdo station (placeAntarctica) where the duration of the balloon flights are expected to reach 6 months. To enable monitoring and controlling of the flights in real time, regardless of the location of the balloons, the Iridium system is used as the communication link between the ground stations and the on-board house-keeping gondola. A mobile Control Station is activated on the balloon operation site for the launch, from where the ascent to flight level and the beginning of the flight is controlled by the team in charge of launching operations. Subsequently after checking the good health of the aerostat (balloon itself and house keeping gondola), the flight control of the balloon is transferred to the Control Center installed in the CNES at Toulouse from where the flight is further controlled : checking housekeeping and scientific telemetries, operations of ballast dropping and helium gas exhausting (superpressure balloons), monitoring the health of the balloon and the house keeping gondola, forecasts extensions of balloon trajectories for the 10 days to come, and management of the end of the flight to ensure a descent of the envelope of the balloon and flight train with its parachute in maximum safety conditions

  8. Risk of maternal, fetal and neonatal complications associated with the use of the transcervical balloon catheter in induction of labour: A systematic review. (United States)

    Gommers, Jip S M; Diederen, Milou; Wilkinson, Chris; Turnbull, Deborah; Mol, Ben W J


    Induction of labour is one of the most frequently applied obstetrical interventions globally. Many studies have compared the use of balloon catheters with pharmacological agents. Although the safety of the balloon catheter is often mentioned, little has been written about the total spectrum of maternal and fetal morbidity associated with induction of labour using a balloon catheter. We evaluated the safety of labour induction with a transcervical balloon catheter by conducting a literature review with pooled risk assessments of the maternal, fetal and neonatal morbidity. We searched Medline, EMBASE and CINAHL as well as the Cochrane database using the Keywords 'induction of labour', 'cervical ripening', 'transcervical balloon', 'balloon catheter' and 'Foley balloon'. We did not use language or date restrictions. Randomized and quasi-randomized controlled trials as well as observational studies that contained original data on occurrence of maternal, fetal or neonatal morbidity during induction of labour with the balloon catheter were included. Studies were excluded if the balloon catheter was used concurrently with oxytocin and concurrently or consecutively with misoprostol, dinoprostone or extra-amniotic saline infusion. Study selection and quality assessment was performed by two authors independently using a standardized critical appraisal instrument. Outcomes were reported as weighted mean rates. We detected 84 articles reporting on 13,791 women. The overall risk of developing intrapartum maternal infection was 11.3% (912 of 8079 women), 3.3% (151 of 4538 women) for postpartum maternal infection and 4.6% (203 of 4460 women) for neonatal infection. Uterine hypercontractility occurred in 2.7% (148 of 5439) of the women. Uterine rupture after previous caesarean section occurred in 1.9% of women (26 of 1373), while other major maternal complications had an occurrence rate of induction with a balloon catheter is a safe intervention, with intrapartum maternal infection

  9. Cutting balloons, covered stents and paclitaxel-coated balloons for the treatment of dysfunctional dialysis access. (United States)

    Kitrou, Panagiotis; Spiliopoulos, Stavros; Karnabatidis, Dimitris; Katsanos, Konstantinos


    Percutaneous transcatheter balloon angioplasty has evolved to the current mainstay treatment for salvage of dysfunctional dialysis access. Nonetheless, it is frequently associated with recurrent vessel restenosis and the need for multiple repeat treatments in order to maintain hemodynamic patency. Cutting-balloons, covered stents or stent-grafts, and paclitaxel-coated balloons have been extensively tested and investigated with the aim to improve immediate anatomical and long-term clinical results. Areas covered: In the present overview, we discuss the background and appraise relevant medical literature on the aforementioned technologies and provide a more in-depth synthesis of the results of different clinical studies for each device category. We will also discuss the limitations in the mode of action of each group of devices and envision what the future holds for the challenging field of dialysis access interventions. Expert commentary: We propose a good practice algorithm for the treatment of thrombosed or dysfunctional dialysis access.

  10. Pneumatic impression: Improving dental arch impression with an inflatable balloon


    Lokendra Gupta


    Purpose: The purpose of this impression technique is to overcome the problem associated with restricted mouth opening in association with high arched palate by employing pneumatic impression technique using latex balloon. Methods: A stock tray was modified with auto polymerizing acrylic resin. On the modified tray, a latex balloon was attached with aid of cyanoacrylate. The outlet of the balloon was then connected to a clinical sphygmomanometer bulb with the rubber pipe for air passage whi...

  11. Radial dilation of nephrostomy balloons: a comparative analysis

    Directory of Open Access Journals (Sweden)

    Kari Hendlin


    Full Text Available PURPOSE: The dynamics of percutaneous balloon expansion may differ with increasing extrinsic compressive forces and increasing inflation pressures. This study compares the ability of percutaneous balloons to expand under different radial constrictive forces. MATERIALS AND METHODS: Three 30F nephrostomy balloons were tested: Bard X-Force™, Boston Scientific Microvasive Amplatz Tractmaster™, and Cook Ultraxx™. With a super stiff guidewire in place, the balloon tip was secured by elevated vice grips on either side of the balloon. A string was wrapped around the balloon center once, and incremental increases in load were added (2g, 42g, 82g, and 122g to represent increasing extrinsic compression. The balloon was inflated with a contrast agent and circumference changes were measured at increments of 4 ATM, 10 ATM, and burst pressure. Balloons were tested in triplicate for each load. RESULTS: All balloons were unable to reach 90% of their expected diameter with larger constrictive loads (122g at low (4 ATM and nominal (10 ATM inflation pressures. Only the Bard and Cook balloons reached at least 90% of the expected diameter with a coefficient of variance (CV less than 10% at burst pressure under the larger constrictive load (122g, 94.3% ± 6.7%, CV 7.1% and 96.3% ± 2.9%, CV 3.0% respectively. All balloons performed well under low constriction forces and reached at least 80% of the expected diameter by 10 ATM under all constrictive loads. CONCLUSIONS: The Bard X-Force and Cook Ultraxx percutaneous nephrostomy balloons achieved the most reliable radial dilation against large constrictive forces simulating fascial or retroperitoneal scar tissue.

  12. Coronary artery aneurysm following drug-coated balloon treatment. (United States)

    Solomonica, Amir; Musallam, Anees; Roguin, Ariel


    Drug-coated balloons are an effective treatment option for stent restenosis. Because of their potential benefits, the use of drug-coated balloons is predicted to increase in the future and expand further for the treatment of de novo lesions as well. We hereby present a case in which a patient developed a coronary artery aneurysm following the treatment of a de novo native coronary narrowing with a drug-coated balloon. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Radial dilation of nephrostomy balloons: a comparative analysis. (United States)

    Hendlin, Kari; Monga, Manoj


    The dynamics of percutaneous balloon expansion may differ with increasing extrinsic compressive forces and increasing inflation pressures. This study compares the ability of percutaneous balloons to expand under different radial constrictive forces. Three 30F nephrostomy balloons were tested: Bard X-Force, Boston Scientific Microvasive Amplatz Tractmaster, and Cook Ultraxx. With a super stiff guidewire in place, the balloon tip was secured by elevated vice grips on either side of the balloon. A string was wrapped around the balloon center once, and incremental increases in load were added (2g, 42g, 82g, and 122g) to represent increasing extrinsic compression. The balloon was inflated with a contrast agent and circumference changes were measured at increments of 4 ATM, 10 ATM, and burst pressure. Balloons were tested in triplicate for each load. All balloons were unable to reach 90% of their expected diameter with larger constrictive loads (122g) at low (4 ATM) and nominal (10 ATM) inflation pressures. Only the Bard and Cook balloons reached at least 90% of the expected diameter with a coefficient of variance (CV) less than 10% at burst pressure under the larger constrictive load (122g), 94.3% +/- 6.7%, CV 7.1% and 96.3% +/- 2.9%, CV 3.0% respectively. All balloons performed well under low constriction forces and reached at least 80% of the expected diameter by 10 ATM under all constrictive loads. The Bard X-Force and Cook Ultraxx percutaneous nephrostomy balloons achieved the most reliable radial dilation against large constrictive forces simulating fascial or retroperitoneal scar tissue.

  14. Balloon infrared astronomy platform (BIRAP). [development and characteristics of a balloon-borne attitude control system (United States)

    Greeb, M. E.; True, G. A.


    The development of a balloon-borne attitude control system for infrared astronomy studies is discussed. The Balloon Infrared Astronomy Platform (BIRAP) is the result of the development effort. The BIRAP uses electronic gimballing for the offset pointing which eliminates a set of mechanical gimbals. Guide stars with visual magnitudes as low as plus 6 are used for fine tracking assuring that all areas of the sky can be covered. The BIRAP control concept uses a closed loop system in the airborne equipment with automatic update through a command link that can be operated either manually or automatically by a ground based computer.

  15. Which uterine sparing technique should be used for uterine atony during cesarean section? The Bakri balloon or the B-Lynch suture? (United States)

    Kaya, Baris; Guralp, Onur; Tuten, Abdullah; Unal, Orhan; Celik, Melih Ozgur; Dogan, Askın


    To evaluate various aspects of two popular uterine sparing techniques, the B-Lynch uterine compression suture and Bakri balloon tamponade, in severe postpartum hemorrhage (PPH). 21 women who underwent the Bakri balloon procedure and 24 women who underwent the B-Lynch suture as primary uterus-sparing methods, due to PPH not responding to medical treatment, were retrospectively evaluated. The success rates of the B-Lynch procedure and the Bakri balloon were 79.1 and 80 %, respectively. The success rates of the B-Lynch + IIAL and the Bakri balloon + IIAL were 91.6 and 95 %, respectively. There was no significant difference in success rates, mean duration of time to stop bleeding, estimated blood loss, transfused packed red blood cells or mean duration of hospital stay between the B-Lynch and the Bakri balloon groups. The duration of operation was significantly longer in the Bakri balloon compared to the B-Lynch group (p = 0.01). In our study, the Bakri balloon and the B-Lynch suture had similar success rates in uterine atony during CS. The advantages of the B-Lynch suture include rapid application with no need for lithotomy position or extra material; whereas the Bakri balloon is less invasive and easier to learn, but more time consuming and expensive compared to the B-Lynch suture. We suggest that the B-Lynch suture may be preferred in uterine atony during CS in low resource settings; however, the less invasive Bakri balloon should be the first line in full resource settings. Further studies are needed to evaluate the advantages and disadvantages of the two methods.

  16. The X-point effects on the peeling-ballooning stability conditions (United States)

    Zheng, Linjin


    Due to the X-point singularity the safety factor tends to infinity as the last closed flux surface is approached. The usual numerical treatment of X-point singularity is to cut off a small fraction of edge region for system stability evaluation or simply use an up-down symmetric equilibrium without X-point included. This type of treatments have been used to make the peeling-ballooning stability diagram. We found that the mode types, peel or ballooning, can vary depending on how much the edge portion is cut off. When the cutting-off leads the edge safety factor (qa) to become close to a mode rational number, the peeling modes dominate; otherwise the ballooning type of modes prevail. The stability condition for peeling modes with qa being close to a rational number is much stringent than that for ballooning type of modes. Because qa tends to infinite near the separatrix, the mode rational surfaces are concentrated in the plasma region and thus the peeling modes are basically excluded. This extrapolation indicates that the stability boundary for high edge current, which is related to the peeling modes, need to be reexamined to take into account the X-point effects. Supported by U. S. Department of Energy, Office of Fusion Energy Science: Grant No. DE-FG02-04ER-54742.

  17. Balloon Blocking Technique (BBT) for Superselective Catheterization of Inaccessible Arteries with Conventional and Modified Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Morishita, Hiroyuki, E-mail:, E-mail: [Japan Red Cross Kyoto Daiichi Hospital, Department of Diagnostic Radiology (Japan); Takeuchi, Yoshito, E-mail: [Kyoto Prefectural University of Medicine, Department of Radiology, North Medical Center (Japan); Ito, Takaaki, E-mail: [Japan Red Cross Kyoto Daiichi Hospital, Department of Diagnostic Radiology (Japan); Hayashi, Natsuko, E-mail: [Kyoto Prefectural University of Medicine, Department of Radiology, Graduate School of Medical Science (Japan); Sato, Osamu, E-mail: [Japan Red Cross Kyoto Daiichi Hospital, Department of Diagnostic Radiology (Japan)


    PurposeThe purpose of the study was to retrospectively evaluate the efficacy and safety of the balloon blocking technique (BBT).Materials and MethodsThe BBT was performed in six patients (all males, mean 73.5 years) in whom superselective catheterization for transcatheter arterial embolization by the conventional microcatheter techniques had failed due to anatomical difficulty, including targeted arteries originating steeply or hooked from parent arteries. All BBT procedures were performed using Seldinger’s transfemoral method. Occlusive balloons were deployed and inflated at the distal side of the target artery branching site in the parent artery via transfemoral access. A microcatheter was delivered from a 5-F catheter via another femoral access and was advanced over the microguidewire into the target artery, under balloon blockage of advancement of the microguidewire into non-target branches. After the balloon catheter was deflated and withdrawn, optimal interventions were performed through the microcatheter.ResultsAfter success of accessing the targeted artery by BBT, optimal interventions were accomplished in all patients with no complications other than vasovagal hypotension, which responded to nominal therapy.ConclusionThe BBT may be useful in superselective catheterization of inaccessible arteries due to anatomical difficulties.

  18. Gastro-oesophageal reflux in mechanically ventilated patients: effects of an oesophageal balloon. (United States)

    Orozco-Levi, M; Félez, M; Martínez-Miralles, E; Solsona, J F; Blanco, M L; Broquetas, J M; Torres, A


    Gastro-oesophageal reflux (GOR) and bronchoaspiration of gastric content are risk factors linked with ventilator-associated pneumonia. This study was aimed at evaluating the effect of a nasogastric tube (NGT) incorporating a low-pressure oesophageal balloon on GOR and bronchoaspiration in patients receiving mechanical ventilation. Fourteen patients were studied in a semi-recumbent position for 2 consecutive days. Inflation or deflation of the oesophageal balloon was randomised. Samples of blood, gastric content, and oropharyngeal and bronchial secretions were taken every 2 h over a period of 8 h. A radioactively labelled nutritional solution was continuously administered through the NGT. The magnitude of both the GOR and bronchoaspiration was measured by radioactivity counting of oropharyngeal and bronchial secretion samples, respectively. Inflation of the oesophageal balloon resulted in a significant decrease of both GOR and bronchoaspiration of gastric content. This protective effect was statistically significant from 4 h following inflation throughout the duration of the study. This study demonstrates that an inflated oesophageal balloon delays and decreases gastro-oesophageal and bronchial aspiration of gastric content in patients carrying a nasogastric tube and receiving enteral nutrition during mechanical ventilation. Although the method was found to be safe when applied for 8 h, longer times should be considered with caution.

  19. Serum Fucosylated Haptoglobin as a Novel Diagnostic Biomarker for Predicting Hepatocyte Ballooning and Nonalcoholic Steatohepatitis.

    Directory of Open Access Journals (Sweden)

    Yoshihiro Kamada

    Full Text Available Nonalcoholic fatty liver disease (NAFLD is a growing medical problem around the world. NAFLD patients with nonalcoholic steatohepatitis (NASH can develop cirrhosis and hepatocellular carcinoma. The ability to distinguish NASH from simple steatosis would be of great clinical significance. Ballooning hepatocytes are characteristic of typical pathological NASH; here, the polarized secretion of proteins is disrupted due to destruction of the cytoskeleton. We previously reported that fucosylated glycoproteins are secreted into bile, but not into sera in normal liver. Therefore, we hypothesized that the fucosylation-based sorting machinery would be disrupted in ballooning hepatocytes, and serum fucosylated glycoproteins would increase in NASH patients. To confirm our hypothesis, we evaluated serum fucosylated haptoglobin (Fuc-Hpt levels in biopsy-proven NAFLD patients (n = 126 using a lectin-antibody ELISA kit. Fuc-Hpt levels were significantly increased in NASH patients compared with non-NASH (NAFLD patients without NASH patients. Interestingly, Fuc-Hpt levels showed a significant stepwise increase with increasing hepatocyte ballooning scores. Multiple logistic regression analysis showed that Fuc-Hpt levels were independent and significant determinants of the presence of ballooning hepatocytes. Moreover, Fuc-Hpt levels were useful in monitoring liver fibrosis staging. Next, to investigate the significance of serum Fuc-Hpt in a larger population, we measured Fuc-Hpt levels in ultrasound-diagnosed NAFLD subjects (n = 870 who received a medical health checkup. To evaluate NAFLD disease severity, we used the FIB-4 index (based on age, serum AST and ALT levels, and platelet counts. Fuc-Hpt levels increased stepwise with increasing FIB-4 index.Measurement of serum Fuc-Hpt levels can distinguish NASH from non-NASH patients, and predict the presence of ballooning hepatocytes in NAFLD patients with sufficient accuracy. These results support the


    NARCIS (Netherlands)



    Prolonged angioplasty balloon inflation with an autoperfusion balloon for failed conventional coronary angioplasty, was compared with emergency surgery for this condition. Restenosis was assessed 6 weeks after successful intervention with the autoperfusion balloon. Forty consecutive patients with

  1. Intercomparison of meteorological analyses and trajectories in the Antarctic lower stratosphere with Concordiasi superpressure balloon observations (United States)

    Hoffmann, Lars; Hertzog, Albert; Rößler, Thomas; Stein, Olaf; Wu, Xue


    In this study we compared temperatures and horizontal winds of meteorological analyses in the Antarctic lower stratosphere, a region of the atmosphere that is of major interest regarding chemistry and dynamics of the polar vortex. The study covers the European Centre for Medium-Range Weather Forecasts (ECMWF) operational analysis, the ERA-Interim reanalysis, the Modern-Era Retrospective analysis for Research and Applications version 1 and 2 (MERRA and MERRA-2), and the National Centers for Environmental Prediction and National Center for Atmospheric Research (NCEP/NCAR) reanalysis. The comparison was performed with respect to long-duration observations from 19 superpressure balloon flights during the Concordiasi field campaign in September 2010 to January 2011. Most of the balloon measurements were conducted at altitudes of 17-18.5 km and latitudes of 60-85° S. We found that large-scale state temperatures of the analyses have a mean precision of 0.5-1.4 K and a warm bias of 0.4-2.1 K with respect to the balloon data. Zonal and meridional winds have a mean precision of 0.9-2.3 m s-1 and a bias below ±0.5 m s-1. Standard deviations related to small-scale fluctuations due to gravity waves are reproduced at levels of 15-60 % for temperature and 30-60 % for the horizontal winds. Considering the fact that the balloon observations have been assimilated into all analyses, except for NCEP/NCAR, notable differences found here indicate that other observations, the forecast models, and the data assimilation procedures have a significant impact on the analyses as well. We also used the balloon observations to evaluate trajectory calculations with our new Lagrangian transport model Massive-Parallel Trajectory Calculations (MPTRAC), where vertical motions of simulated trajectories were nudged to pressure measurements of the balloons. We found relative horizontal transport deviations of 4-12 % and error growth rates of 60-170 km day-1 for 15-day trajectories. Dispersion

  2. Intercomparison of meteorological analyses and trajectories in the Antarctic lower stratosphere with Concordiasi superpressure balloon observations

    Directory of Open Access Journals (Sweden)

    L. Hoffmann


    Full Text Available In this study we compared temperatures and horizontal winds of meteorological analyses in the Antarctic lower stratosphere, a region of the atmosphere that is of major interest regarding chemistry and dynamics of the polar vortex. The study covers the European Centre for Medium-Range Weather Forecasts (ECMWF operational analysis, the ERA-Interim reanalysis, the Modern-Era Retrospective analysis for Research and Applications version 1 and 2 (MERRA and MERRA-2, and the National Centers for Environmental Prediction and National Center for Atmospheric Research (NCEP/NCAR reanalysis. The comparison was performed with respect to long-duration observations from 19 superpressure balloon flights during the Concordiasi field campaign in September 2010 to January 2011. Most of the balloon measurements were conducted at altitudes of 17–18.5 km and latitudes of 60–85° S. We found that large-scale state temperatures of the analyses have a mean precision of 0.5–1.4 K and a warm bias of 0.4–2.1 K with respect to the balloon data. Zonal and meridional winds have a mean precision of 0.9–2.3 m s−1 and a bias below ±0.5 m s−1. Standard deviations related to small-scale fluctuations due to gravity waves are reproduced at levels of 15–60 % for temperature and 30–60 % for the horizontal winds. Considering the fact that the balloon observations have been assimilated into all analyses, except for NCEP/NCAR, notable differences found here indicate that other observations, the forecast models, and the data assimilation procedures have a significant impact on the analyses as well. We also used the balloon observations to evaluate trajectory calculations with our new Lagrangian transport model Massive-Parallel Trajectory Calculations (MPTRAC, where vertical motions of simulated trajectories were nudged to pressure measurements of the balloons. We found relative horizontal transport deviations of 4–12 % and error growth rates

  3. Successful use of BT-Cath(®) balloon tamponade in the management of postpartum haemorrhage due to placenta previa. (United States)

    Uygur, D; Altun Ensari, T; Ozgu-Erdinc, A S; Dede, H; Erkaya, S; Danisman, A N


    To investigate efficacy of the BT-Cath(®) in cases of uncontrollable haemorrhage due to placenta previa. Retrospective study of women treated with the BT-Cath in the event of postpartum haemorrhage (PPH) due to placenta previa, despite optimal management with medical treatment. Between 2011 and 2013, 237 women had placenta previa (0.45%) at the study hospital. This study evaluated 53 women who underwent uterine tamponade with a BT-Cath. Haemostasis was achieved in 45 women (85%), and hysterectomy was required in six women (11%). Two women required repeat laparotomy. The mean duration of balloon tamponade was 9.8h (standard deviation 6.4h). When the relationship between balloon volume and treatment success was evaluated, the area under the receiver operating characteristic curve was 0.803 (95% confidence interval 0.633-0.973; p=0.007) and the optimal cut-off point was 220ml, with sensitivity of 88% and specificity of 71%. The intra-uterine BT-Cath is simple to use, even among clinicians with little experience, and is an effective treatment choice in patients with PPH due to placenta previa when medical treatment is unsuccessful. Minimal inflation of the balloon, a shorter period of intra-uterine balloon tamponade and early deflation of the balloon are recommended. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  4. Primary balloon angioplasty for symptomatic, high-grade intracranial stenosis. (United States)

    Tomycz, Luke; Bansal, Neil K; Lockney, Tim; Strothers, Megan; Connors, John J; Shay, Scott; Singer, Robert J


    In light of recent controversy about the safety and efficacy of intracranial stenting, we sought to evaluate our experience with primary balloon angioplasty for symptomatic, high-grade intracranial stenosis. All intracranial angioplasty cases performed at Vanderbilt University Medical Center from 2006 to 2011 were retrospectively reviewed for degree of stenosis pre- and post-procedure. Immediate peri-procedural complications were evaluated as well as one-month and long-term outcomes. A total of 26 patients were included in the study with a mean age of 63.0 years and a mean follow-up of 350.2 days. The average pre-procedure stenosis was 71.2%. The immediate, average post-procedure stenosis was 46.6%, and the average post-procedure stenosis at last angiographic follow-up was 44.5%. Retreatment was required in only 3.8% of patients. The primary end-point of major stroke or death at 30 days was observed in 11.5%, and the overall intra-procedural complication rate was 7.7%. The incidence of stroke or death at last follow-up was 15.4%, which is comparable to the one-year stroke or death rate in the medical arm of the SAMPRISS trial. In this retrospective series, primary balloon angioplasty was found to be effective as a treatment option for symptomatic intracranial stenosis with the risk of stroke or death at 30 days higher than the medical arm of SAMPRIS but lower than the stenting arm. The one-year risk of stroke was comparable to that reported for the one-year outcomes in the SAMPRISS medical arm.

  5. Advanced Thin Ionization Calorimeter (ATIC) Balloon Experiment (United States)

    Wefel, John P.; Guzik, T. Gregory


    During grant NAG5-5064, Louisiana State University (LSU) led the ATIC team in the development, construction, testing, accelerator validation, pre-deployment integration and flight operations of the Advanced Thin Ionization Calorimeter (ATIC) Balloon Experiment. This involved interfacing among the ATIC collaborators (UMD, NRL/MSFC, SU, MSU, WI, SNU) to develop a new balloon payload based upon a fully active calorimeter, a carbon target, a scintillator strip hodoscope and a pixilated silicon solid state detector for a detailed investigation of the very high energy cosmic rays to energies beyond 10(exp 14) eV/nucleus. It is in this very high energy region that theory predicts changes in composition and energy spectra related to the Supernova Remnant Acceleration model for cosmic rays below the "knee" in the all-particle spectrum. This report provides a documentation list, details the anticipated ATIC science return, describes the particle detection principles on which the experiment is based, summarizes the simulation results for the system, describes the validation work at the CERN SPS accelerator and details the balloon flight configuration. The ATIC experiment had a very successful LDB flight from McMurdo, Antarctica in 12/00 - 1/01. The instrument performed well for the entire 15 days. Preliminary data analysis shows acceptable charge resolution and an all-particle power law energy deposition distribution not inconsistent with previous measurements. Detailed analysis is underway and will result in new data on the cosmic ray charge and energy spectra in the GeV - TeV energy range. ATIC is currently being refurbished in anticipation of another LDB flight in the 2002-03 period.

  6. Flight Qualification of the NASA's Super Pressure Balloon (United States)

    Cathey, Henry; Said, Magdi; Fairbrother, Debora

    Designs of new balloons to support space science require a number of actual flights under various flight conditions to qualify them to as standard balloon flight offerings to the science community. Development of the new Super Pressure Balloon for the National Aeronautics and Space Administration’s Balloon Program Office has entailed employing new design, analysis, and production techniques to advance the state of the art. Some of these advances have been evolutionary steps and some have been revolutionary steps requiring a maturing understanding of the materials, designs, and manufacturing approaches. The NASA Super Pressure Balloon development end goal is to produce a flight vehicle that is qualified to carry a ton of science instrumentation, at an altitude greater than 33 km while maintaining a near constant pressure altitude for extended periods of up to 100 days, and at any latitude on the globe. The NASA’s Balloon Program Office has pursued this development in a carefully executed incremental approach by gradually increasing payload carrying capability and increasing balloon volume to reach these end goal. A very successful test flight of a ~200,700 m3 balloon was launch in late 2008 from Antarctica. This balloon flew for over 54 days at a constant altitude and circled the Antarctic continent almost three times. A larger balloon was flown from Antarctica in early 2011. This ~422,400 m3 flew at a constant altitude for 22 days making one circuit around Antarctica. Although the performance was nominal, the flight was terminated via command to recover high valued assets from the payload. The balloon designed to reach the program goals is a ~532,200 m3 pumpkin shaped Super Pressure Balloon. A test flight of this balloon was launched from the Swedish Space Corporation’s Esrange Balloon Launch Facilities near Kiruna, Sweden on 14 August, 2012. This flight was another success for this development program. Valuable information was gained from this short test

  7. Improving uv resistance of high strength fibers used in large scientific balloons (United States)

    Said, M.; Gupta, A.; Seyam, A.; Mock, G.; Theyson, T.

    For the last three decades, NASA has been involved in the development of giant balloons that are capable of lifting heavy payloads of equipment (such as large telescopes and scientific instruments) to the upper atmosphere. While the use of such balloons has led to scientific discoveries, the demand for competitive science payloads and observational programs continues to rise. The NASA Balloon Program Office has entered a new phase of research to develop an Ultra Long Duration Balloon (ULDB) that will lift payloads of up to 3,600 kg to altitudes of up to 40 km. The flight duration is targeted to ranges between 30 to 100 days. Attaining these target durations requires the development of a super-pressure balloon design. The use of textile structures have already been established in these missions in the form of high strength tendons essential for the super pressure pumpkin design. Unfortunately, high strength fibers lose significant strength upon exposure to Ultra Violet (UV) radiation. Such UV degradation poses a serious challenge for the development of the ULDB. To improve the mission performance of the ULDB, new methods for protecting the tendons from the environmental effects need to be developed. NASA and NC State University College of Textiles are undertaking a research program to address these issues. Four tracks have been identified to prepare finishes that are believed to enhance the resistance of high strength fibers to UV. These tracks are: (a) self-polymerizing, (b) diffusion application, (c) polymer-filled with 30-40% UV absorber, and (d) combination of dyeing plus surface application. Four high performance fibers have been selected for this research investigation. These are Vectran, Spectra, Kevlar and, PBO (Zylon). This work will address the current progress of evaluating the performance of the UV finishes. This will be accomplished by comparing the tensile properties (strenthg, breaking elongation, modulus, etc) of untreated, unexposed to UV fibers

  8. External caps: An approach to stress reduction in balloons (United States)

    Hazlewood, K. H.

    Recent findings of the catastrophic balloon failures investigation in the U.S.A. indicate that very large gross inflations, in balloons using present design philosophy, over-stress currently available materials. External caps are proposed as an economic approach to reducting those stresses to an acceptable level.

  9. Scientific ballooning in the 20 th century; a historical perspective (United States)

    Nishimura, J.

    Hess discovered the cosmic rays in 1912. Using a manned balloon, he found the altitude variation of the radiation. After this discovery, many balloon experiments were performed to explore the most mysterious radiation coming from outside of the earth during the 1920's to the 1930's. At the end of the 1940's, balloon systems were revolutionized by the use of new plastic films and telemetry systems. At almost the same time, highly sensitive nuclear emulsions were developed. Balloon exposures of emulsions brought us new discoveries of the heavy primaries in cosmic rays. Extensive studies with nuclear emulsions discovered high-energy phenomena and new particles between the end of 1940's to the 1960's. At the same time, in various countries, experiments with more sophisticated electronic devices were begun together with ingenious work on balloon technology. Inventions were made in the areas of designing, manufacturing, materials, telemetry systems for balloons and long duration flight systems etc. Several permanent launching stations were established in various countries in the 1960's Here, I review the development of essential technologies in scientific ballooning, and their value in contributing to the growth of space physics. As the future prospect, I stress the point that scientific ballooning is indispensable and a most cost-effective way to explore space astrophysics and Earth science, in addition to the preparation of satellite and the space station experiments.

  10. The Balloon Foot ; A Rare Presentation Of Congenital Constricting ...

    African Journals Online (AJOL)

    We present a case of a rare manifestation of congenital constricting annular band (CAB) in the lower extremity resulting in a severe excessive swelling of the foot which we have termed Balloon foot. The ballooned foot is caused by a progressive deepening of the circumferential constriction into the soft tissue of the lower ...

  11. Coronary artery angioplasty with a helical autoperfusion balloon catheter

    NARCIS (Netherlands)

    Gurbel, PA; Anderson, RD; vanBoven, AJ; denHeijer, P

    The initial in-hospital and long-term clinical experience with a helical autoperfusion balloon catheter in the treatment of coronary artery disease is reported, This new catheter design allows blood to flow passively around the inflated balloon through a protected helical channel molded into the

  12. [Long-term efficacy and safety of balloon kyphoplasty for treatment of osteoporotic vertebral fractures]. (United States)

    Bornemann, R; Deml, M; Wilhelm, K E; Jansen, T R; Wirtz, D C; Pflugmacher, R


    The aim of the evaluation of treatment protocols was an extension of the documentation regarding efficacy, duration of action and safety of balloon kyphoplasty. In addition, the data analysis should be used to clarify whether differences arise concerning the treatment success, depending on the number and/or position of the augmented vertebral bodies. The data of all patients who were admitted and operated on for vertebral body fractures between 2004 and 2009 were collected and evaluated for this study. The patients were examined pre-operatively and during the control visits clinically and radiologically. The intensity of pain was recorded on a visual analogue scale (VAS: 0-100 mm). To determine the functional limitations the Oswestry questionnaire was used. In addition, the middle and anterior heights of the vertebral body and the kyphosis angle were measured. To perform the balloon kyphoplasty the Kyphon® system was applied. The findings of all patients were documented in order to evaluate the efficacy and safety of balloon kyphoplasty for up to 3 years and to compare them with regard to the differences depending on the number and/or location of vertebral fractures (T = 1, T > 1, L = 1, L > 1, T + L). The overall evaluation of all patients (n = 464) in whom a balloon kyphoplasty was carried out showed an average improvement in VAS scores by 53 mm and the Oswestry scores by 47 percentage points. It was possible to demonstrate a significant improvement of the vertebral body height (mean 1.6 mm) and the kyphosis angle (1.3 degrees) in long-term controls up to 3 years. When comparing the findings in the groups that had been operated on a different number of vertebrae and/or at different positions in the spinal region (n = 466) it could be proven that the average decrease in pain intensity did not differ in all 5 groups (> 50 mm). Also for the Oswestry scores the reduction was almost comparable in all 5 groups. The radiological findings did not show striking

  13. Effects of Hemibridge with Ball and Balloon Exercise on Forced Expiratory Volume and Pain in Patients with Chronic Low Back Pain: An Experimental Study


    Jorida Fernandes; Akshay Chougule


    Background and objectives: Suboptimal breathing patterns and impairments of posture and trunk stability are often associated with musculoskeletal complaints such as low back pain. Respiration is also affected by poor neuromuscular control of core muscles. Immediate effects of hemibridge with ball and balloon exercise has been studied on chronic pain in athlete population. Objective: To evaluate the effects of hemibridge with ball and balloon exercise on pain, forced expiratory volume and func...

  14. Balloon concepts for scientific investigation of Mars and Jupiter (United States)

    Ash, R. L.


    Opportunities for scientific investigation of the atmospheric planets using buoyant balloons have been explored. Mars and Jupiter were considered in this study because design requirements at those planets bracket nominally the requirements at Venus, and plans are already underway for a joint Russian-French balloon system at Venus. Viking data has provided quantitative information for definition of specific balloon systems at Mars. Free flying balloons appear capable of providing valuable scientific support for more sophisticated Martian surface probes, but tethered and powered aerostats are not attractive. The Jovian environment is so extreme, hot atmosphere balloons may be the only scientific platforms capable of extended operations there. However, the estimated system mass and thermal energy required are very large.

  15. A Rare and Serious Unforeseen Complication of Cutting Balloon Angioplasty

    Directory of Open Access Journals (Sweden)

    Praveen Vemula


    Full Text Available Cutting balloon angioplasty (CBA is one of the adept ways of treating “in-stent restenosis.” Various complications related to cutting balloon angioplasty have been reported including arterial rupture, delayed perforation and fracture of microsurgical blades. Here we report a very unusual and inadvertent extraction of a stent previously deployed in the ramus intermedius coronary branch by a cutting balloon catheter. This required repeat stenting of the same site for an underlying dissection. Even though stent extraction is a rare complication it can be serious due to dissection, perforation, and closure of the artery. Physicians performing coronary artery interventions would need to be aware of this rare and serious complication especially if any difficulty is encountered while withdrawing the cutting balloon. Therefore, after removal, cutting balloon should be examined thoroughly for possible stent dislodgment or extraction when used for “in-stent restenosis.”

  16. Coordinated weather balloon solar radiation measurements during a solar eclipse. (United States)

    Harrison, R G; Marlton, G J; Williams, P D; Nicoll, K A


    Solar eclipses provide a rapidly changing solar radiation environment. These changes can be studied using simple photodiode sensors, if the radiation reaching the sensors is unaffected by cloud. Transporting the sensors aloft using standard meteorological instrument packages modified to carry extra sensors, provides one promising but hitherto unexploited possibility for making solar eclipse radiation measurements. For the 20 March 2015 solar eclipse, a coordinated campaign of balloon-carried solar radiation measurements was undertaken from Reading (51.44°N, 0.94°W), Lerwick (60.15°N, 1.13°W) and Reykjavik (64.13°N, 21.90°W), straddling the path of the eclipse. The balloons reached sufficient altitude at the eclipse time for eclipse-induced variations in solar radiation and solar limb darkening to be measured above cloud. Because the sensor platforms were free to swing, techniques have been evaluated to correct the measurements for their changing orientation. In the swing-averaged technique, the mean value across a set of swings was used to approximate the radiation falling on a horizontal surface; in the swing-maximum technique, the direct beam was estimated by assuming that the maximum solar radiation during a swing occurs when the photodiode sensing surface becomes normal to the direction of the solar beam. Both approaches, essentially independent, give values that agree with theoretical expectations for the eclipse-induced radiation changes.This article is part of the themed issue 'Atmospheric effects of solar eclipses stimulated by the 2015 UK eclipse'. © 2016 The Authors.


    NARCIS (Netherlands)


    Some of the newer over-the-wire coronary angioplasty catheters have shaft sizes of 3.0 French (F) or less. The inner diameter of modern 8-F guiding catheters is large enough to accommodate two of such balloon catheters. We report a kissing balloon procedure with two over-the-wire catheters through a

  18. A novel balloon colonoscope detects significantly more simulated polyps than a standard colonoscope in a colon model. (United States)

    Hasan, Nazia; Gross, Seth A; Gralnek, Ian M; Pochapin, Mark; Kiesslich, Ralf; Halpern, Zamir


    Although standard colonoscopy is considered the optimal test to detect adenomas, it can have a significant adenoma miss rate. A major contributing factor to high miss rates is the inability to visualize adenomas behind haustral folds and at anatomic flexures. To compare the diagnostic yield of balloon-assisted colonoscopy versus standard colonoscopy in the detection of simulated polyps in a colon model. Prospective, cohort study. International gastroenterology meeting. A colon model composed of elastic material, which mimics the flexible structure of haustral folds, allowing for dynamic responses to balloon inflation, with embedded simulated colon polyps (n = 12 silicone "polyps"). Fifty gastroenterologists were recruited to identify simulated colon polyps in a colon model, first using standard colonoscopy immediately followed by balloon-assisted colonoscopy. Detection of simulated polyps. The median polyp detection rate for all simulated polyps was significantly higher with balloon-assisted as compared with standard colonoscopy (91.7% vs 45.8%, respectively; P standard colonoscopy was notable both for non-obscured polyps (100.0% vs 75.0%; P model, and simulated colon polyps. As compared with standard colonoscopy, balloon-assisted colonoscopy detected significantly more obscured and non-obscured simulated polyps in a colon model. Clinical studies in human participants are being pursued to further evaluate this new colonoscopic technology. Copyright © 2014 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.

  19. Successful treatment of a congenital pulmonic valvular stenosis in a snow leopard (Uncia uncia) by percutaneous balloon valvuloplasty. (United States)

    Chai, Norin; Behr, Luc; Chetboul, Valérie; Pouchelon, Jean Louis; Wedlarski, Rudy; Tréhiou-Sechi, Emilie; Gouni, Vassiliki; Misbach, Charlotte; Petit, Amandine M P; Bourgeois, Aude; Hazan, Thierry; Borenstein, Nicolas


    A 3-yr-old intact female snow leopard (Uncia uncia) was evaluated for progressive apathy, lethargy, and decreased appetite. Cardiac auscultation revealed a left basal grade IV/VI systolic ejection murmur, and an echocardiogram confirmed a severe pulmonic valvular stenosis (pressure gradient of 98 mm Hg). The lesion was managed by balloon valvuloplasty, resulting in a marked pressure gradient reduction (30 mm Hg). The cat recovered well, and clinical signs resolved. This is the first description of a pulmonary valve stenosis and management with balloon valvuloplasty in a wild felid.

  20. National Report France: The French Balloon Programme 2013-2016 (United States)

    Dubourg, V.; Vassaux, D.; Vargas, A.; Cocquerez, P.; Louvel, S.; Douchin, F.; Saccocio, M.; Mirc, F.


    With over 50 years' experience in the field, the French Centre National dEtudes Spatiales (CNES) goes on supporting a significant scientific ballooning program. In particular so because balloons still give a unique access to near space science. Over the past 6 years, most of the systems, beginning by the Zero Pressure Balloons, had to be renewed to comply with more stringent Safety constraints and to growing performance and reliability requirements from the scientific missions. This paper will give an overview of the CNES new capabilities and services for operational balloon activities, and their availability status. The scientific launch campaigns of the past two years will be presented. A focus will be made on the results of the Stratoscience 2014 flight campaign from Timmins, Ontario, using the NOSYCA command and control system for zero pressure balloons, qualified in 2013. The ChArMEx campaign (Chemistry-AeRosol Mediterranean Experiment) performed in 2013 from the Baleares islands and from the south of France, with Boundary Layer Pressurized Balloons will also be presented as well as the LOAC-VOLTAIRE experiment, carried out from Aire-sur-l'Adour (France), through the flights of 20 instrumented light expandable balloons. An outlook of the new stratospheric long duration flight systems currently studied at CNES will be given. The scientific launch campaigns and the main payloads in the study for the near future will also be presented.

  1. A Survey of Titan Balloon Concepts and Technology Status (United States)

    Hall, Jeffery L.


    This paper surveys the options for, and technology status of, balloon vehicles to explore Saturn's moon Titan. A significant amount of Titan balloon concept thinking and technology development has been performed in recent years, particularly following the spectacular results from the descent and landing of the Huygens probe and remote sensing observations by the Cassini spacecraft. There is widespread recognition that a balloon vehicle on the next Titan mission could provide an outstanding and unmatched capability for in situ exploration on a global scale. The rich variety of revealed science targets has combined with a highly favorable Titan flight environment to yield a wide diversity of proposed balloon concepts. The paper presents a conceptual framework for thinking about balloon vehicle design choices and uses it to analyze various Titan options. The result is a list of recommended Titan balloon vehicle concepts that could perform a variety of science missions, along with their projected performance metrics. Recent technology developments for these balloon concepts are discussed to provide context for an assessment of outstanding risk areas and technological maturity. The paper concludes with suggestions for technology investments needed to achieve flight readiness.

  2. Pneumatic impression: Improving dental arch impression with an inflatable balloon. (United States)

    Gupta, Lokendra


    The purpose of this impression technique is to overcome the problem associated with restricted mouth opening in association with high arched palate by employing pneumatic impression technique using latex balloon. A stock tray was modified with auto polymerizing acrylic resin. On the modified tray, a latex balloon was attached with aid of cyanoacrylate. The outlet of the balloon was then connected to a clinical sphygmomanometer bulb with the rubber pipe for air passage which would aid in inflating the balloon. The prepared tray assembly was then equipped for recording the impression. An adequate amount of addition polysiloxane impression material, sufficient to cover the entire area of the balloon was loaded onto the tray. The balloon was then inflated with the help of a sphygmomanometer bulb which transferred the air only in one direction. On completion of setting time of the impression material, the air pressure was relieved by deflating of balloon which helped in the easy removal of the impression. The impression was subsequently removed from the oral cavity and disinfected. This novel technique was helpful for recording impression in patients presenting with restricted mouth opening and high arched palate.

  3. The Falcon(TM) eccentric coronary balloon angioplasty catheter : A randomized safety and efficacy study

    NARCIS (Netherlands)

    Qureshi, N; denHeijer, P; vanBoven, AJ; Tio, R; deKam, PJ; Crijns, HJGM


    Percutaneous coronary angioplasty (PTCA) is usually performed using concentric shaped balloon catheters with the guidewire passing through the center of the shaft. The Falcon(TM) balloon catheter features a guide wire lumen on the outside of the balloon so that an eccentric balloon catheter profile

  4. SU-E-T-257: Development of a New Endorectal Balloon with An Unfoldable Radiochromic Film for In-Vivo Rectal Dosimetry During Prostate Cancer Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Jeang, E; Lim, Y; Cho, K; Hwang, U; Jeong, J; Kim, H; Kim, S; Lee, S; Shin, D; Park, J; Kim, J [National Cancer Center, Goyang-si, Gyeonggi-do (Korea, Republic of); Kwak, J [Asan Medical Center, Seoul (Korea, Republic of); Choi, S [Korea institute of Radiological and Medical Sciences, Seoul (Korea, Republic of)


    Purpose: We developed an endorectal balloon for in-vivo rectal dosimetry in two-dimensions, and evaluated its dosimetric properties for the radiation treatment of prostate cancer. Methods: The endorectal balloon for in-vivo rectal dosimetry is equipped with a radiochromic film so that two-dimensional dose distribution can be measured in the rectal wall. The film is unrolled as the balloon is inflated, and it is rolled as the balloon is deflated. The outer diameter of the balloon is about 14 mm before inflating it, but its outer diameter can be increased up to about 50 mm after inflating it with 80 ml distilled water. The size of the film is 80(L) x 64(W) mm2, so large as to measure a dose distribution of an anterior half of the rectal wall. After it was inserted into a fabricated rectal phantom, the phantom was scanned by a CT scanner and 5 Gy was delivered to a target inside the phantom with a 15 MV photon beam in AP direction. Finally, the dose distribution measured in the endorectal balloon was compared with that of the treatment plan. Results: The two dose distributions were compared each other in the parallel and the perpendicular directions along an axis of the balloon. The two dose profiles analyzed from the radiochromic film agreed well with the plan within 3% for 15 MV photon beam. Conclusion: An endorectal balloon for two-dimensional in-vivo rectal dosimetry was developed and its dosimetric effectiveness was evaluated for the radiation treatment of prostate cancer. The measured dose distributions showed good agreement with the plans.

  5. Support of AFGL Balloon Telemetry System. (United States)


    exception. The capabilities of the system can now logically occur to keep pace with the ever increasing sophistication of balloon bourne instrumentation. The...8217 I’kL m)J1)t Cr fac (A a Ciso ilUded in theI L蓑 llt (2i II i11t C for da&1t al 0 og Yi n1g ari1d pr1-o g ramIl ex chan1ge riled a. TheC (𔃺niJILtt’l...there are some ozenera I areajs which are felt to be logical and necessary advance- inents in the system cap~abilities: * Implement a computer based

  6. Management of intra-aortic balloon pumps. (United States)

    Webb, Christopher A-J; Weyker, Paul D; Flynn, Brigid C


    Intra-aortic balloon pumps (IABPs) continue to be the most widely used cardiac support devices with an annual estimate of 200 000 IABPs placed worldwide. IABPs enhance myocardial function by maximizing oxygen supply and minimizing oxygen demand. The use of IABPs is not without risk, with major vascular injury, ischemia, and infection being the most common complications, especially in high-risk patients. While recent studies have questioned the use of IABPs in patients with cardiogenic shock secondary to myocardial infarction, these studies have limitations making it difficult to formulate definitive conclusions. This review will focus on the mechanisms of counterpulsation, the management of IABPs and the evidence supporting this ventricular support therapy. © The Author(s) 2014.

  7. The use of double-balloon enteroscopy in retrieving mucosal biopsies from the entire human gastrointestinal tract

    DEFF Research Database (Denmark)

    Rhee, Nicolai Alexander; Vilmann, Peter; Hassan, Hazem


    OBJECTIVE: The aim of this explorative study was to evaluate double-balloon enteroscopy (DBE) as a new tool for collecting mucosal biopsies from well-defined parts of the entire small and large bowel in patients with type 2 diabetes and in matched healthy subjects. MATERIAL AND METHODS: Twelve...

  8. Management of Intra-Aortic Balloon Pump Entrapment (United States)

    Fitzmaurice, Gerard J.; Collins, Anton; Parissis, Haralambos


    An intra-aortic balloon pump is one of the most valuable tools in the cardiac surgeon's armament to assist in the management of the failing heart. Despite its widespread use, there are associated risks and complications, one of which is balloon rupture with associated entrapment. Numerous approaches for dealing with this complication have been described; here we review the previous experience with intra-aortic balloon pump entrapment and discuss potential management, with particular reference to a recent case of our own. PMID:23109753

  9. Intragastric balloon for morbid obesity causing chronic gastric dilatation

    Energy Technology Data Exchange (ETDEWEB)

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


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

  10. Controlled meteorological (CMET) balloon profiling of the Arctic atmospheric boundary layer (United States)

    Roberts, Tjarda; Hole, Lars; Voss, Paul


    profiling the free atmosphere and atmospheric boundary layer in remote regions such as the Arctic, where few other in-situ observations are available to trace processes and for model evaluation. References: Roberts, T. J., Dütsch, M., Hole, L. R., and Voss, P. B.: Controlled meteorological (CMET) free balloon profiling of the Arctic atmospheric boundary layer around Spitsbergen compared to ERA-Interim and Arctic System Reanalyses. Atmos. Chem. Phys., 16, 12383-12396, doi:10.5194/acp-16-12383-2016, 2016. Hole L. R., Bello A. P., Roberts T. J., Voss P. B., Vihma T.: Measurements by controlled meteorological balloons in coastal areas of Antarctica. Antarctic Science, 1-8, doi:10.1017/S0954102016000213, 2016. Voss P. B., Hole L. R., Helbling E. F., Roberts T. J.: Continuous in-situ soundings in the arctic boundary layer: a new atmospheric measurement technique using controlled meteorological balloons. Journal of Intelligent Robot Systems, 70, 609-617, doi 10.1007/s10846-012-9758-6, 2013.

  11. The Role of Balloon Sinuplasty in the Treatment of Vacuum Rhinogenic Headache. (United States)

    Marzetti, A; Mazzone, S; Tedaldi, M; Topazio, D; Passali, F M


    In this study we tried to demonstrate how balloon sinuplasty could be an option in the treatment of the Rhinogenic Headache due to a probably disventilation of frontal sinus recess. 107 patients were included in the study with diagnosis of Rhinogenic Headache. The surgical group underwent bilateral balloon sinuplasty of the frontal sinus. The medical group underwent pharmacological treatment. Headaches characteristics were evaluated by a clinical personal diary. The severity was recorded by Visual Analog Scale 4 and 8 months after treatment. 98 out of 107 patients completed the protocol. In surgical group and in medical one the mean headache score improved at four and eight months follow up. The headache frequency attacks per month decrease from a preoperative frequency of 18 (±4 SD) in surgical group and 17 (±3 SD) in medical group to 3 (±1 SD) and 6 (±3 SD) respectively at 4 months control but increased slightly to 5 (±2 SD) and 12 (±4 SD) after 8 months. We concluded that the balloon sinuplasty should be considered as an effective alternative option after an accurate selection of surgical candidates. However, it is important a 6-8 month follow-up to evaluate the efficacy and stability of the treatment used.

  12. [MDCT after balloon kyphoplasty: analysis of vertebral body architecture one year after treatment of osteoporotic fractures]. (United States)

    Röhrl, B; Sadick, M; Brocker, K; Brade, J; Voggenreiter, G; Obertacke, U; Düber, C


    To evaluate the value of MDCT in the monitoring of vertebral body architecture after balloon kyphoplasty and observe morphological changes of the vertebral body. During a period of 26 months, 66 osteoporotic fractures of the vertebral bodies were treated with percutanous balloon kyphoplasty. The height of the vertebral body, width of spinal space, sagittal indices, kyphosis und COBB angle, and cement leakage were evaluated by computed tomography before and after treatment and in a long-term follow up. Statistical analysis was performed by calculating quantitative constant parameters of descriptive key data. In addition, parametric and distribution-free procedures were performed for all questions. After kyphoplasty, the treated vertebral bodies showed a significant gain in the height of the leading edge (0.15 cm; p architecture after treatment with balloon kyphoplasty. Morphological changes in the vertebral bodies, and complications such as pallacos leakage and progression of osteoprosis can be accurately documented. The significant increase in the vertebral body height after treatment is closely correlated with a gain in the sagittal index and reduced kyphosis and COBB angle.

  13. Balloon-Expandable Stent Graft for Treating Uretero-Iliac Artery Fistula

    Energy Technology Data Exchange (ETDEWEB)

    Guntau, Moritz, E-mail: [Philipps University, Department of Diagnostic and Interventional Radiology, Marburg University Hospital (Germany); Hegele, Axel [Philipps University, Department of Urology and Pediatric Urology, Marburg University Hospital (Germany); Rheinheimer, Stephan [Philipps University, Department of Diagnostic and Interventional Radiology, Marburg University Hospital (Germany); Hofmann, Rainer [Philipps University, Department of Urology and Pediatric Urology, Marburg University Hospital (Germany); Mahnken, Andreas H. [Philipps University, Department of Diagnostic and Interventional Radiology, Marburg University Hospital (Germany)


    PurposeTo evaluate the safety, efficacy and outcome of percutaneous balloon-expandable covered stent graft placement for uretero-iliac artery fistula (UAF) treatment.MethodsThis retrospective study evaluated the single-center experience of percutaneous balloon-expandable covered stent graft placement (ADVANTA™, Atrium Hudson, NH, USA) in UAF. Data were obtained from a prospective institutional database. Patient follow-up included complications, symptoms recurrence and mortality rate.ResultsTen UAFs in eight patients (3 males; 5 females) with a mean age of 64.5 (35–77) years were identified. All patients had a history pelvic malignancy, extirpative surgery (n = 6), long-term ureteral stenting (n = 7) and pelvic radiation (n = 5). All procedures were completed successfully without complications. Thirty-day mortality rate was zero. At a median follow-up of 6 (1–60) months, one patient suffered recurrent hematuria requiring a secondary stent graft placement 26 months after the initial treatment. During follow-up, five patients died of the underlying disease (43, 66, 105, and 183 and 274 days after the last procedure).ConclusionPercutaneous balloon-expandable stent graft placement in UAF is a safe and effective treatment option. Implantation of stent grafts should be considered as treatment of choice in UAF.

  14. [Results of percutaneous mitral balloon commissurotomy in pregnant women about 12 cases]. (United States)

    Zairi, I; Mzoughi, K; Mroua, F; Ben Moussa, F; Amri, I; Kammoun, S; Fennira, S; Kraiem, S


    Mitral stenosis (MS) is the most common valvular heart disease revealed or exacerbated by pregnancy. Percutaneous mitral balloon commissurotomy (PMC) is currently the treatment of choice when mitral valve morphology is favorable. The purpose of this study is to evaluate the immediate, medium and long term results of percutaneous mitral balloon commissurotomy in pregnant women with a severe symptomatic mitral stenosis despite medical treatment. It is a retrospective study including 12 pregnant patients diagnosed with severe mitral stenosis and hospitalized in the cardiology department of Habib Thameur hospital between 1994 and 2014. A clinical and ultrasonographic monitoring was performed for over 15 years. Mean patients age was 31.5±4.4 years. All patients were in NYHA class III or IV despite medical treatment. Mitral regurgitation was rated as moderate in four cases. Functional improvement was observed in all cases immediately after the procedure. Mitral valve area increased from 1.02±0.5cm 2  averaged to 2±0.35cm 2 . Mitral regurgitation increased in three cases and appeared in two cases. All patients delivered at term. Newborns were all healthy. Two of them had a low birth weight. On the long term follow-up (95.58±64.1 months), five patients had mitral restenosis: two had a surgical valve replacement and three underwent a second percutaneous mitral balloon commissurotomy. The effectiveness of the percutaneous mitral balloon commissurotomy is clearly documented by clinical and echocardiographic evaluation. In the case of pregnancy, the goal is not so much to obtain an optimal result but to cause hemodynamic improvement authorizing the continuation of pregnancy and childbirth. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  15. TU-AB-201-07: Image Guided Endorectal HDR Brachytherapy Using a Compliant Balloon Applicator

    Energy Technology Data Exchange (ETDEWEB)

    Cohen, G; Goodman, K [Memorial Sloan Kettering Cancer Center, New York, NY (United States)


    Purpose: High dose rate endorectal brachytherapy is an option to deliver a focal, high-dose radiotherapy to rectal tumors for patients undergoing non-operative management. We investigate a new multichannel, MR compatible applicator with a novel balloon-based design to provide improved treatment geometry. We report on the initial clinical experience using this applicator. Methods: Patients were enrolled on an IRB-approved, dose-escalation protocol evaluating the use of the anorectal (AR-1) applicator (Ancer Medical, Hialeah, FL), a multichannel applicator with two concentric balloons. The inner balloon supports 8 source lumens; the compliant outer balloon expands to separate the normal rectal wall and the source lumens, yet deforms around a firm, exophytic rectal mass, leading to dose escalation to tumor while sparing normal rectum. Under general anesthesia, gold fiducial markers were inserted above and below the tumor, and the AR applicator was placed in the rectum. MRI-based treatment plans were prepared to deliver 15 Gy in 3 weekly fractions to the target volume while sparing healthy rectal tissue, bladder, bowel and anal muscles. Prior to each treatment, CBCT/Fluoroscopy were used to place the applicator in the treatment position and confirm the treatment geometry using rigid registration of the CBCT and planning MRI. After registration of the applicator images, positioning was evaluated based on the match of the gold markers. Results: Highly conformal treatment plans were achieved. MR compatibility of the applicator enabled good tumor visualization. In spite of the non-rigid nature of the applicators and the fact that a new applicator was used at each treatment session, treatment geometry was reproducible to within 2.5 mm. Conclusions: This is the first report on using the AR applicator in patients. Highly conformal plans, confidence in MRI target delineation, in combination with reproducible treatment geometry provide encouraging feedback for continuation with

  16. Randomized and prospective trial comparing tract creation using plasma vaporization with balloon dilatation in percutaneous nephrolithotomy. (United States)

    Chiang, Po Hui; Su, Hsin Hao


    WHAT'S KNOWN ON THE SUBJECT? AND WHAT DOES THE STUDY ADD?: Use of balloon dilatation leads to less blood transfusion rates than metallic dilators. Plasma vaporization leads to less blood loss than balloon dilatation in this study. The study evaluates a novel technique for the creation of a nephrostomy tract for PCNL. Compared with other techniques, plasma vaporization is a safer procedure that causes lesser blood loss, requires a shorter hospital stay, causes less radiation exposure, and enables easier nephrostomy tract creation for PCNL. To evaluate the efficacy and safety of plasma vaporization for tract creation in percutaneous nephrolithotomy (PCNL). In this randomized prospective trial we enrolled 65 patients and assigned each to one of two groups: 33 patients were randomly scheduled to undergo plasma vaporization and 32 were scheduled to undergo balloon dilatation for tract creation. A bipolar resectoscope mounted with a plasma vaporization button electrode or a traditional balloon dilator were used to create the nephrostomy tract. The mean blood loss, mean length of hospital stay and mean operating time, stone-free rates and postoperative complications in the two groups were compared using the t-test or chi-squared test (Fisher's exact test). The plasma vaporization group had a significantly lower mean (SD) decrease in haematocrit level (3.5 [2.8]% vs 6.6 [3.3]%; P = 0.02) and a shorter mean (SD) hospital stay (2.6 [1.2] days vs 5.3 [3.4] days; P = 0.0). There were no significant differences in the operating time, stone-free rate or cases of postoperative fever between the two groups. The plasma vaporization technique is safe, leads to less blood loss than the other techniques, and is a simple solution for creating the nephrostomy tract for PCNL. © 2012 BJU International.

  17. Preoperative weight loss by intragastric balloon in super-obese patients treated with laparoscopic gastric banding: a case-control study. (United States)

    Busetto, Luca; Segato, Gianni; De Luca, Maurizio; Bortolozzi, Enzo; MacCari, Tommaso; Magon, Alessandro; Inelmen, Eminé Meral; Favretti, Franco; Enzi, Giuliano


    The authors investigated the usefulness of preoperative treatment with the BIB intragastric balloon in super-obese patients before undergoing laparoscopic adjustable gastric banding (LAGB). The case-control study involved 43 case patients treated with the intragastric balloon followed by LAGB ("Case" group) and 43 sex-, age- and BMI-matched historical controls treated with LAGB alone. Mean length of the intragastric balloon treatment was 164.4+/-39.7 days, with a fill volume of 609+/-95 ml. Total complication rate with balloon was 7.0% and percent excess weight loss (%EWL) was 26.1 +/- SD 9.3 %. At the time of gastric band placement, both operative time and hospital stay were shorter in patients treated previously with the balloon (Case group) than in the Control group patients. No Case patients required conversion to open surgery or had intraoperative complications. In the Control group, the rate of conversion was 16.3% (P<0.05) and the rate of intraoperative complications was 7.0%. Postoperative follow-up length was 1.1+/-1.0 years in Case patients and 4.4+/-1.8 years in Control patients (P<0.001). The %EWL produced by the intragastric balloon in the Case patients was identical to the %EWL observed in the first 6 months after LAGB in the Control group (26.1+/-9.3 vs 25.3+/-12.4%). %EWL 6 months after banding was higher in the Case patients than in Controls (33.6+/-12.5 vs 25.3+/-12.4%, P<0.01). However, no significant difference in %EWL between the two groups was observed at the subsequent postoperative evaluations. Preoperative treatment with the intragastric balloon reduced the risk of conversion to open surgery and the risk of intraoperative complications in super-obese patients treated with LAGB. Preoperative treatment with the intragastric balloon did not change the total weight loss after LAGB.

  18. SU-E-T-281: Reduction of Treatment Times in CyberKnife Prostate SBRT Using a Water Filled Rectal Balloon

    Energy Technology Data Exchange (ETDEWEB)

    Desai, P; Caroprese, B; McKellar, H [East Texas Medical Center, Tyler, TX (United States)


    Purpose: To illustrate 25% reduction in CyberKnife prostate SBRT treatment times using a water filled rectal balloon. Methods: We perform prostate SBRT using a 3800cGy in 4 fraction regimen prescribed between 51% 59% iso-dose lines to 95% of PTV using a CyberKnife System. The resultant heterogeneous dosimetry is analogous to HDR dosimetry. Our patients are treated in a feet first supine position to decrease treatment couch sag and also to position the prostate anatomy closer to the robot. CT imaging is performed with a Radiadyne Immobiloc rectal balloon filled with 45-50cc water placed firmly inside the patient's rectum. A treatment plan is developed from this CT study using Multiplan. The patient is treated every other day for 4 days using the rectal balloon for each fraction. Gold fiducials previously implanted inside the prostate are used for tracking by the CyberKnife system. Results: Critical structures comprise the usual GU anatomy of bladder, rectum, urethra, femoral-heads along with emphasis on doses to anterior rectal wall and rectal mucosa. The water filled rectal balloon localizes the rectum, which enables the physician to accurately contour both anterior rectal wall, and rectal mucosa. The balloon also has a gas release valve enabling better patient comfort. Rectum localization enables the CyberKnife system to make fewer corrections resulting in fewer treatment interruptions and time lost to re-adjustment for rectal motion, bowel filling and gas creation. Effective treatment times are reduced by 25% to approximately 45 minutes. Adoption of the balloon has required minimal change to our planning strategy and plan evaluation process. Conclusion: Patient follow-up comparisons show no difference in effectiveness of treatment with and without balloons We conclude that rectal balloons enhance patient comfort and decrease effective treatment times.

  19. 10 meter Sub-Orbital Large Balloon Reflector (LBR) Project (United States)

    National Aeronautics and Space Administration — Besides serving as a launch vehicle, the carrier balloon provides a stable mount for the enclosed telescope. Looking up, the LBR will serve as a telescope. Looking...

  20. SMEX02 Balloon-borne Radiosonde Data, Iowa (United States)

    National Aeronautics and Space Administration — This data set includes radiosonde measurements of upper air temperature and pressure, relative humidity, and wind direction and speed during the balloons' ascent to...

  1. Current status of intragastric balloon for obesity treatment. (United States)

    Kim, Seung Han; Chun, Hoon Jai; Choi, Hyuk Soon; Kim, Eun Sun; Keum, Bora; Jeen, Yoon Tae


    Endoscopic bariatric therapy may be a useful alternative to pharmacological treatment for obesity, and it provides greater efficacy with lower risks than do conventional surgical procedures. Among the various endoscopic treatments for obesity, the intragastric balloon is associated with significant efficacy in body weight reduction and relief of comorbid disease symptoms. Anatomically, this treatment is based on gastric space-occupying effects that increase the feeling of satiety and may also affect gut neuroendocrine signaling. The simplicity of the intragastric balloon procedure may account for its widespread role in obesity treatment and its applicability to various degrees of obesity. However, advances in device properties and procedural techniques are still needed in order to improve its safety and cost-effectiveness. Furthermore, verification of the physiological outcomes of intragastric balloon treatment and the clinical predictive factors for treatment responses should be considered. In this article, we discuss the types, efficacy, safety, and future directions of intragastric balloon treatment.

  2. Experimental study of aerosol deposition in pulsating balloon structures. (United States)

    Yue, G; Fadl, A; Barek, T; Zhang, Z; Major, J


    In this study, aerosol depositions within pulsating balloon structures are investigated. Cyclical motion of expansion and contraction of the balloon models are controlled by varying the surrounding vacuum pressures inside the air chamber. Balloons of various configurations are used to induce the air flows as well as to collect the deposited particles. The non-uniform distribution patterns of particle deposition inside the models are measured by fluorescence spectrophotometer. Different airflow rates are investigated. The objective of this study is to qualitatively investigate the phenomena of enhanced particle local deposition in pockets with moving wall conditions. It has been observed in the experiments that a particle deposition "hot spot" exists at the entrance of balloon model for almost all flow rates covered in the study and the moving boundary flow enhances the aerosol deposition significantly.

  3. Balloon valvuloplasty for severe mitral valve stenosis in pregnancy

    African Journals Online (AJOL)

    . Commerford, B. Levetan. Balloon Valvuloplasties for severe mitral stenosis were performed on 11 ... 140 patients each year with cardiac disease - an incidence of 0.5%. ... Department of Medicine, Groote Schuur Hospital and University of.

  4. Development of Venus Balloon Seismology Missions Through Earth Analog Experiments (United States)

    Krishnamoorthy, S.; Komjathy, A.; Cutts, J. A.; Pauken, M. T.; Garcia, R. F.; Mimoun, D.; Jackson, J. M.; Kedar, S.; Smrekar, S. E.; Hall, J. L.


    The study of a planet’s seismic activity is central to the understanding of its internal structure. We discuss advances made through Earth analog testing for performing remote seismology on Venus using balloons floated in the mid-atmosphere.

  5. Puerperal uterine inversion managed by the uterine balloon ...

    African Journals Online (AJOL)

    Puerperal uterine inversion managed by the uterine balloon tamponade. Mariétou Thiam, Mouhamadou Mansour Niang, Lamine Gueye, Fatou Rachel Sarr, Marie Edouard Faye Diémé, Mamadou Lamine Cissé ...

  6. Balloon Pump with Floating Valves for Portable Liquid Delivery

    Directory of Open Access Journals (Sweden)

    Yuya Morimoto


    Full Text Available In this paper, we propose a balloon pump with floating valves to control the discharge flow rates of sample solutions. Because the floating valves were made from a photoreactive resin, the shapes of the floating valves could be controlled by employing different exposure patterns without any change in the pump configurations. Owing to the simple preparation process of the pump, we succeeded in changing the discharge flow rates in accordance with the number and length of the floating valves. Because our methods could be used to easily prepare balloon pumps with arbitrary discharge properties, we achieved several microfluidic operations by the integration of the balloon pumps with microfluidic devices. Therefore, we believe that the balloon pump with floating valves will be a useful driving component for portable microfluidic systems.

  7. SMEX02 Balloon-borne Radiosonde Data, Iowa, Version 1 (United States)

    National Aeronautics and Space Administration — This data set includes radiosonde measurements of upper air temperature and pressure, relative humidity, and wind direction and speed during the balloons' ascent to...

  8. Low Cost Variable Conductance Heat Pipe for Balloon Payload Project (United States)

    National Aeronautics and Space Administration — While continuously increasing in complexity, the payloads of terrestrial high altitude balloons need a thermal management system to reject their waste heat and to...

  9. A comparison of Loon balloon observations and stratospheric reanalysis products

    National Research Council Canada - National Science Library

    Friedrich, Leon S; McDonald, Adrian J; Bodeker, Gregory E; Cooper, Kathy E; Lewis, Jared; Paterson, Alexander J


      Location information from long-duration super-pressure balloons flying in the Southern Hemisphere lower stratosphere during 2014 as part of X Project Loon are used to assess the quality of a number...

  10. Absence of Bacteria on Coronary Angioplasty Balloons from Unselected Patients

    DEFF Research Database (Denmark)

    Hansen, Gorm Mørk; Nilsson, Martin; Nielsen, Claus Henrik


    , and translocation of bacteria from the oral cavity to the coronary arteries may play a role in the development of coronary artery disease. Very few studies have used angioplasty balloons for in vivo sampling from diseased coronary arteries, and with varying results. Therefore, the aim of this study was to assess...... if bacterial DNA from primarily oral bacteria could be detected on coronary angioplasty balloons by use of an optimized sampling process combined with an internally validated sensitive polymerase chain reaction (PCR) assay. Coronary angioplasty balloons and control samples from a total of 45 unselected...... and purification steps, and demonstration of sensitivity levels of 25-125 colony forming units (CFU), we did not detect bacterial DNA from any of the coronary angioplasty balloons. A subsequent questionnaire indicated that the prevalence of periodontitis in the study cohort was at least 39.5%. Although coronary...

  11. Characterising argon-bomb balloons for high-speed photography

    CSIR Research Space (South Africa)

    Olivier, M


    Full Text Available -1 SABO 2013 TME Workshop Alkantpan Characterising Argon-bomb balloons for High-speed Photography M Olivier and FJ Mostert Landward Sciences, Defence Peace Safety and Security, CSIR, Meiring Naude Road, Pretoria, RSA. Abstract A...

  12. Relationship between biomarkers and subsequent clinical and angiographic restenosis after paclitaxel-eluting stents for treatment of STEMI: a HORIZONS-AMI substudy

    NARCIS (Netherlands)

    Claessen, Bimmer E.; Stone, Gregg W.; Mehran, Roxana; Witzenbichler, Bernhard; Brodie, Bruce R.; Wöhrle, Jochen; Witkowski, Adam; Guagliumi, Giulio; Zmudka, Krzysztof; Henriques, José P. S.; Tijssen, Jan G. P.; Sanidas, Elias A.; Chantziara, Vasiliki; Hakim, Diaa; Leon, Selene; Xu, Ke; Dangas, George D.


    Drug-eluting stents (DES) reduce the incidence of in-stent restenosis (ISR) after primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). Whether the use of biomarkers might be of utility to identify patients who remain at risk for DES ISR after primary PCI

  13. Intravascular ultrasound assessment of expansion of the sirolimus-eluting (cypher select) and Paclitaxel-eluting (taxus express-2) stent in patients with diabetes mellitus

    DEFF Research Database (Denmark)

    Jensen, Lisette Okkels; Maeng, Michael; Mintz, Gary S


    Patients with diabetes have a higher risk for in-stent restenosis after coronary stent implantation. Drug-eluting stents (DES) are highly effective in reducing in-stent restenosis. Once neointimal hyperplasia is suppressed with DES, the impact of stent underexpansion becomes magnified. The aim of...

  14. Intravascular ultrasound assessment of expansion of the sirolimus-eluting (Cypher Select) and paclitaxel-eluting (Taxus Express-2) stent in patients with diabetes mellitus

    DEFF Research Database (Denmark)

    Jensen, L.O.; Maeng, M.; Mintz, G.S.


    Patients with diabetes have a higher risk for in-stent restenosis after coronary stent implantation. Drug-eluting stents (DES) are highly effective in reducing in-stent restenosis. Once neointimal hyperplasia is suppressed with DES, the impact of stent underexpansion becomes magnified. The aim of...

  15. Small Research Balloons in a Physics Course for Education Majors (United States)

    Bruhweiler, F. C.; Verner, E.; Long, T.; Montanaro, E.


    At The Catholic Univ. of America, we teach an experimental physics course entitled Physics 240: The Sun-Earth Connection, which is designed for the undergraduate education major. The emphasis is on providing hands-on experience and giving the students an exciting experience in physics. As part of this course, in the Spring 2013 semester, we instituted a project to plan, build, launch, and retrieve a small (~1.3 kg) research balloon payload. The payload flown was a small GPS unit that sent its position to an Internet site, a small wide-angle high-resolution video camera, and an analog refrigerator thermometer placed in the field of view of the camera. All data were stored on the camera sim-card. Students faced the problems of flying a small research balloon in the congested, densely populated Northeast Corridor of the US. They used computer simulators available on the Web to predict the balloon path and flight duration given velocities for the Jet Stream and ground winds, as well as payload mass and amount of helium in the balloon. The first flight was extremely successful. The balloon was launched 140 km NW of Washington DC near Hagerstown, MD and touched down 10 miles (16 km) NW of York, PA, within 1.6 km of what was predicted. The balloon reached 73,000 ft (22,000 m) and the thermometer indicated temperatures as low as -70 degrees Fahrenheit (-57 C) during the flight. Further balloon flights are planned in conjunction with this course. Additional exercises and experiments will be developed centered around these flights. Besides learning that science can be exciting, students also learn that science is not always easily predictable, and that these balloon flights give an understanding of many of problems that go into real scientific space missions. This project is supported in part by an educational supplement to NASA grant NNX10AC56G

  16. Prospects for infrasound bolide detections from balloon-borne platforms (United States)

    Young, Eliot; Bowman, Daniel; Arrowsmith, Stephen; Boslough, Marc; Klein, Viliam; Ballard, Courtney; Lees, Jonathan


    We report on an experiment to assess whether balloon-borne instruments can improve sensitivities to bolides exploding in the Earth's atmosphere (essentially using the atmosphere as a witness plate to characterize the small end of the NEO (Near Earth Object) population). The CTBTO's infrasound network regularly detects infrasound disturbances caused by bolides, including the 15-FEB-2013 Chelybinsk impact. Balloon-borne infrasound sensors should have two important advantages over ground-based infrasound stations: there should be virtually no wind noise on a free-floating platform, and a sensor in the stratosphere should benefit from its location within the stratospheric duct. Balloon-borne sensors also have the disadvantage that the amplitude of infrasound waves will decrease as they ascend with altitude. To test the performance of balloon-borne sensors, we conducted an experiment on a NASA high altitude (35 km) balloon launched from Ft Sumner, NM on 28-SEP-2016. We were able to put two independent infrasound payloads on this flight. We arranged for three 3000-lb ANFO explosions to be detonated from Socorro, NM at 12:00, 14:00 and 16:29:59 MST. The first two explosions were detected from the NASA balloon, with the first explosion showing three separate waveforms arriving within a 25-s span. The peak-to-peak amplitude of the waveforms was about 0.06 Pa, and the cleanest microphone channel detected this waveform with an SNR greater than 20. A second balloon at 15 km altitude also detected the second explosion. We have signals from a dozen ground stations at various positions from Socorro to Ft Sumner. We will report on wave propagation models and how they compare with observations from the two balloons and the various ground-stations.

  17. The Hubble party balloon and the expanding universe (United States)

    Zendri, G.; Rosi, T.; Oss, S.


    We show that the metaphor of the inflated balloon used to describe expanding space-time according to the Hubble law can be transformed into a simple laboratory experiment. We obtain, in terms of measured recession speeds and distances of ink dots drawn on a party balloon, easy renditions of various cosmological models, such as the static one and the Einstein-De Sitter universe.

  18. Introduction (Special Issue on Scientific Balloon Capabilities and Instrumentation) (United States)

    Gaskin, Jessica A.; Smith, I. S.; Jones, W. V.


    In 1783, the Montgolfier brothers ushered in a new era of transportation and exploration when they used hot air to drive an un-tethered balloon to an altitude of 2 km. Made of sackcloth and held together with cords, this balloon challenged the way we thought about human travel, and it has since evolved into a robust platform for performing novel science and testing new technologies. Today, high-altitude balloons regularly reach altitudes of 40 km, and they can support payloads that weigh more than 3,000 kg. Long-duration balloons can currently support mission durations lasting 55 days, and developing balloon technologies (i.e. Super-Pressure Balloons) are expected to extend that duration to 100 days or longer; competing with satellite payloads. This relatively inexpensive platform supports a broad range of science payloads, spanning multiple disciplines (astrophysics, heliophysics, planetary and earth science.) Applications extending beyond traditional science include testing new technologies for eventual space-based application and stratospheric airships for planetary applications.

  19. [Latex covering and mechanical analysis of balloon expandable stents]. (United States)

    Marty, B; von Segesser, L K; Carrel, T; Turina, M


    To the moment a few stents of metallic coils or meshes are available with a sealing coverage. In the present study balloon-expandable stents have been covered with a thin layer of natural rubber latex. The physical properties of these impervious stents were compared to the conventional stents. The expansion, the loss of expansion and the deformity during and after balloon inflation have been analyzed. In the pressure zone of 4-6 bar the mechanical characteristics of the impervious stents were similar to the conventional stents. The stents were expanded at 100% related on the balloon diameter used for expansion. Additional pressure of 1 bar was necessary to expand the impervious stents. At balloon pressure below 4 bar the stents tied the balloons in the midzone. The impervious stents, expanded at 6, 8 and 10mm, underwent a loss of expansion of 10% after withdrawal of the balloons. Their configuration was barrel-shaped (4% central enlargement) due to the latex rubber, constricting the wire meshes at both ends. These preliminary results are encouraging and allow further investigations.

  20. Bakri balloon in vaginal-perineal hematomas complicating vaginal delivery: a new therapeutic approach. (United States)

    Gizzo, Salvatore; Saccardi, Carlo; Patrelli, Tito Silvio; Di Gangi, Stefania; D'Antona, Donato; Battista Nardelli, Giovanni


    The study aimed to evaluate the effectiveness of Bakri balloon as a hemostatic device in severe postpartum hemorrhage due to complicated vaginal-perineal hematoma not responsive to standard surgical treatments. The article discusses an effective and minimally invasive technique for resolving a case of massive vaginal-perineal bleeding after vaginal delivery complicated by ischiorectal fossa hematoma. A 36-year-old primipara white woman, 41 weeks 1 day pregnant, was admitted to our unit for beginning of labor. She experienced a precipitous delivery of a healthy male baby (3.72 kg, 51 cm in length), and spontaneous complete afterbirth of placenta and membranes. The intervention involved positioning of an hemostatic Bakri balloon device in the vagina, to compress the vaginal wall, ensuring that the draining apex was well positioned into the uterine cervix. The patient was discharged after having a puerperal course without further complications. Vaginal hemostatic Bakri balloon device shows hemostatic efficacy immediately assessable, is promptly removable, not interfering with subsequent surgical or radiological procedures, does not increase the risk of infections as other compressive procedures, allows flow of lochia, does not cause pain or discomfort in women, and permits adjustable compression when a drainage is placed during surgery. Despite the high cost, it does not show disadvantages.

  1. Segmentation of pituitary adenoma: a graph-based method vs. a balloon inflation method. (United States)

    Egger, Jan; Zukić, Dženan; Freisleben, Bernd; Kolb, Andreas; Nimsky, Christopher


    Among all abnormal growths inside the skull, the percentage of tumors in sellar region is approximately 10-15%, and the pituitary adenoma is the most common sellar lesion. A time-consuming process that can be shortened by using adequate algorithms is the manual segmentation of pituitary adenomas. In this contribution, two methods for pituitary adenoma segmentation in the human brain are presented and compared using magnetic resonance imaging (MRI) patient data from the clinical routine: Method A is a graph-based method that sets up a directed and weighted graph and performs a min-cut for optimal segmentation results: Method B is a balloon inflation method that uses balloon inflation forces to detect the pituitary adenoma boundaries. The ground truth of the pituitary adenoma boundaries - for the evaluation of the methods - are manually extracted by neurosurgeons. Comparison is done using the Dice Similarity Coefficient (DSC), a measure for spatial overlap of different segmentation results. The average DSC for all data sets is 77.5±4.5% for the graph-based method and 75.9±7.2% for the balloon inflation method showing no significant difference. The overall segmentation time of the implemented approaches was less than 4s - compared with a manual segmentation that took, on the average, 3.9±0.5min. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  2. Benign post-radiation rectal stricture treated with endoscopic balloon dilation and intralesional triamcinolone injection. (United States)

    Karanikas, Michael; Touzopoulos, Panagiotis; Mitrakas, Alexandros; Zezos, Petros; Zarogoulidis, Paul; Machairiotis, Nikolaos; Efremidou, Eleni; Liratzopoulos, Nikolaos; Polychronidis, Alexandros; Kouklakis, George


    Post-radiation stricture is a rare complication after pelvis irradiation, but must be in the mind of the clinician evaluating a lower gastrointestinal obstruction. Endoscopy has gained an important role in chronic radiation proctitis with several therapeutic options for management of intestinal strictures. The treatment of rectal strictures has been limited to surgery with high morbidity and mortality. Therefore, a less invasive therapeutic approach for benign rectal strictures, endoscopic balloon dilation with or without intralesional steroid injection, has become a common treatment modality. We present a case of benign post-radiation rectal stricture treated successfully with balloon dilation and adjuvant intralesional triamcinolone injection. A 70-year-old woman presented to the emergency room complaining for 2 weeks of diarrhea and meteorism, 11 years after radiation of the pelvis due to adenocarcinoma of the uterus. Colonoscopy revealed a stricture at the rectum and multiple endoscopic biopsies were obtained from the stricture. The stricture was treated with endoscopic balloon dilation and intralesional triamcinolone injection. The procedure appears to have a high success rate and a very low complication rate. Histologic examination of the biopsies revealed non-specific inflammatory changes of the rectal mucosa and no specific changes of the mucosa due to radiation. All biopsies were negative for malignancy. The patient is stricture-free 12 months post-treatment.

  3. Benign Post-Radiation Rectal Stricture Treated with Endoscopic Balloon Dilation and Intralesional Triamcinolone Injection

    Directory of Open Access Journals (Sweden)

    Michael Karanikas


    Full Text Available Post-radiation stricture is a rare complication after pelvis irradiation, but must be in the mind of the clinician evaluating a lower gastrointestinal obstruction. Endoscopy has gained an important role in chronic radiation proctitis with several therapeutic options for management of intestinal strictures. The treatment of rectal strictures has been limited to surgery with high morbidity and mortality. Therefore, a less invasive therapeutic approach for benign rectal strictures, endoscopic balloon dilation with or without intralesional steroid injection, has become a common treatment modality. We present a case of benign post-radiation rectal stricture treated successfully with balloon dilation and adjuvant intralesional triamcinolone injection. A 70-year-old woman presented to the emergency room complaining for 2 weeks of diarrhea and meteorism, 11 years after radiation of the pelvis due to adenocarcinoma of the uterus. Colonoscopy revealed a stricture at the rectum and multiple endoscopic biopsies were obtained from the stricture. The stricture was treated with endoscopic balloon dilation and intralesional triamcinolone injection. The procedure appears to have a high success rate and a very low complication rate. Histologic examination of the biopsies revealed non-specific inflammatory changes of the rectal mucosa and no specific changes of the mucosa due to radiation. All biopsies were negative for malignancy. The patient is stricture-free 12 months post-treatment.

  4. Dilation Time in Endoscopic Papillary Balloon Dilation for Common Bile Duct Stones. (United States)

    Shen, Yong-Hua; Yang, Liu-Qing; Yao, Yu-Ling; Wang, Lei; Zhang, Yi-Yang; Cao, Jun; He, Qi-Bin; Zou, Xiao-Ping; Li, Yun-Hong


    To assess the short-term outcomes after endoscopic sphincterotomy (EST) plus endoscopic papillary balloon dilation (EPBD) versus EPBD alone and appropriate balloon dilation time in EPBD alone. A total of 413 patients with common bile duct stones (CBDSs) were included in the EST plus EPBD group and 84 were in the EPBD alone group. We retrospectively evaluated the safety and efficacy between EST plus EPBD and EPBD alone group. The patients in EPBD alone group were assigned to dilation time ≥5 minutes group (n=35) and time dilation time on the procedure-related complications. Compared with EST plus EPBD, the patients in EPBD alone group were younger [56.6 (range: 18 to 95) vs. 65.1 (24 to 92) y; P=0.006], had smaller diameter of the largest stone [10.4 (range: 3 to 20) vs. 12.3 (5 to 30) mm; Pdilation time dilation time ≥5 minutes group had less procedure-related hemorrhage than the EST plus EPBD group [0 vs. 36 (8.7%); P=0.047]. Long balloon dilation time in EPBD alone is safe and effective in treating CBDSs.

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

    Energy Technology Data Exchange (ETDEWEB)

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


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

  6. Infrainguinal vein graft stenosis: cutting balloon angioplasty as the first-line treatment of choice. (United States)

    Schneider, Peter A; Caps, Michael T; Nelken, Nicolas


    The optimal treatment for hemodynamically significant infrainguinal vein bypass graft stenosis is not known. This study compares three options as first choice for the revision of failing infrainguinal vein grafts: cutting balloon angioplasty (CBA), standard percutaneous transluminal balloon angioplasty (PTA), and open surgical revision (OS). Infrainguinal vein bypass graft lesions treated in a single institution during a 12-year period were evaluated. Of these, 161 lesions in 124 infrainguinal bypasses (101 patients) were treated with OS (n = 42), PTA (n = 57), or CBA (n = 62). The initial indication for the bypass in these patients was limb salvage in 73% and claudication in 27%. The primary outcome of interest was the development of vein graft occlusion or significant stenosis (>or=70%) as detected by surveillance duplex ultrasound scanning or arteriography some time after repair. The stenosis-free patency rates at 48 months for OS, CBA, and PTA were 74%, 62%, and 34%, respectively. PTA was associated with an increased risk of treatment failure compared with both OS (hazard ratio [HR], 3.9; P difference between OS and CBA (HR, 1.3 for CBA vs OS, P = .6). Pseudoaneurysms developed in two CBA patients. One ruptured and required interposition graft, and one was monitored. Cutting balloon angioplasty is a reasonable, initial treatment for infrainguinal vein graft stenosis in most patients. It is a safe, minimally invasive, outpatient procedure with patency rates that are comparable to OS and superior to PTA.

  7. Preparatory balloon aortic valvuloplasty during transcatheter aortic valve implantation for improved valve sizing. (United States)

    Patsalis, Polykarpos C; Al-Rashid, Fadi; Neumann, Till; Plicht, Björn; Hildebrandt, Heike A; Wendt, Daniel; Thielmann, Matthias; Jakob, Heinz G; Heusch, Gerd; Erbel, Raimund; Kahlert, Philipp


    This study sought to evaluate whether supra-aortic angiography during preparatory balloon aortic valvuloplasty (BAV) improves valve sizing. Current recommendations for valve size selection are based on annular measurements by transesophageal echocardiography and computed tomography, but paravalvular aortic regurgitation (PAR) is a frequent problem. Data of 270 consecutive patients with either conventional sizing (group 1, n = 167) or balloon aortic valvuloplasty-based sizing (group 2, n = 103) were compared. PAR was graded angiographically and quantitatively using several hemodynamic indices. PAR was observed in 113 patients of group 1 and 41 patients of group 2 (67.7% vs. 39.8%, p < 0.001). More than mild PAR was found in 24 (14.4%) patients of group 1 and 8 (7.8%) patients of group 2. According to pre-interventional imaging, 40 (39%) patients had a borderline annulus size, raising uncertainty regarding valve size selection. Balloon sizing resulted in selection of the bigger prosthesis in 30 (29%) and the smaller prosthesis in the remaining patients, and only 1 of these 40 patients had more than mild PAR. As predicted by the hemodynamic indices of PAR, mortality at 30 days and 1 year was less in group 2 than in group 1 (5.8% vs. 9%, p = 0.2 and 10.6% vs. 20%, p = 0.01). Preparatory balloon aortic valvuloplasty during transcatheter aortic valve implantation improves valve size selection, reduces the associated PAR, and increases survival in borderline cases. Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  8. Catching Comet's Particles in the Earth's Atmosphere by Using Balloons (United States)

    Potashko, Oleksandr; Viso, Michel

    The project is intended to catch cometary particles in the atmosphere by using balloons. The investigation is based upon knowledge that the Earth crosses the comet’s tails during the year. One can catch these particles at different altitudes in the atmosphere. So, we will be able to gradually advance in the ability to launch balloons from low to high altitudes and try to catch particles from different comet tails. The maximum altitude that we have to reach is 40 km. Both methods - distance observation and cometary samples from mission Stardust testify to the presence of organic components in comet’s particles. It would be useful to know more details about this organic matter for astrobiology; besides, the factor poses danger to the Earth. Moreover, it is important to prove that it is possible to get fundamental scientific results at low cost. In the last 5 years launching balloons has become popular and this movement looks like hackers’ one - as most of them occur without launch permission to airspace. The popularity of ballooning is connected with low cost of balloon, GPS unit, video recording unit. If you use iPhone, you have a light solution with GPS, video, picture and control function in one unit. The price of balloon itself begins from $50; it depends on maximum altitude, payload weight and material. Many university teams realized balloon launching and reached even stratosphere at an altitude of 33 km. But most of them take only video and picture. Meanwhile, it is possible to carry out scientific experiments by ballooning, for example to collect comet particles. There is rich experience at the moment of the use of mineral, chemical and isotopic analysis techniques and data of the comet’s dust after successful landing of StarDust capsule with samples in 2006. Besides, we may use absolutely perfect material to catch particles in the atmosphere, which was used by cosmic missions such as Stardust and Japanese Hayabusa. As to balloon launches, we could use

  9. Burn Injury Arise From Flying Balloon Toys

    Directory of Open Access Journals (Sweden)

    Yalcin Kulahci


    Full Text Available Many of peoples are faced minor or major burn injuries in their life. Even the most widespread burn cause is flame injuries, too different burn cause pointed out in literature like Acetylen burns. The cases which imply in literature, mostly causes from explosion of high pressure acetylene tube, metal oxygene patch flame or carbide lamp using from cave explorers. An interesting acetylene burn cause in Turkey was publised by the authors. This cases was to come into being from flying toy balloons flame. 80 person was injured from flying toy ballons flame in a meeting in 2002. Although this potential risks of acetylene, helium have not any of some risk. But helium was provided from other countries and have more price. The injuries which caused from acetylene burns like 1st -2nd degree burns. Consequently that was known helium is more avaliable for using in toy sector, and never cause burn injuries like this. [TAF Prev Med Bull. 2007; 6(4: 291-296

  10. Controlled weather balloon ascents and descents for atmospheric research and climate monitoring (United States)

    Kräuchi, Andreas; Philipona, Rolf; Romanens, Gonzague; Hurst, Dale F.; Hall, Emrys G.; Jordan, Allen F.


    In situ upper-air measurements are often made with instruments attached to weather balloons launched at the surface and lifted into the stratosphere. Present-day balloon-borne sensors allow near-continuous measurements from the Earth's surface to about 35 km (3-5 hPa), where the balloons burst and their instrument payloads descend with parachutes. It has been demonstrated that ascending weather balloons can perturb the air measured by very sensitive humidity and temperature sensors trailing behind them, particularly in the upper troposphere and lower stratosphere (UTLS). The use of controlled balloon descent for such measurements has therefore been investigated and is described here. We distinguish between the single balloon technique that uses a simple automatic valve system to release helium from the balloon at a preset ambient pressure, and the double balloon technique that uses a carrier balloon to lift the payload and a parachute balloon to control the descent of instruments after the carrier balloon is released at preset altitude. The automatic valve technique has been used for several decades for water vapor soundings with frost point hygrometers, whereas the double balloon technique has recently been re-established and deployed to measure radiation and temperature profiles through the atmosphere. Double balloon soundings also strongly reduce pendulum motion of the payload, stabilizing radiation instruments during ascent. We present the flight characteristics of these two ballooning techniques and compare the quality of temperature and humidity measurements made during ascent and descent.

  11. Paclitaxel Drug-eluting Tracheal Stent Could Reduce Granulation Tissue Formation in a Canine Model. (United States)

    Wang, Ting; Zhang, Jie; Wang, Juan; Pei, Ying-Hua; Qiu, Xiao-Jian; Wang, Yu-Ling


    Currently available silicone and metallic stents for tracheal stenosis are associated with many problems. Granulation proliferation is one of the main complications. The present study aimed to evaluate the efficacy of paclitaxel drug-eluting tracheal stent in reducing granulation tissue formation in a canine model, as well as the pharmacokinetic features and safety profiles of the coated drug. Eight beagles were randomly divided into a control group (bare-metal stent group, n = 4) and an experimental group (paclitaxel-eluting stent group, n = 4). The observation period was 5 months. One beagle in both groups was sacrificed at the end of the 1st and 3rd months, respectively. The last two beagles in both groups were sacrificed at the end of 5th month. The proliferation of granulation tissue and changes in tracheal mucosa were compared between the two groups. Blood routine and liver and kidney function were monitored to evaluate the safety of the paclitaxel-eluting stent. The elution method and high-performance liquid chromatography were used to characterize the rate of in vivo release of paclitaxel from the stent. Compared with the control group, the proliferation of granulation tissue in the experimental group was significantly reduced. The drug release of paclitaxel-eluting stent was the fastest in the 1st month after implantation (up to 70.9%). Then, the release slowed down gradually. By the 5th month, the release reached up to 98.5%. During the observation period, a high concentration of the drug in the trachea (in the stented and adjacent unstented areas) and lung tissue was not noted, and the blood test showed no side effect. The paclitaxel-eluting stent could safely reduce the granulation tissue formation after stent implantation in vivo, suggesting that the paclitaxel-eluting tracheal stent might be considered for potential use in humans in the future.

  12. Continuous controllable balloon dilation: a novel approach for cervix dilation

    Directory of Open Access Journals (Sweden)

    Arsenijevic Slobodan


    Full Text Available Abstract Background Cervical dilation using mechanical dilators is associated with various complications, such as uterine perforation, cervical laceration, infections and intraperitoneal hemorrhage. To achieve safe and painless cervical dilation, we constructed a new medical device to achieve confident mechanical cervical dilation: a continuous controllable balloon dilator (CCBD. Methods Controlled pumping of incompressible fluid into the CCBD increases the pressure and outer diameter of the CCBD, continuously dilating the cervical canal. The reliability of the CCBD was confirmed in vitro (testing for consistency and endurance, with no detected risk for breakage and in vivo. A multi-center clinical study was conducted,with 120 pregnant women randomly assigned to one of three groups: Group I,control group, no dilation;Group II,mechanical dilation, Hegar dilator (HeD; and Group III,CCBD. The tissue material for histological evaluation was obtained from the endocervical mucosa before and after dilation using the HeD or CCBD. Results The CCBD dilations were successful and had no complications in all 40 patients of Group III. The cervical tissue was markedly less damaged after CCBD dilation compared with HeD dilation (epithelium damage: 95% (HeD vs. 45% (CCBD, P P P Conclusions The CCBD should be used as a replacement for mechanical dilators to prevent uterine and cervical injury during cervical dilation. Trial registration ISRCTN54007498

  13. Endoscopic balloon dilation for stenotic lesions in Crohn's disease. (United States)

    Kanamori, Akira; Sugaya, Takeshi; Tominaga, Keiichi; Takahashi, Fumiaki; Takenaka, Kazuhiro; Hoshino, Atushi; Koike, Takero; Nakano, Masakazu; Hiraishi, Hideyuki


    Endoscopic balloon dilation (EBD) can serve as an alternative to surgery for intestinal stenosis associated with Crohn's disease (CD). However, there has been controversy regarding the efficacy and safety of EBD. Here we sought to determine the therapeutic efficacy and safety of EBD for intestinal stenosis in CD. Of 43 patients with CD accompanied by intestinal stenosis, 30 underwent EBD. These 30 patients were examined retrospectively in terms of the scope passage rate, surgery-free rate, and whether or not the observation of the distal intestinal tract influenced the therapeutic strategy. The overall scope passage and surgery-free rates were 90.0% and 76.7%, respectively. There were no statistically significant differences in the site of the dilated intestinal tract among groups. Patients who had inflammation in the distal intestinal tract alone after EBD accounted for 56.7%. The rate of re-dilation was 46.7%, and time until re-dilation was 6.6±3.6 months. EBD was associated with favorable short-term and long-term outcomes and good safety. Observation of the distal intestinal tract influenced the decision-making process for therapeutic strategies. The results of this study suggest that EBD may allow the postponement or even avoidance of surgery, enabling not only intestinal dilation but also the evaluation of mucosal healing to be performed. Thus, EBD is considered to be an effective alternative treatment for intestinal stenotic lesions in patients with CD.

  14. Suction thrombectomy after balloon maceration for dural venous sinus thrombosis. (United States)

    Lee, Chung-Wei; Liu, Hon-Man; Chen, Ya-Fang; Lin, Yen-Heng; Wang, Jaw-Lin


    To introduce the combination of suction thrombectomy (ST) and balloon maceration (BM) for the management of dural venous sinus thrombosis (DVST). Ten consecutive patients (average age, 53±15years; range, 30 to 73years) with DVST treated by ST after BM were evaluated including location of DVST, imaging presentation, procedural findings, and 3-month modified Rankin scale (mRS). All 10 patients had evidence of venous infarct on MR or CT. In addition, seven patients had intracerebral hemorrhage (ICH), one had subarachnoid hemorrhage (SAH), and one had both ICH and SAH. More than one sinus was involved in nine patients. ST after BM was technically successful in all patients, and angiographic relief of venous congestion and good outcome (3-month mRS 0 or 1) was achieved in eight patients (80%). The average procedural time was 73.5±24.7min. Two patients who were in coma status had negative outcomes, and one had a known chronic thrombotic segment refractory to treatment. No recurrent thrombosis of recanalized sinus was found on follow-up MR venography in six patients and CT venography in two patients. BM followed by ST is a promising technique for the treatment of acute DVST. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. The University of Alberta High Altitude Balloon Program (United States)

    Johnson, W.; Buttenschoen, A.; Farr, Q.; Hodgson, C.; Mann, I. R.; Mazzino, L.; Rae, J.; University of Alberta High Altitude Balloon Team


    The University of Alberta High Altitude Balloon (UA-HAB) program is a one and half year program sponsored by the Canadian Space Agency (CSA) that offers hands on experience for undergraduate and graduate students in the design, build, test and flight of an experimental payload on a high altitude balloon platform. Utilising low cost weather balloon platforms, and through utilisation of the CSA David Florida Laboratory for thermal-vacuum tests , in advance of the final flight of the payload on a NASA high altitude balloon platform. Collectively the program provided unique opportunities for students to experience mission phases which parallel those of a space satellite mission. The program has facilitated several weather balloon missions, which additionally provide educational opportunities for university students and staff, as well as outreach opportunities among junior and senior high school students. Weather balloon missions provide a cheap and quick alternative to suborbital missions; they can be used to test components for more expensive missions, as well as to host student based projects from different disciplines such as Earth and Atmospheric Sciences (EAS), Physics, and Engineering. In addition to extensive skills development, the program aims to promote recruitment of graduate and undergraduate students into careers in space science and engineering. Results from the UA-HAB program and the flight of the UA-HAB shielded Gieger counter payload for cosmic ray and space radiation studies will be presented. Lessons learned from developing and maintaining a weather balloon program will also be discussed. This project is undertaken in partnership with the High Altitude Student Platform, organized by Louisiana State University and the Louisiana Space Consortium (LaSpace), and sponsored by NASA, with the financial support of the Canadian Space Agency.

  16. SU-E-T-297: Dosimetric Assessment of An Air-Filled Balloon Applicator in HDR Vaginal Cuff Brachytherapy Using the Monte Carlo Method

    Energy Technology Data Exchange (ETDEWEB)

    Jiang, H; Lee, Y; Pokhrel, D; Badkul, R [University of Kansas Hospital, Kansas City, KS (United States)


    Purpose: As an alternative to cylindrical applicators, air inflated balloon applicators have been introduced into HDR vaginal cuff brachytherapy treatment to achieve sufficient dose to vagina mucosa as well as to spare rectum and bladder. In general, TG43 formulae based treatment planning systems do not take into account tissue inhomogeneity, and air in the balloon applicator can cause higher delivered dose to mucosa than treatment plan reported. We investigated dosimetric effect of air in balloon applicator using the Monte Carlo method. Methods: The thirteen-catheter Capri applicator with a Nucletron Ir-192 seed was modeled for various balloon diameters (2cm to 3.5cm) using the MCNP Monte Carlo code. Ir-192 seed was placed in both central and peripheral catheters to replicate real patient situations. Existence of charged particle equilibrium (CPE) with air balloon was evaluated by comparing kerma and dose at various distances (1mm to 70mm) from surface of air-filled applicator. Also mucosa dose by an air-filled applicator was compared with by a water-filled applicator to evaluate dosimetry accuracy of planning system without tissue inhomogeneity correction. Results: Beyond 1mm from air/tissue interface, the difference between kerma and dose was within 2%. CPE (or transient CPE) condition was deemed existent, and in this region no electron transport was necessary in Monte Carlo simulations. At 1mm or less, the deviation of dose from kerma became more apparent. Increase of dose to mucosa depended on diameter of air balloon. The increment of dose to mucosa was 2.5% and 4.3% on average for 2cm and 3.5cm applicators, respectively. Conclusion: After introduction of air balloon applicator, CPE fails only at the proximity of air/tissue interface. Although dose to mucosa is increased, there is no significant dosimetric difference (<5%) between air and water filled applicators. Tissue inhomogeneity correction is not necessary for air-filled applicators.

  17. A rare instructive complication of balloon catheter fracture during percutaneous coronary intervention. (United States)

    Nomura, Tetsuya; Higuchi, Yusuke; Kato, Taku; Keira, Natsuya; Tatsumi, Tetsuya


    The entrapment, fracture, and dislodgement of catheterization devices during percutaneous coronary intervention (PCI) are rare complications, for which cardiac surgery is sometimes required. Here, we encountered a rare but instructive case of balloon catheter fracture during PCI. Although there have been some reports of guidewire fracture in PCI, reports on balloon catheter fracture are very rare to our knowledge. A simulation test to examine the mechanism of balloon catheter fracture revealed that overuse of the balloon catheter, both for kissing balloon inflation and balloon anchor, was highly likely to have been the cause of the fracture.

  18. Intracavitary moderator balloon combined with (252)Cf brachytherapy and boron neutron capture therapy, improving dosimetry in brain tumour and infiltrations. (United States)

    Brandão, S F; Campos, T P R


    This article proposes a combination of californium-252 ((252)Cf) brachytherapy, boron neutron capture therapy (BNCT) and an intracavitary moderator balloon catheter applied to brain tumour and infiltrations. Dosimetric evaluations were performed on three protocol set-ups: (252)Cf brachytherapy combined with BNCT (Cf-BNCT); Cf-BNCT with a balloon catheter filled with light water (LWB) and the same set-up with heavy water (HWB). Cf-BNCT-HWB has presented dosimetric advantages to Cf-BNCT-LWB and Cf-BNCT in infiltrations at 2.0-5.0 cm from the balloon surface. However, Cf-BNCT-LWB has shown superior dosimetry up to 2.0 cm from the balloon surface. Cf-BNCT-HWB and Cf-BNCT-LWB protocols provide a selective dose distribution for brain tumour and infiltrations, mainly further from the (252)Cf source, sparing the normal brain tissue. Malignant brain tumours grow rapidly and often spread to adjacent brain tissues, leading to death. Improvements in brain radiation protocols have been continuously achieved; however, brain tumour recurrence is observed in most cases. Cf-BNCT-LWB and Cf-BNCT-HWB represent new modalities for selectively combating brain tumour infiltrations and metastasis.

  19. Intracavitary moderator balloon combined with 252Cf brachytherapy and boron neutron capture therapy, improving dosimetry in brain tumour and infiltrations (United States)

    Brandão, S F


    Objective: This article proposes a combination of californium-252 (252Cf) brachytherapy, boron neutron capture therapy (BNCT) and an intracavitary moderator balloon catheter applied to brain tumour and infiltrations. Methods: Dosimetric evaluations were performed on three protocol set-ups: 252Cf brachytherapy combined with BNCT (Cf-BNCT); Cf-BNCT with a balloon catheter filled with light water (LWB) and the same set-up with heavy water (HWB). Results: Cf-BNCT-HWB has presented dosimetric advantages to Cf-BNCT-LWB and Cf-BNCT in infiltrations at 2.0–5.0 cm from the balloon surface. However, Cf-BNCT-LWB has shown superior dosimetry up to 2.0 cm from the balloon surface. Conclusion: Cf-BNCT-HWB and Cf-BNCT-LWB protocols provide a selective dose distribution for brain tumour and infiltrations, mainly further from the 252Cf source, sparing the normal brain tissue. Advances in knowledge: Malignant brain tumours grow rapidly and often spread to adjacent brain tissues, leading to death. Improvements in brain radiation protocols have been continuously achieved; however, brain tumour recurrence is observed in most cases. Cf-BNCT-LWB and Cf-BNCT-HWB represent new modalities for selectively combating brain tumour infiltrations and metastasis. PMID:25927876

  20. Free boundary ballooning mode representation and its application (United States)

    Zheng, Linjin


    Free boundary ballooning mode representation is developed in this paper. This representation allows the two dimensional problem of peeling ballooning modes to be treated in one dimensional formalism. In contrast to the conventional ballooning representation, which requires the translational invariance of the Fourier components of the perturbations, the new invariance reflects that the independent solutions of the high n mode equations are translationally invariant from one radial interval surrounding a single singular surface to the other intervals. The conventional ballooning mode invariance breaks down at the vicinity of plasma edge, since the Fourier components with rational surfaces in vacuum region are completely different from those with rational surfaces in plasma region. But, the new type of invariance remains valid. This overcomes the limitation of the conventional ballooning mode representation for studying free boundary modes. Since the current formalism is adaptable to the cases with various sharp boundary changes, it therefore can be also generalized to study the piece-wise equilibrium cases, for example, the H-mode pedestal and X-point physics.

  1. Aerial Deployment and Inflation System for Mars Helium Balloons (United States)

    Lachenmeler, Tim; Fairbrother, Debora; Shreves, Chris; Hall, Jeffery, L.; Kerzhanovich, Viktor V.; Pauken, Michael T.; Walsh, Gerald J.; White, Christopher V.


    A method is examined for safely deploying and inflating helium balloons for missions at Mars. The key for making it possible to deploy balloons that are light enough to be buoyant in the thin, Martian atmosphere is to mitigate the transient forces on the balloon that might tear it. A fully inflated Mars balloon has a diameter of 10 m, so it must be folded up for the trip to Mars, unfolded upon arrival, and then inflated with helium gas in the atmosphere. Safe entry into the Martian atmosphere requires the use of an aeroshell vehicle, which protects against severe heating and pressure loads associated with the hypersonic entry flight. Drag decelerates the aeroshell to supersonic speeds, then two parachutes deploy to slow the vehicle down to the needed safe speed of 25 to 35 m/s for balloon deployment. The parachute system descent dynamic pressure must be approximately 5 Pa or lower at an altitude of 4 km or more above the surface.

  2. Time-dependent strains and stresses in a pumpkin balloon (United States)

    Gerngross, T.; Xu, Y.; Pellegrino, S.

    This paper presents a study of pumpkin-shaped superpressure balloons consisting of gores made from a thin polymeric film attached to high stiffness meridional tendons This type of design is being used for the NASA ULDB balloons The gore film shows considerable time-dependent stress relaxation whereas the behaviour of the tendons is essentially time-independent Upon inflation and pressurization the instantaneous i e linear-elastic strain and stress distributions in the film show significantly higher values in the meridional direction However over time and due to the biaxial visco-elastic stress relaxation of the the gore material the em hoop strains increase and the em meridional stresses decrease whereas the em remaining strain and stress components remain substantially unchanged These results are important for a correct assessment of the structural integrity of a pumpkin balloon in a long-duration mission both in terms of the material performance and the overall stability of the shape of the balloon An experimental investigation of the time dependence of the biaxial strain distribution in the film of a 4 m diameter 48 gore pumpkin balloon is presented The inflated shape of selected gores has been measured using photogrammetry and the time variation in strain components at some particular points of these gores has been measured under constant pressure and temperature The results show good correlation with a numerical study using the ABAQUS finite-element package that includes a widely used model of

  3. Air-filled vs water-filled intragastric balloon: a prospective randomized study. (United States)

    Giardiello, Cristiano; Borrelli, Alessandro; Silvestri, Eufemia; Antognozzi, Valentina; Iodice, Giuseppe; Lorenzo, Michele


    The positioning of an intragastric saline-filled balloon has been developed as temporary and reversible therapeutic option for treatment of morbid obesity. Recently, an air-filled balloon was also developed. The aim of this study is to prospectively compare these two devices in terms of weight loss parameters, safety, and tolerance. Sixty patients were randomized into two groups: group A (Bioenterics Intragastric Balloon-BIB; n = 30; 20 F/10 M, mean age 36.7 ± 10.9; mean BMI 46.5 ± 5.9) and group B (Endobag-Heliosphere; n = 30; 20 F/10 M, mean age 37.8 ± 10.6; mean BMI 46.1 ± 5.6). All patients of both groups were sedated with midazolam (5 mg) + Propofol (2 mg/kg i.v.). The Heliosphere Bag was air-filled with 950 ml while BIB® was inflated with 500 ml of saline and 10 ml of methylene blue. Percentage of excess weight loss (%EWL) and body mass index (BMI) were evaluated. Student t test, Fisher exact test, and χ(2) test were used for statistical analysis. Similar weight loss parameters were observed in patients treated with liquid or air-filled balloon at time of removal: mean BMI was 40.8 ± 6.2 and 41.9 ± 6.5(p = ns), and mean %EWL was 20 ± 12 and 18 ± 14 (p = ns) in groups A and B, respectively. Significant longer extraction time, with high patient discomfort, was observed in group B due to difficult passage through the cardia and the lower pharynx. Air-filled balloon can be another valid therapeutic option in the temporary treatment of obesity, but at this time, the quality of the device must be improved to ameliorate the patient compliance at removal and avoid the spontaneous deflations.

  4. Validation of the balloon evacuation test: reproducibility and agreement with findings from anorectal manometry and electromyography. (United States)

    Chiarioni, Giuseppe; Kim, Sung Min; Vantini, Italo; Whitehead, William E


    The balloon evacuation test (BET) measures the time required to evacuate a balloon filled with 50 mL water; it has been incorporated into many algorithms for diagnosis of pelvic floor dyssynergia. We aimed to assess the reproducibility of the BET, determine the upper limit of normal, and assess its concordance with evaluation of pelvic floor dyssynergia by anorectal manometry (ARM) and pelvic floor surface electromyography (EMG). The BET was tested in 286 consecutive patients with chronic constipation (mean age, 44 years; 91% female) before and after 30 days of conservative treatment at a tertiary gastroenterology clinic in Italy from March 2010 through May 2012. The BET was tested twice, 7 days apart, in 40 healthy individuals (controls: mean age, 38 years; 92% female). The 238 constipated patients who responded incompletely to conservative therapy were examined by ARM, EMG, and digital rectal examination. Forty-seven patients with conflicting ARM and BET results underwent defecography. The balloon was evacuated within 1 minute by 37 controls (93%; 3 individuals required 1-2 minutes). Among patients with constipation, 148 (52%) passed the balloon within 5 minutes (110 passed the balloon in 1 minute, 35 passed it in 1-2 minutes, and 3 passed it in 2-5 minutes). The BET showed perfect reproducibility in 280 of the patients with constipation (98%) when a time less than 2 minutes was set as abnormal. The level of agreement between BET and ARM for dyssynergia was 78%, and between BET and EMG it was 83%. Thirty-two patients had abnormal results from the BET but normal results from ARM; 31 cases had inadequate straining (n = 11) or anatomic defects (n = 20), which could account for the abnormal findings from BET. The BET is reliable for analysis of pelvic floor dyssynergia; the optimal upper limit of normal is 2 minutes. Findings from the BET have a high level of agreement with those from ARM and EMG. Copyright © 2014 AGA Institute. Published by Elsevier Inc. All rights

  5. SU-E-J-97: Pretreatment Test and Post-Treatment Evaluation for Iso-NTCP Dose Guided Adapive Radiotherapy (DGART), Experience with Prostate Cancer Patients Treated with Rectal Balloons

    Energy Technology Data Exchange (ETDEWEB)

    Yu, J [The University of Wisconsin-Madison, Madison, WI (United States); Thomas Jefferson UniversityHospital, Philadelphia, PA (United States); Hardcastle, N [The University of Wisconsin-Madison, Madison, WI (United States); Peter MacCallum Cancer Centre, Melbourne (Australia); University of Wollongong, Wollongong (Australia); Bender, E [The University of Wisconsin-Madison, Madison, WI (United States); Jeong, K [The University of Wisconsin-Madison, Madison, WI (United States); Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY (United States); Xiao, Y; Ritter, M [Thomas Jefferson UniversityHospital, Philadelphia, PA (United States); Tome' , M [The University of Wisconsin-Madison, Madison, WI (United States); University of Wollongong, Wollongong (Australia); Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, NY (United States)


    Purpose: To explore the feasibility of pretreatment test for iso-NTCP DGART and to compare the pretreatment test results with post-treatment evaluations. Methods: NTCP here refers to late rectal wall toxicity only and is calculated with the ring rectal wall DVH. Simulation for one time iso- NTCP DGART starts after half of the total dose was done for 10 patients to investigate if TCP gains could be achieved. Six patients were treated using a 12-fraction 4.3Gy technique and four using 16-fraction 3.63Gy technique. For each of the 12-fraction cases a VMAT plan was generated in Pinnacle3™ using the daily CT obtained prior to the 6th fraction. A pretreatment simulation was performed using only the first 6 daily CTs. The idea is to add the 6 original plan delivered doses with 6 DGART plan delivered doses by deformable dose accumulation (DDA) on each of the first 6 CTs, resulting in 6 rectal wall doses (RWDs) and NTCPs. The 95% confidence interval (95%CI) for the 6 NTCPs were computed.The posttreatment evaluation was done by: a) copy the DGART plan to 6 CTs for fraction 7–12 and calculate the 6 actual DGART delivered fractional doses; b) sum the 6 actual DGART doses with the 6 original plan delivered doses by DDA on each of the 12 CTs resulting in 12 post-treatment RWDs and NTCPs; c) boxplot the 12 post-treatment NTCPs. Results: Target dose gain is 0.76–1.93 Gy. The 95%CI widths of the pretreatment tests NTCPs were 1.1–2.7%. For 5 patients, the planned NTCP fell within the 95%CI. For 4 patients, the planned NTCP was lower than the 95%CI lines. Post-treatment results show that for 7 patients, the upper quartile was within the 95%CI; for 2 patients, the upper quartile were higher than the 95%CI. Conclusion: The pretreatment test yields conservative prediction of the actual delivered NTCP.

  6. Popping balloons: formation of a crack network in rubber membranes (United States)

    Moulinet, Sebastien; Adda-Bedia, Mokhtar; Equipe Morphogenèse et phénomènes multi-échelle Team


    Everyone can make the observation: a rubber balloon inflated until it spontaneously pop breaks into a large number of shreds. In contrast, a balloon pierced with a needle at an early stage of its inflation breaks into two large pieces. Using model latex balloons, we have experimentally investigated the transition between these two breaking regimes. We have showed that, above a threshold stress in the latex membrane, a single crack become unstable and separates into two new cracks. Then, a cascade of tip-splitting generates a network of cracks that eventually form a large number of fragments. We have observed that the instability of the crack occurs when it reaches a limit velocity that could the speed of sound. By studying the energy balance during the explosion, we can determine the intrinsic fracture energy of rubber, a measurement difficult to achieve with usual tensile testing.

  7. Intragastric Balloon for Management of Severe Obesity: a Systematic Review. (United States)

    Yorke, Ekua; Switzer, Noah Jacob; Reso, Artan; Shi, Xinhe; de Gara, Christopher; Birch, Daniel; Gill, Richdeep; Karmali, Shahzeer


    Older models of intragastric balloons (IGBs) had unacceptably high complication rates and inconsequential weight loss. With FDA approval of newer models, we aimed to systematically examine the literature regarding the efficacy of IGB therapy for obesity. A comprehensive electronic database search was completed. Title searching was restricted to the following keywords: bariatric, gastric, gastric bypass, gastric band, sleeve gastrectomy, and intragastric balloon. Twenty-six primary studies (n = 6101) were included. At balloon removal, mean change in weight and BMI were 15.7 ± 5.3 kg and 5.9 ± 1.0 kg/m(2). The most common complications were nausea/vomiting (23.3 %) and abdominal pain (19.9 %). Serious complications were rare: mortality (0.05 %) and gastric perforation (0.1 %). IGBs are associated with marked short-term weight loss with limited serious complications.

  8. Prognostic factors for the success of thermal balloon ablation in the treatment of menorrhagia

    NARCIS (Netherlands)

    Bongers, M. Y.; Mol, B. W. J.; Brölmann, H. A. M.


    OBJECTIVE: To identify predictive factors that will ensure successful menorrhagia treatment using hot fluid balloon endometrial ablation. METHODS: This is a prospective study on patients referred for menorrhagia and treated with hot fluid thermal balloon ablation. Potential prognostic factors for

  9. Use of a Balloon Catheter With Intraoperative C-Arm Fluoroscan for Reduction of Zygomatic Arch Fractures. (United States)

    Noh, Woon Jae; Park, Tae Jung; Kim, Joo Yeon; Kwon, Jae Hwan


    The purpose of this study was to evaluate the usefulness of C-arm fluoroscan with a balloon catheter in patients undergoing closed reduction of zygomatic arch fractures. All patients who had zygomatic arch reduction surgery between 2006 and 2015 were identified and classified into 2 groups. Group A included those patients who underwent closed reduction of zygomatic arch fractures. Group B included those who underwent zygomatic arch reduction surgery with a C-arm fluoroscan and supporting balloon. A balloon catheter was used to stabilize the zygomatic bone after reduction. Results were scored from 1 (poor) to 3 (good) to assess surgical outcomes based on 3 criteria: alignment of the zygomatic arch on a postoperative computed tomography scan, facial asymmetry in photography, and the patient's subjective satisfaction. The authors enrolled 32 patients with zygomatic arch fractures. 18 patients underwent closed reduction for zygomatic arch fractures (group A), while 14 patients underwent closed reduction with C-arm fluoroscan and balloon support (group B). The average score for group A was 2.00 for alignment, 2.56 for facial asymmetry, and 2.67 for subjective satisfaction compared with 2.64 for alignment, 2.86 for facial asymmetry, and 2.79 for subjective satisfaction in group B. There were statistically significant differences in the alignment and facial asymmetry scores between the 2 groups. The authors suggest that C-arm fluoroscan with balloon support is a useful modality for reduction of zygomatic arch fractures that provides better surgical outcomes than conventional closed reduction surgery.

  10. Balloon-Borne Infrasound Detection of Energetic Bolide Events (United States)

    Young, Eliot F.; Ballard, Courtney; Klein, Viliam; Bowman, Daniel; Boslough, Mark


    Infrasound is usually defined as sound waves below 20 Hz, the nominal limit of human hearing. Infrasound waves propagate over vast distances through the Earth's atmosphere: the CTBTO (Comprehensive Nuclear-Test-Ban Treaty Organization) has 48 installed infrasound-sensing stations around the world to detect nuclear detonations and other disturbances. In February 2013, several CTBTO infrasound stations detected infrasound signals from a large bolide that exploded over Chelyabinsk, Russia. Some stations recorded signals that had circumnavigated the Earth, over a day after the original event. The goal of this project is to improve upon the sensitivity of the CTBTO network by putting microphones on small, long-duration super-pressure balloons, with the overarching goal of studying the small end of the NEO population by using the Earth's atmosphere as a witness plate.A balloon-borne infrasound sensor is expected to have two advantages over ground-based stations: a lack of wind noise and a concentration of infrasound energy in the "stratospheric duct" between roughly 5 - 50 km altitude. To test these advantages, we have built a small balloon payload with five calibrated microphones. We plan to fly this payload on a NASA high-altitude balloon from Ft Sumner, NM in August 2016. We have arranged for three large explosions to take place in Socorro, NM while the balloon is aloft to assess the sensitivity of balloon-borne vs. ground-based infrasound sensors. We will report on the results from this test flight and the prospects for detecting/characterizing small bolides in the stratosphere.

  11. Mixing processes in the stratosphere inferred from Project Loon balloons. (United States)

    Conway, J. P.; Bodeker, G. E.; Cameron, C.; Lewis, J.; Cooper, K.


    Dynamical processes that occur in the stratosphere between 15 and 50 km above Earth's surface, can affect our weather and climate. The vortex of westerly winds that encircles the Antarctic stratosphere in the winter and spring of each year is a defining dynamical feature of the Southern Hemisphere stratosphere. The permeability of the vortex edge determines the north to south gradient in a number of trace gases. Many of these trace gases, such as ozone, are radiatively active gases whose morphology defines temperature gradients in the stratosphere. The processes controlling the permeability of the Antarctic vortex, and how they are likely to respond to a changing climate, have not been well studied and, as a result, are not well simulated in atmosphere-ocean global climate models. Since 2014, hundreds of long-duration stratospheric balloons have been flown by Project Loon, a project of X [formerly Google(x)] aimed at providing Internet access to remote locations. The position and pressure data from these balloons provide an unprecedented opportunity to detail the transport and small-scale turbulent diffusion processes active in the southern middle and high latitude stratosphere. Transport and mixing processes are analysed through a variety of methods. Firstly, the divergence of actual balloon trajectories from paths calculated with a trajectory model reveal either where sub-grid-scale winds matter, where analysed large-scale winds are erroneous, or where regions of chaotic mixing occur. Regions of chaotic mixing are identified using reverse domain filling and Lyapunov exponents. A number of coordinated sequential launches of Loon balloons make it possible to calculate Lyapunov exponents directly from balloon location data, allowing the validation of Lyapunov exponents calculated from reanalysis. Finally, the geometric relationships between balloons in close proximity (within tens of kilometres) also allows the identification of coherent structures that are

  12. Properties of nylon 12 balloons after thermal and liquid carbon dioxide treatments. (United States)

    Ro, Andrew J; Davé, Vipul


    Critical design attributes of angioplasty balloons include the following: tear resistance, high burst pressures, controlled compliance, and high fatigue. Balloons must have tear resistance and high burst pressures because a calcified stenosis can be hard and nominal pressures of up to 16 atm can be used to expand the balloon. The inflated balloon diameter must be a function of the inflation pressure, thus compliance is predictable and controlled. Reliable compliance is necessary to prevent damage to vessel walls, which may be caused by over-inflation. Balloons are often inflated multiple times in a clinical setting and they must be highly resistant to fatigue. These design attributes are dependent on the mechanical properties and polymer morphology of the balloon. The effects of residual stresses on shrinkage, crystallite orientation, balloon compliance, and mechanical properties were studied for angioplasty nylon 12 balloons. Residual stresses of these balloons were relieved by oven heat treatment and liquid CO2 exposure. Residual stresses were measured by quantifying shrinkage at 80 °C of excised balloon samples using a dynamic mechanical analyzer. Shrinkage was lower after oven heat treatment and liquid CO2 exposure compared to the as-received balloons, in the axial and radial directions. As-received, oven heat treated, and liquid CO2-exposed balloon samples exhibited similar thermal properties (T(g), T(m), X(t)). Crystallite orientation was not observed in the balloon cylindrical body using X-ray scattering and polarized light microscopy, which may be due to balloon fabrication conditions. Significant differences were not observed between the stress-strain curves, balloon compliance, and average burst pressures of the as-received, oven heat treated, and liquid CO2-exposed balloons. Copyright © 2012 Elsevier B.V. All rights reserved.

  13. Nonlinear simulation of resistive ballooning modes in Large Helical Device

    Energy Technology Data Exchange (ETDEWEB)

    Miura, Hideaki; Hayashi, Takaya; Sato, Tetsuya


    Nonlinear simulations of a magneto-hydrodynamic (MHD) plasma in full three-dimensional geometry of the Large Helical Device (LHD) are conducted to study nonlinear evolution of pressure-driven instabilities. A series of simulations for a resistive plasma shows growth of resistive ballooning instability. The growth rate of the most unstable resistive ballooning mode is shown to be proportional to the one-third power of the resistivity. Nonlinear saturation of the instability and its slow decay are observed. After the nonlinear saturation, the pressure takes a profile similar to so-called pedestal. A possible scenario of nonlinear relaxation of a plasma toward a new equilibrated state is discussed. (author)

  14. EBEX: A Balloon-Borne CMB Polarization Experiment (United States)

    Chapman, Daniel; Aboobaker, A. M.; Ade, P.; Aubin, F.; Baccigalupi, C.; Bandura, K.; Bao, C.; Borrill, J.; Didier, J.; Dobbs, M.; Gold, B.; Grain, J.; Grainger, W.; Hanany, S.; Helson, K.; Hillbrand, S. N.; Hilton, G.; Hubmayr, H.; Irwin, K.; Johnson, B.; Jaffe, A.; Jones, T. J.; Kisner, T.; Klein, J.; Korotkov, A.; Leach, S.; Lee, A. T.; Levinson, L.; Limon, M.; MacDermid, K.; Miller, A. D.; Milligan, M.; Pascale, E.; Raach, K.; Reichborn-Kjennerud, B.; Sagiv, I.; Smecher, G.; Stompor, R.; Tristram, M.; Tucker, G. S.; Westbrook, B.; Zilic, K.


    The E and B Experiment (EBEX) is a balloon-borne telescope designed to probe polarization signals in the CMB resulting from primordial gravitational waves, gravitational lensing, and Galactic dust emission. EBEX is the first balloon-borne astrophysical polarimeter to use a continuously rotating achromatic half-wave plate on a superconducting magnetic bearing and over 1000 transition edge sensor bolometers read out with SQUID amplifiers. The instrument completed an 11 day flight over Antarctica in January 2013 and data analysis is underway. We will provide an overview of the experiment and the Antarctic flight, and give an update on the analysis.

  15. AIAA Educator Academy: The Space Weather Balloon Module (United States)

    Longmier, B.; Henriquez, E.; Bering, E. A.; Slagle, E.


    Educator Academy is a K-12 STEM curriculum developed by the STEM K-12 Outreach Committee of the American Institute of Aeronautics and Astronautics (AIAA). Consisting of three independent curriculum modules, K-12 students participate in inquiry-based science and engineering challenges to improve critical thinking skills and enhance problem solving skills. The Space Weather Balloon Curriculum Module is designed for students in grades 9-12. Throughout this module, students learn and refine physics concepts as well as experimental research skills. Students participate in project-based learning that is experimental in nature. Students are engaged with the world around them as they collaborate to launch a high altitude balloon equipped with HD cameras.The program leaders launch high altitude weather balloons in collaboration with schools and students to teach physics concepts, experimental research skills, and to make space exploration accessible to students. A weather balloon lifts a specially designed payload package that is composed of HD cameras, GPS tracking devices, and other science equipment. The payload is constructed and attached to the balloon by the students with low-cost materials. The balloon and payload are launched with FAA clearance from a site chosen based on wind patterns and predicted landing locations. The balloon ascends over 2 hours to a maximum altitude of 100,000 feet where it bursts and allows the payload to slowly descend using a built-in parachute. The payload is located using the GPS device. In April 2012, the Space Weather Balloon team conducted a prototype field campaign near Fairbanks Alaska, sending several student-built experiments to an altitude of 30km, underneath several strong auroral displays. To better assist teachers in implementing one or more of these Curriculum Modules, teacher workshops are held to give teachers a hands-on look at how this curriculum is used in the classroom. And, to provide further support, teachers are each

  16. Predicting paravalvular leak after balloon-expandable TAVR. (United States)

    Krishnaswamy, Amar; Tuzcu, E Murat


    Objective measurement of a Valve Calcification Index (calcium volume/BSA) may predict PVL after TAVR using a cutoff value > 418 mm(3) /mm(2) Oversizing the balloon-expandable SAPIEN valve with a goal ratio of valve diameter: average annulus diameter > 1.055 may reduce PVL after TAVR Single parameters are unlikely to provide adequate sensitivity to reduce PVL; a thorough analysis of root sizing, calcification, and morphology is important to balloon-expandable TAVR safety and efficacy. © 2015 Wiley Periodicals, Inc.

  17. BioEnterics Intragastric Balloon (BIB) versus Spatz Adjustable Balloon System (ABS): Our experience in the elderly. (United States)

    Russo, Teresa; Aprea, Giovanni; Formisano, Cesare; Ruggiero, Simona; Quarto, Gennaro; Serra, Raffaele; Massa, Guido; Sivero, Luigi


    The BioEnterics Intragastric Balloon (BIB) and the Spatz Adjustable Balloon System (ABS) are in fact recommended for weight reduction as a bridge to bariatric surgery. We retrospected studied patients with body mass index (BMI) and age ranges of 37-46 and 70-80 years, respectively, who had undergone BIB from January 2010 to July 2012 and prospected studied patients who had undergone Spatz balloon from July 2012 to August 2014. The aim of this study is to compare BIB and Spatz in terms of weight loss, complications, and maintenance of weight after removal. For both procedures, the median weight loss was 20 ± 3 kg, median BMI at the end of the therapy was 32 ± 2, and no severe complication occurred. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  18. Three dimensional intravascular ultrasonic assessment of the local mechanism of restenosis after balloon angioplasty

    NARCIS (Netherlands)

    M.A. Costa (Marco); P.J. de Feyter (Pim); K. Kozuma (Ken); A.L. Gaster; M. Sabaté (Manel); I.P. Kay (Ian Patrick); J.M.R. Ligthart (Jürgen); P. Thayssen; M.J.B.M. van den Brand (Marcel); P.W.J.C. Serruys (Patrick); D.P. Foley (David); W.J. van der Giessen (Wim)


    textabstractOBJECTIVE: To assess the mechanism of restenosis after balloon angioplasty. DESIGN: Prospective study. PATIENTS: 13 patients treated with balloon angioplasty. INTERVENTIONS: 111 coronary subsegments (2 mm each) were analysed after balloon angioplasty and at a six month follow up using

  19. Biomechanical impact of provisional stenting and balloon dilatation on coronary bifurcation: clinical implications. (United States)

    Chen, Henry Y; Al-Saadon, Khalid; Louvard, Yves; Kassab, Ghassan S


    In-stent restenosis (ISR) and stent thrombosis remain clinically significant problems for bifurcations. Although the role of wall shear stress (WSS) has been well investigated, the role of circumferential wall stresses (CWS) has not been well studied in provisional stenting with and without final kissing balloon (FKB). We hypothesized that the perturbation of CWS at the SB in provisional stenting and balloon dilatation is an important factor in addition to WSS, and, hence, may affect restenosis rates (i.e., higher CWS correlates with higher restenosis). To test this hypothesis, we developed computational models of stent, FKB at bifurcation, and finite element simulations that considered both fluid and solid mechanics of the vessel wall. We computed the stress ratio (CWS/WSS) to show potential correlation with restenosis in clinical studies (i.e., higher stress ratio correlates with higher restenosis). Our simulation results show that stenting in the main branch (MB) increases the maximum CWS in the side branch (SB) and, hence, yields a higher stress ratio in the SB, as compared with the MB. FKB dilatation decreases the CWS and increases WSS, which collectively lowers the stress ratio in the SB. The changes of stress ratio were correlated positively with clinical data in provisional stenting and FKB. Both fluid and solid mechanics need to be evaluated when considering various stenting techniques at bifurcations, as solid stresses also play an important role in clinical outcome. An integrative index of bifurcation mechanics is the stress ratio that considers both CWS and WSS.NEW & NOTEWORTHY Although the role of wall shear stress (WSS) has been well investigated, the role of circumferential wall stresses (CWS) has not been well studied in provisional stenting with and without final kissing balloon. Both fluid and solid mechanics need to be evaluated when considering various stenting techniques at bifurcations. An integrative index of bifurcation mechanics is the

  20. Prospective, randomized study of cutting balloon angioplasty versus conventional balloon angioplasty for the treatment of hemodialysis access stenoses. (United States)

    Saleh, Hossam M; Gabr, Ahmed K; Tawfik, Mohamed M; Abouellail, Hesham


    The aim of this trial was to compare the rates of patency achieved by cutting and conventional balloon angioplasty to treat hemodialysis access stenoses. End-stage renal failure patients (at three tertiary referral centers) with significant hemodialysis access stenoses were prospectively randomized to have percutaneous transluminal angioplasty (PTA) by either cutting or conventional balloons. Patients with more than one hemodynamically significant stenosis were excluded. Kaplan-Meier method was used to compare the primary assisted patency rates for the two groups. The study randomized 623 patients into two groups, and the duration of follow-up was 15 ± 3 months. In the cutting balloon angioplasty group, the clinical success rate was 89% (282 of 316 stenoses). In the conventional balloon angioplasty group, the clinical success rate was 86% (265 of 307 stenoses; P = .637). Assisted primary patency for cutting PTA was statistically significantly higher at 6 months and 1 year (86% and 63%) than that for conventional PTA (56% and 37%, respectively; P = .037) in the treatment of stenosis of the graft-to-vein anastomosis. In the venous stenosis subgroup, equivalent primary assisted patency at 6 months and 1 year was observed for cutting PTA (84% and 55%) and conventional PTA (70% and 46%, respectively; P = .360). In the intragraft stenosis subgroup, primary assisted patency was equivalent at 6 months and 1 year for cutting PTA (67% and 39%) and conventional PTA (62% and 49%, respectively; P = .371). In the arterial anastomotic stenosis subgroup, assisted primary patency at 6 months and 1 year was equivalent for cutting PTA (70% and 30%) and conventional PTA (75% and 33%, respectively; P = .921). Cutting balloon angioplasty proved to be a safe and effective treatment of graft-to-vein anastomotic stenosis, with significantly higher patency than that of conventional balloon angioplasty. Copyright © 2014 Society for Vascular Surgery. Published by Mosby, Inc. All rights

  1. Comparison of double balloon enteroscopy in adults and children (United States)

    Gurkan, Odul Egritas; Karakan, Tarkan; Dogan, Ibrahim; Dalgic, Buket; Unal, Selahattin


    AIM: To compare results of double balloon enteroscopy (DBE) procedures in pediatric and adult patients. METHODS: The medical files of patients who underwent DBE at Gazi University School of Medicine, Ankara, Turkey between 2009 and 2011 were examined retrospectively. Adult and pediatric patients were compared according to DBE indications, procedure duration, final diagnosis, and complications. DBE procedures were performed in an operating room under general anesthesia by two endoscopists. An oral or anal approach was preferred according to estimated lesion sites. Overnight fasting of at least 6 h prior to the start of the procedure was adequate for preprocedural preparation of oral DBE procedures. Bowel cleansing was performed by oral administration of sennosides A and B solution, 2 mL/kg, and anal saline laxative enema. The patients were followed up for 2 h after the procedure in terms of possible complications. RESULTS: DBE was performed in 35 patients (5 pediatric and 30 adult). DBE procedures were performed for abdominal pain, chronic diarrhea, bleeding, chronic vomiting, anemia, and postoperative evaluation of anastomosis. Final diagnosis was diffuse gastric angiodysplasia (n = 1); diffuse jejunal angiodysplasia (n = 1); ulceration in the bulbus (n = 1); celiac disease (n = 1); low differentiated metastatic carcinoma (n = 1); Peutz-Jeghers syndrome (n = 1); adenomatous polyp (n = 1) and stricture formation in anastomosis line (n = 1). During postprocedural follow-up, abdominal pain and elevated amylase levels were noted in three patients and one patient developed abdominal perforation. CONCLUSION: With the help of technological improvements, we may use enteroscopy as a safe modality more frequently in younger and smaller children. PMID:23922469

  2. Huge Left Ventricular Thrombus and Apical Ballooning associated with Recurrent Massive Strokes in a Septic Shock Patient

    Directory of Open Access Journals (Sweden)

    Hyun-Jung Lee


    Full Text Available The most feared complication of left ventricular thrombus (LVT is the occurrence of systemic thromboembolic events, especially in the brain. Herein, we report a patient with severe sepsis who suffered recurrent devastating embolic stroke. Transthoracic echocardiography revealed apical ballooning of the left ventricle with a huge LVT, which had not been observed in chest computed tomography before the stroke. This case emphasizes the importance of serial cardiac evaluation in patients with stroke and severe medical illness.

  3. Using a Cloud Computing System to Reduce Door-to-Balloon Time in Acute ST-Elevation Myocardial Infarction Patients Transferred for Percutaneous Coronary Intervention. (United States)

    Ho, Chi-Kung; Chen, Fu-Cheng; Chen, Yung-Lung; Wang, Hui-Ting; Lee, Chien-Ho; Chung, Wen-Jung; Lin, Cheng-Jui; Hsueh, Shu-Kai; Hung, Shin-Chiang; Wu, Kuan-Han; Liu, Chu-Feng; Kung, Chia-Te; Cheng, Cheng-I


    This study evaluated the impact on clinical outcomes using a cloud computing system to reduce percutaneous coronary intervention hospital door-to-balloon (DTB) time for ST segment elevation myocardial infarction (STEMI). A total of 369 patients before and after implementation of the transfer protocol were enrolled. Of these patients, 262 were transferred through protocol while the other 107 patients were transferred through the traditional referral process. There were no significant differences in DTB time, pain to door of STEMI receiving center arrival time, and pain to balloon time between the two groups. Pain to electrocardiography time in patients with Killip I/II and catheterization laboratory to balloon time in patients with Killip III/IV were significantly reduced in transferred through protocol group compared to in traditional referral process group (both p cloud computing system in our present protocol did not reduce DTB time.

  4. Results from GLAST-LAT Prototype Balloon Experiment (United States)

    Kamae, Tuneyoshi


    The GLAST Large Area Telescope (LAT) is a pair-production high-energy (>20 MeV) gamma-ray telescope being built by an international partnership of astrophysicists and particle physicists for a satellite launch in 2006, designed to study a wide variety of high-energy astrophysical phenomena. As part of the development effort, the collaboration has built a Balloon Flight Engineering Model (BFEM) for flight on a high-altitude scientific balloon. The BFEM is approximately the size of one of the 16 GLAST-LAT towers and contains all the components of the full instrument: plastic scintillator anticoincidence system (ACD), high-Z foil/Si strip pair-conversion tracker (TKR), CsI hodoscopic calorimeter (CAL), triggering and data acquisition electronics (DAQ), commanding system, power distribution, telemetry, real-time data display, and ground data processing system. The goal of the balloon flight was to demonstrate the performance of this instrument configuration under conditions similar to the low earth orbit and to study background produced by cosmic ray particles. We obtained from a balloon flight at Palestine, Texas, on August 4, 2001, nearly 2 million \\x81gunbiased\\x81h event samples extracted gamma-rays from high-background environment. The data have been compared with a computer simulation based a cosmic ray flux model.

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

    LENUS (Irish Health Repository)

    Fenton, S


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

  6. Long Duration Balloon flights development. (Italian Space Agency) (United States)

    Peterzen, S.; Masi, S.; Dragoy, P.; Ibba, R.; Spoto, D.

    Stratospheric balloons are rapidly becoming the vehicle of choice for near space investigations and earth observations by a variety of science disciplines. With the ever increasing research into climatic change, earth observations, near space research and commercial component testing, instruments suspended from stratospheric balloons offer the science team a unique, stable and reusable platform that can circle the Earth in the polar region or equatorial zone for thirty days or more. The Italian Space Agency (ASI) in collaboration with Andoya Rocket Range (Andenes, Norway) has opened access in the far northern latitudes above 78º N from Longyearbyen, Svalbard. In 2006 the first Italian UltraLite Long Duration Balloon was launched from Baia Terra Nova, Mario Zuchelli station in Antarctica and now ASI is setting up for the their first equatorial stratospheric launch from their satellite receiving station and rocket launch site in Malindi, Kenya. For the equatorial missions we have analysed the statistical properties of trajectories considering the biennial oscillation and the seasonal effects of the stratospheric winds. Maintaining these launch sites offer the science community 3 point world coverage for heavy lift balloons as well as the rapidly deployed Ultra-light payloads and TM systems ASI developed to use for test platforms, micro experiments, as well as a comprehensive student pilot program. This paper discusses the development of the launch facilities and international LDB development.

  7. Treatment of traumatic carotid cavernous fistulas using detachable balloons

    Energy Technology Data Exchange (ETDEWEB)

    Han, Moon Hee; Han, Joon Koo; Chang, Kee Hyun [Seoul National University College of Medicine, Seoul (Korea, Republic of)


    Since the introduction of the concept of detachable balloon technique to occlude arteriovenous fistulas, this technique has become the treatment of choice in the management of traumatic carotid cavernous fistulas (CCF). We tried the occlusion of fistula using detachable balloons in 30 consecutive cases of traumatic CCF and the result of our experience is reported. Transarterial approach with manually-tied latex balloons is tried in all cases and the fistulas were successfully occlude in 28 cases of all. In 20 cases, internal carotid artery was preserved and the arterial lumen was occluded along with fistula opening in 9 cases. In rest of 2 cases, surgical ligation was done because of procedure-related thromboembolism and incomplete occlusion of fistula. We experienced hemiparesis as a major complication in 3 cases. In one of them, the symptom developed during occlusion tolerance test, one just after insertion of guiding catheter into the internal carotid artery, and in one case 2 days after the occlusion of internal carotid artery. In one case, the procedure was performed by the direct puncture of carotid artery because of the ligation of common carotid artery by previous surgery. It is suggested that the systemic heparinization during the procedure is indispensable and starting the procedure with No 9 balloon is considered reasonable.

  8. Binary restenosis post-cutting balloon ptca before stenting

    National Research Council Canada - National Science Library

    Flores, Jesús Flores; Villada, José Antonio Palomo; Ruiz, Enrique Bernal; Hernández, Jaime Santiago; Silvestre, Armando Montoya; Sandoval, Raúl Astudillo; Gallegos, Joel Estrada; Velasco, Arturo Abundes; Campa, Javier Farell


    .... From January 2003 to June 2004, 1,300 PTCA with stent were made; we selected a group of 39 patients in whom the cutting balloon was used (3.3%). Average age was 60.4+/-9.2 years. There were 32 men (80%) and 8 women (20...

  9. Virginia Space Grant Consortium Upper Atmospheric Payload Balloon System (Vps) (United States)

    Marz, Bryan E.; Ash, Robert L.


    This document provides a summary of the launch and post-launch activities of Virginia Space Grant Consortium Upper Atmospheric Payload Balloon System, V(ps). It is a comprehensive overview covering launch activities, post-launch activities, experimental results, and future flight recommendations.

  10. Malfunctioning Plastic Biliary Endoprosthesis: Percutaneous Transhepatic Balloon Pulling Technique (United States)

    Rossi, Umberto G.; Rigamonti, Paolo; Cariati, Maurizio


    Percutaneous transhepatic removal techniques for malfunctioning plastic biliary endoprosthesis are considered safe and efficient second-line strategies, when endoscopic procedures are not feasible. We describe the percutaneous transhepatic balloon pulling technique in a patient with an unresectable malignant hilar cholangiocarcinoma. PMID:23984158

  11. Malfunctioning Plastic Biliary Endoprosthesis: Percutaneous Transhepatic Balloon Pulling Technique

    Directory of Open Access Journals (Sweden)

    Umberto G. Rossi


    Full Text Available Percutaneous transhepatic removal techniques for malfunctioning plastic biliary endoprosthesis are considered safe and efficient second-line strategies, when endoscopic procedures are not feasible. We describe the percutaneous transhepatic balloon pulling technique in a patient with an unresectable malignant hilar cholangiocarcinoma.

  12. Overview of the TILDAE High-Altitude Balloon Mission (United States)

    Godbole, N. H.; Maruca, B.; Marino, R.; Sundkvist, D. J.; Constantin, S.; Zimmerman, H.; Carbone, V.


    Though the presence of intermittent turbulence in the stratosphere has been well established, much remains unknown about it. In situ observations of this phenomenon, which have provided the greatest detail of it, have typically been achieved via sounding balloons (i.e., small balloons which burst at peak altitude) carrying constant-temperature "hot wire" anemometers (CTAs). The Turbulence and Intermittency Long-Duration Atmospheric Experiment (TILDAE) was developed to test a new paradigm for stratospheric observations. Rather than flying on a sounding balloon, TILDAE was incorporated as an "add-on" experiment to the payload of a NASA long-duration balloon mission that launched in January, 2016 from McMurdo Station, Antarctica. Furthermore, TILDAE's key instrument was a sonic anemometer, which (relative to a CTA) provides better-calibrated measurements of wind velocity and more-robust separation of velocity components. This presentation focuses on the technical details of TILDAE's instrumentation and the performance thereof during its flight. Potential design improvements for future flights are also discussed.

  13. Percutaneous transvenous angioplasty of inferior vena cava by balloon dilatation

    Energy Technology Data Exchange (ETDEWEB)

    Suh, Kyung Suk; Kim, Jae Kyu; Park, Jin Gyun; Kang, Heung Keun; Chung, Hyon De; Kim, Shin Kon; Chung, Sang Young [Chonnam National University College of Medicine, Kwangju (Korea, Republic of)


    3 patients with membranous (2 patients) and segmental (1 patient) obstruction of IVC were successfully treated by percutaneous transvenous angioplasty using balloon catheter. Improvements of clinical and radiological findings could be obtained after procedures. Relatively good patency was obtained in all cases without complications. This procedure can be applied safely to membranous or segmental obstructions of IVC and elsewhere in the venous systems.

  14. Scientific Ballooning Technologies Workshop STO-2 Thermal Design and Analysis (United States)

    Ferguson, Doug


    The heritage thermal model for the full STO-2 (Stratospheric Terahertz Observatory II), vehicle has been updated to model the CSBF (Columbia Scientific Balloon Facility) SIP-14 (Scientific Instrument Package) in detail. Analysis of this model has been performed for the Antarctica FY2017 launch season. Model temperature predictions are compared to previous results from STO-2 review documents.

  15. Balloon-borne gamma-ray telescope with nuclear emulsion


    Takahashi, Satoru; Group, for the Emulsion Gamma-ray Telescope


    By detecting the beginning of electron pairs with nuclear emulsion, precise gamma-ray direction and gamma-ray polarization can be detected. With recent advancement in emulsion scanning system, emulsion analyzing capability is becoming powerful. Now we are developing the balloon-borne gamma-ray telescope with nuclear emulsion. Overview and status of our telescope is described.

  16. 28. Critical pulmonary valve stenosis: Medical management beyond balloon dilation

    Directory of Open Access Journals (Sweden)

    Muhammad Arif Khan


    Conclusion: Phentolamine and/or Captopril have a therapeutic role in neonates with critical PVS who remain oxygen dependent after balloon dilation. Both medicationslead to vasodilatation of pulmonary and systemic vascularity. They facilitate inflowto the right ventricle. Right to left shunt across a PFO or/ ASD minimizesand saturation improves leading to a significantreduction in length of hospitalization.

  17. Complications of flow-directed balloon-tipped catheters. (United States)

    Smart, F W; Husserl, F E


    Acute or short-term complications following the use of flow-directed balloon-tipped catheters are well recognized. Long-term sequelae are rarely reported. We report herein an early complication of pulmonary arterial rupture with infarction followed by the delayed development of a pulmonary arterial aneurysm.

  18. Latex micro-balloon pumping in centrifugal microfluidic platforms. (United States)

    Aeinehvand, Mohammad Mahdi; Ibrahim, Fatimah; Harun, Sulaiman Wadi; Al-Faqheri, Wisam; Thio, Tzer Hwai Gilbert; Kazemzadeh, Amin; Madou, Marc


    Centrifugal microfluidic platforms have emerged as point-of-care diagnostic tools. However, the unidirectional nature of the centrifugal force limits the available space for multi-step processes on a single microfluidic disc. To overcome this limitation, a passive pneumatic pumping method actuated at high rotational speeds has been previously proposed to pump liquid against the centrifugal force. In this paper, a novel micro-balloon pumping method that relies on elastic energy stored in a latex membrane is introduced. It operates at low rotational speeds and pumps a larger volume of liquid towards the centre of the disc. Two different micro-balloon pumping mechanisms have been designed to study the pump performance at a range of rotational frequencies from 0 to 1500 rpm. The behaviour of the micro-balloon pump on the centrifugal microfluidic platforms has been theoretically analysed and compared with the experimental data. The experimental data show that the developed pumping method dramatically decreases the required rotational speed to pump liquid compared to the previously developed pneumatic pumping methods. It also shows that within a range of rotational speed, a desirable volume of liquid can be stored and pumped by adjusting the size of the micro-balloon.

  19. Conservative therapy versus intra-gastric balloon in treatment of ...

    African Journals Online (AJOL)

    diet and exercises) versus intra-gastric balloon in PWS patients. Ten children born with PWS from both sexes ranging in age from 8 to 15 years were assigned into two groups of equal number. Study group I received conservative therapy in the ...

  20. Balloon atrial septostomy under echocardiographic guide: case series

    Directory of Open Access Journals (Sweden)

    SM Meraji


    Full Text Available Background: Balloon atrial septostomy is an emergent procedure in pediatric cardiology. Nowadays, most patients in need of the procedure have acceptable outcomes after surgical repair. Thus, it is important to perform this procedure as safe as possible. By performing early arterial switch operation and prostaglandin infusion, the rate of balloon atrial septostomy has markedly decreased. However, not all centers performing early arterial switch repairs have abandoned atrial septostomy, even in patients who respond favorably to prostaglandin infusion.Case presentation: In total, eight 1- to 15-day old term neonates admitted in Shahid Rajaee Heart Center in Tehran, Iran from October 2009 to February 2011, with congenital heart diseases were scheduled for balloon atrial septostomy. In six cases the procedure was done exclusively under echocardiographic guidance and in two cases with the help of fluoroscopy. Success was defined as the creation of an atrial septal defect with a diameter equal to or more than 5 mm and ample mobility of its margins.Results: Male sex was predominant (87% and the mean age of the neonates was six days. The diagnosis in all cases was simple transposition of great arteries. The procedure was successful in all patients with any cardiovascular complication.Conclusion: Balloon atrial septostomy is an emergent procedure that can be done safely and effectively under echocardiographic guidance. According to the feasibility of this technique it could be performed fast, safe and effective at bedside, avoiding patient transportation to hemodynamic laboratory or referral center.

  1. Balloon valvuloplasty for severe mitral valve stenosis in pregnancy ...

    African Journals Online (AJOL)

    Balloon valvuloplasties for severe mitral stenosis were performed on 11 pregnant patients with excellent resutts and no complications. The mitral valve area was increased from a mean of 0.9 cnr to 2.1 cnr. There was no clinically significant mitral regurgitation. The pregnancies proceeded normally to delivery at or near tenn, ...

  2. Anchor balloons assisted deep intubation of 5F catheters for ...

    African Journals Online (AJOL)


    Jul 24, 2015 ... other lesions that cannot be crossed, even with the aforementioned techniques. Here, we report four ..... balloon technique may damage the anchored branch. The 5F “child‑in‑mother” catheter would be another .... Rev Esp Cardiol (Engl Ed) 2013;66:636‑43. 2. Chambers JW, Feldman RL, Himmelstein SI, ...

  3. Comparison of balloon kyphoplasty with the new Kiva® VCF system for the treatment of vertebral compression fractures. (United States)

    Otten, Lucia A; Bornemnn, Rahel; Jansen, Tom R; Kabir, Koursh; Pennekamp, Peter H; Wirtz, Dieter C; Stuwe, Brit; Pflugmacher, Robert


    Vertebral compression fractures are common among the elderly, which is conditioned by osteoporosis. They cause back pain and limit the patient's activities. The Kiva® VCF Treatment System is a new device to treat vertebral compression fractures. Compared to other methods, the utilization of the Kiva System reduces the risk for complications and delivers improvements in back pain reduction and functionality. Evaluation of safety and effectiveness of the Kiva System in comparison to balloon kyphoplasty on the basis of matched pairs. 52 patients (47 - 89 years, 68 fractures) were treated with balloon kyphoplasty or with the new Kiva System. Back pain and impairment of motility were assessed preoperatively and 6 months postoperatively, with the Visual Analog Scale (VAS) and Oswestry Disability Index (ODI). The operation time and cement extravasation were recorded. Control radiographs were evaluated for new fractures and vertebral heights. Mean VAS values in both groups improved from preoperatively 87.6 ± 12.8 and 83.1 ± 14.9 to 10.8 ± 20.8 and 24.6 ± 11.0 6 months after the treatment. The improvement after 6 months in the Kiva group was significantly better than in the balloon kyphoplasty group (P kyphoplasty group preoperatively to 24.8 ± 18.6% and 33.2 ± 6.3% 6 months after treatment. The mean operation time for the Kiva group was 12.7 ± 3.7 minutes per vertebra and cement leakage occurred in 6 patients. The mean operation time for the balloon kyphoplasty group was 34.1 ± 7.0 minutes per vertebra and cement leakage occurred in 8 patients. Anterior and mid vertebral height in the Kiva group increased from preoperatively 21.06 ± 7.44 mm and 18.36 ± 5.64 mm to postoperatively 22.41 ± 7.14 mm and 20.41 ± 6.00 mm. Anterior and mid vertebral height in the balloon kyphoplasty group increased from preoperatively 21.68 ± 2.06 mm and 21.97 ± 1.78 mm to postoperatively 25.09 ± 2.54 mm and 25.29 ± 2.10 mm. Vertebral height restoration could be therefore

  4. Lightweight Liquid Helium Dewar for High-Altitude Balloon Payloads (United States)

    Kogut, Alan; James, Bryan; Fixsen, Dale


    Astrophysical observations at millimeter wavelengths require large (2-to-5- meter diameter) telescopes carried to altitudes above 35 km by scientific research balloons. The scientific performance is greatly enhanced if the telescope is cooled to temperatures below 10 K with no emissive windows between the telescope and the sky. Standard liquid helium bucket dewars can contain a suitable telescope for telescope diameter less than two meters. However, the mass of a dewar large enough to hold a 3-to-5-meter diameter telescope would exceed the balloon lift capacity. The solution is to separate the functions of cryogen storage and in-flight thermal isolation, utilizing the unique physical conditions at balloon altitudes. Conventional dewars are launched cold: the vacuum walls necessary for thermal isolation must also withstand the pressure gradient at sea level and are correspondingly thick and heavy. The pressure at 40 km is less than 0.3% of sea level: a dewar designed for use only at 40 km can use ultra thin walls to achieve significant reductions in mass. This innovation concerns new construction and operational techniques to produce a lightweight liquid helium bucket dewar. The dewar is intended for use on high-altitude balloon payloads. The mass is low enough to allow a large (3-to-5-meter) diameter dewar to fly at altitudes above 35 km on conventional scientific research balloons without exceeding the lift capability of the balloon. The lightweight dewar has thin (250- micron) stainless steel walls. The walls are too thin to support the pressure gradient at sea level: the dewar launches warm with the vacuum space vented continuously during ascent to eliminate any pressure gradient across the walls. A commercial 500-liter storage dewar maintains a reservoir of liquid helium within a minimal (hence low mass) volume. Once a 40-km altitude is reached, the valve venting the vacuum space of the bucket dewar is closed to seal the vacuum space. A vacuum pump then

  5. The recovery time of traumatic carotid-cavernous fistula-induced oculomotor nerve paresis after endovascular treatment with detachable balloons. (United States)

    Liu, Yan-Chao; Duan, Chuan-Zhi; Gu, Da-Qun; Zhang, Xin; Li, Xi-Feng; He, Xu-Ying; Su, Shi-Xing; Lai, Ling-Feng; Hui-Li


    The recovery time of traumatic carotid-cavernous fistula-induced oculomotor nerve paresis (ONP) after endovascular embolization with detachable balloons has not yet been adequately evaluated. This study was performed to make a deep analysis of the factors, which affect the prognosis of ONP after endovascular treatment of traumatic carotid-cavernous fistula (TCCF). We retrospectively evaluated the clinical characteristics and the outcome of oculomotor nerve function in a series of 98 consecutive patients with ONP due to traumatic carotid-cavernous fistula which were endovascular treated with detachable balloons. Univariate analysis was applied to test the association between the time of ONP recovery and clinical variables. Ninety-eight consecutive patients (62 males, 36 females, mean age 34.2±12.7years) having presented with ONP underwent endovascular treatment with detachable balloons were enrolled in this study. ONP was complete in 22 (22.4%) patients and partial in 76 (77.6%) patients. Ninety (91.8%) patients were successfully occluded by single-session endovascular embolization. Retreatments by transarterial routes had to be performed in 8 (8.2%) patients because of recurrent fistula having occurred within 4weeks after embolization. ONP was recovered completely in all the patients, among who 4 (4.1%) were treated with occlusion of internal carotid artery. Factors showing significant association with the recovery time of ONP were the location of the fistula (P=0.007), the degree of preoperative ONP (P=0.003), the number of detachable balloon used (P=0.000) and the length of ONP before endovascular treatment (P=0.000). Endovascular treatment of traumatic carotid-cavernous fistula-induced ONP with detachable balloons is a safe and effective method. The length of ONP before endovascular treatment, the location of the fistula, the degree of preoperative ONP, the number of detachable balloons used were the statistically significant predictors of the length of ONP

  6. Generalised ballooning theory of two-dimensional tokamak modes (United States)

    Abdoul, P. A.; Dickinson, D.; Roach, C. M.; Wilson, H. R.


    In this work, using solutions from a local gyrokinetic flux-tube code combined with higher order ballooning theory, a new analytical approach is developed to reconstruct the global linear mode structure with associated global mode frequency. In addition to the isolated mode (IM), which usually peaks on the outboard mid-plane, the higher order ballooning theory has also captured other types of less unstable global modes: (a) the weakly asymmetric ballooning theory (WABT) predicts a mixed mode (MM) that undergoes a small poloidal shift away from the outboard mid-plane, (b) a relatively more stable general mode (GM) balloons on the top (or bottom) of the tokamak plasma. In this paper, an analytic approach is developed to combine these disconnected analytical limits into a single generalised ballooning theory. This is used to investigate how an IM behaves under the effect of sheared toroidal flow. For small values of flow an IM initially converts into a MM where the results of WABT are recaptured, and eventually, as the flow increases, the mode asymptotically becomes a GM on the top (or bottom) of the plasma. This may be an ingredient in models for understanding why in some experimental scenarios, instead of large edge localised modes (ELMs), small ELMs are observed. Finally, our theory can have other important consequences, especially for calculations involving Reynolds stress driven intrinsic rotation through the radial asymmetry in the global mode structures. Understanding the intrinsic rotation is significant because external torque in a plasma the size of ITER is expected to be relatively low.

  7. Challenges of the opto-mechanical conceptual design of a small far-IR balloon experiment (United States)

    Dournaux, Jean-Laurent; Berthod, Christophe; Horville, David; Huet, Jean-Michel; Laporte, Philippe; Wiedner, Martina; Romanow, Alexia; Krieg, Jean-Michel; Pagani, Laurent; Evrard, Jean; Gomes, Albert; Jouret, Martine


    Astronomers require more and more precise instruments for their observations. Here we describe the challenges encountered in the optical and mechanical designs of the CIDRE (Campagne d'Identification du Deutérium par Réception hEtérodyne) project, which was to be flown on a high altitude balloon at 40 km. The project aimed to measure the transitions of the HD molecule at 2.675 THz band and some other THz lines in our galaxy. The astronomers asked to fly the biggest possible telescope in a standard balloon gondola, and required high pointing accuracy (7 arcsec). In January 2014, the technical project, including the optical and mechanical designs, was evaluated to be of excellent standard, but, for all that, the project was cancelled because of financial constraints. Nevertheless the phase A study allowed us to identify the optical and mechanical challenges of balloon projects and we were able to come up with a simple design, that fulfilled all the requirements. The 900 mm primary mirror and the rest of the optics were designed to be supported by a sandwich-panel composite structure with carbon epoxy skins and aluminum honeycomb core to improve the mechanical stiffness and the thermal behavior of the instrument without increasing its mass or its complexity. In this paper, we describe the optical design and the mechanical structure of the instrument. Finite element analysis is carried out to estimate the gravitational flexure and the thermal deformations, which can both harm the pointing accuracy and the performances of the instrument. These simulations show that the proposed design would fulfill the different requirements (pointing accuracy, landing survival as well as the dynamic behavior).

  8. Percutaneous anterolateral balloon kyphoplasty for metastatic lytic lesions of the cervical spine (United States)

    Anagnostidis, Kleovoulos S.; AlZeer, Ziad; Kapetanos, George A.


    The purpose of our report is to describe a new application of kyphoplasty, the percutaneous anterolateral balloon kyphoplasty that we performed in two cases of metastatic osteolytic lesions in cervical spine. The first patient, aged 48 years, with primary malignancy in lungs had two metastatic lesions in C2 and C6 vertebrae. Patient’s complaints were about pain and restriction of movements (due to the pain) in the cervical spine. The second patient, aged 70 years, with primary malignancy in stomach, had multiple metastatic lesions in thoracolumbar spine and C3, C4 and C5 vertebrae without neurological symptoms. The main symptoms were from cervical spine with severe pain even in bed rest and systematic use of opiate-base analgesis. The preoperative status was evaluated with X-rays, CT scan, MRI scan and with Karnofsky score and visual analogue pain (VAS) scale. Both patients underwent percutaneous anterolateral balloon kyphoplasty via the anterolateral approach in cervical spine under general anaesthesia. No clinical complications occurred during or after the procedure. Both patients experienced pain relief immediately after balloon kyphoplasty and during the following days. The stiffness also resolved rapidly and cervical collars were removed. VAS score significantly improved from 85 and 95 preoperatively to 30 in both patients. Karnofsky score showed also improvement from 40 and 30 preoperatively to 80 and 70, respectively, at the final follow-up (7 months after the procedure). Fluoroscopy-guided percutaneous anterolateral ballon kyphoplasty proved to be safe and effective minimally invasive procedure for metastatic osteolytic lesions of the cervical spine, reducing pain and avoiding vertebral collapse. Experience and attention are necessary in order to avoid complications. PMID:20499113

  9. Radiologically inserted gastrostomy: differences of maintenance of balloon- vs. loop-retained devices. (United States)

    Busch, J D; Herrmann, J; Adam, G; Habermann, C R


    To compare outcome and associated complications of ballon- vs. loop-retained devices for radiologically inserted gastrostomy (RIG). From 2007 to 2011 233 patients (age 63.7 ± 10.6 years) were referred for a RIG because of pharyngeal stricture Intervention was performed with four different devices: balloon-retained - Freka(®) GastroTube, Fresenius Kabi (n = 121); MIC(®) Gastrostomy Feeding Tube, Kimberly-Clark (n = 34); Russell(®) Gastrostomy Tray, Cook Medical Inc. (n = 17); and loop-retained - Tilma(®) Gastrostomy Set, Cook Medical Inc. (n = 50). Follow-up was performed with regard to RIG-related complications, cause of removal and fatalities. Revision-free survival times after RIG were evaluated using Kaplan-Meier analysis and group differences by log-rank tests. For analysis of demographic and methodical variables multivariate Cox regression models were used. With a primary technical success rate of 95.3% (222/233) a total of 92 instances of revisions were necessary in 66 patients (66/233, 28.3%) during follow-up (mean 182.8 ± 86.6 days). The most common complication was tube dislodgement (14.3%). There were no significant differences between the distinct devices (p = 0.098), but analyzing the data in subgroups of balloon-compared to loop-retained gastrostomy tubes we observed a significantly higher probability of minor complications for the latter (p = 0.023). As it is significantly less prone to minor complications we recommend the use of balloon-retained gastrostomy tubes to improve the practicability and maintenance of RIG.

  10. Short- and long-term efficacy of endoscopic balloon dilation in Crohn's disease strictures. (United States)

    de'Angelis, Nicola; Carra, Maria Clotilde; Borrelli, Osvaldo; Bizzarri, Barbara; Vincenzi, Francesca; Fornaroli, Fabiola; De Caro, Giuseppina; de'Angelis, Gian Luigi


    To evaluate short- and long-term efficacy of endoscopic balloon dilation in a cohort of consecutive patients with symptomatic Crohn's disease (CD)-related strictures. Twenty-six CD patients (11 men; median age 36.8 year, range 11-65 years) with 27 symptomatic strictures underwent endoscopic balloon dilation (EBD). Both naive and post-operative strictures, of any length and diameter, with or without associated fistula were included. After a clinical and radiological assessment, EBD was performed with a Microvasive Rigiflex through the scope balloon system. The procedure was considered successful if no symptom reoccurred in the following 6 mo. The long-term clinical outcome was to avoid surgery. The mean follow-up time was 40.7 ± 5.7 mo (range 10-94 mo). In this period, forty-six EBD were performed with a technical success of 100%. No procedure-related complication was reported. Surgery was avoided in 92.6% of the patients during the entire follow-up. Two patients, both presenting ileocecal strictures associated with fistula, failed to respond to the treatment and underwent surgical strictures resection. Of the 24 patients who did not undergo surgery, 11 patients received 1 EBD, and 13 required further dilations over time for the treatment of relapsing strictures (7 patients underwent 2 dilations, 5 patients 3 dilations, and 1 patient 4 dilations). Overall, the EBD success rate after the first dilation was 81.5%. No difference was observed between the EBD success rate for naive (n = 12) and post-operative (n = 15) CD related strictures (P > 0.05). EBD appears to be a safe and effective procedure in the therapeutic management of CD-related strictures of any origin and dimension in order to prevent surgery.

  11. Short- and long-term efficacy of endoscopic balloon dilation in Crohn’s disease strictures (United States)

    de’Angelis, Nicola; Carra, Maria Clotilde; Borrelli, Osvaldo; Bizzarri, Barbara; Vincenzi, Francesca; Fornaroli, Fabiola; De Caro, Giuseppina; de’Angelis, Gian Luigi


    AIM: To evaluate short- and long-term efficacy of endoscopic balloon dilation in a cohort of consecutive patients with symptomatic Crohn’s disease (CD)-related strictures. METHODS: Twenty-six CD patients (11 men; median age 36.8 year, range 11-65 years) with 27 symptomatic strictures underwent endoscopic balloon dilation (EBD). Both naive and post-operative strictures, of any length and diameter, with or without associated fistula were included. After a clinical and radiological assessment, EBD was performed with a Microvasive Rigiflex through the scope balloon system. The procedure was considered successful if no symptom reoccurred in the following 6 mo. The long-term clinical outcome was to avoid surgery. RESULTS: The mean follow-up time was 40.7 ± 5.7 mo (range 10-94 mo). In this period, forty-six EBD were performed with a technical success of 100%. No procedure-related complication was reported. Surgery was avoided in 92.6% of the patients during the entire follow-up. Two patients, both presenting ileocecal strictures associated with fistula, failed to respond to the treatment and underwent surgical strictures resection. Of the 24 patients who did not undergo surgery, 11 patients received 1 EBD, and 13 required further dilations over time for the treatment of relapsing strictures (7 patients underwent 2 dilations, 5 patients 3 dilations, and 1 patient 4 dilations). Overall, the EBD success rate after the first dilation was 81.5%. No difference was observed between the EBD success rate for naive (n = 12) and post-operative (n = 15) CD related strictures (P > 0.05). CONCLUSION: EBD appears to be a safe and effective procedure in the therapeutic management of CD-related strictures of any origin and dimension in order to prevent surgery. PMID:23674873

  12. Efficiency of Balloon Kyphoplasty in the Treatment of Osteoporotic Vertebral Compression Fractures. (United States)

    Baz, Ali Bülent; Akalin, Serdar; Kiliçaslan, Ömer Faruk; Tokatman, Bogaçhan; Arik, Hasan; Duygun, Fatih


    Eighty-seven osteoporotic vertebral fractures of 82 patients were treated with balloon kyphoplasty. Preoperative, postoperative and follow-up outcomes of functional impairment, pain scores and vertebral height restorations of the patients were recorded and evaluated statistically. Seventy-two of the patients were female (87.8%) and 10 (12.2%) were male. Mean age of all patients were 66.4 years. Preoperative mean Anterior Vertebral Body Height of 48.20±13.94 % and Middle Vertebral Body Height of 59.40±14.26 % were recorded as 79.91±9.50 % and 86.90±8.38 % respectively postoperatively and noted to be 73.26±8.59 % and 84.65±8.19 % at last controls respectively. The mean Oswestry Disability Index and Visual Analog Pain Scale also improved significantly. Local Kyphosis of all the patients were also evaluated and a significant improvement was noted postoperatively. The long term results of this study suggest that balloon kyphoplasty is an effective and safe treatment option in osteoporotic vertebral fractures and should be considered for functional improvement, pain relief and height restoration.

  13. Efficacy and safety of balloon-occluded retrograde transvenous obliteration with sodium tetradecyl sulfate liquid sclerotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Chang, Il Soo; Park, Sang Woo; Kwon, So Young; Cheo, Won Hyeok; Cheon, Young Koog; Shim, Chan Sup; Lee, Tae Yoon; Kim, Jeong Han [Digestive Disease Center, Konkuk University School of Medicine, Seoul (Korea, Republic of)


    To evaluate the efficacy and safety of balloon-occluded retrograde transvenous obliteration (BRTO) with sodium tetradecyl sulfate (STS) liquid sclerotherapy of gastric varices. Between February 2012 and August 2014, STS liquid sclerotherapy was performed in 17 consecutive patients (male:female = 8:9; mean age 58.6 years, range 44-86 years) with gastric varices. Retrograde venography was performed after occlusion of the gastrorenal shunt using a balloon catheter and embolization of collateral draining veins using coils or gelfoam pledgets, to evaluate the anatomy of the gastric varices. We prepared 2% liquid STS by mixing 3% STS and contrast media in a ratio of 2:1. A 2% STS solution was injected into the gastric varices until minimal filling of the afferent portal vein branch was observed (mean 19.9 mL, range 6-33 mL). Patients were followed up using computed tomography (CT) or endoscopy. Technical success was achieved in 16 of 17 patients (94.1%). The procedure failed in one patient because the shunt could not be occluded due to the large diameter of gastrorenal shunt. Complete obliteration of gastric varices was observed in 15 of 16 patients (93.8%) with follow-up CT or endoscopy. There was no rebleeding after the procedure. There was no procedure-related mortality. BRTO using STS liquid can be a safe and useful treatment option in patients with gastric varices.

  14. From Capsule Endoscopy to Balloon-Assisted Deep Enteroscopy: Exploring Small-Bowel Endoscopic Imaging (United States)

    Cooley, D. Matthew; Walker, Andrew J.


    In the past 15 years, the use of endoscopic evaluations in patients with obscure gastrointestinal bleeding has become more common. Indications for further endoscopic interventions include iron deficiency anemia, suspicion of Crohn’s disease or small-bowel tumors, assessment of celiac disease or of ulcers induced by nonsteroidal anti-inflammatory drugs, and screening for familial adenomatous polyposis. Often, capsule endoscopy is performed in concert with other endoscopic studies and can guide decisions regarding whether enteroscopy should be carried out in an anterograde or a retrograde approach. Retrograde endoscopy is beneficial in dealing with disease of the more distal small bowel. Multiple studies have examined the diagnostic yield of balloon-assisted deep enteroscopy and have estimated a diagnostic yield of 40% to 80%. Some of the studies have found that diagnostic yields are higher when capsule endoscopy is performed before balloon-assisted deep enteroscopy in a search for small-bowel bleeds. Each of these procedures has a role when performed alone; however, research suggests that they are especially effective as complementary techniques and together can provide better-directed therapy. Both procedures are relatively safe, with high diagnostic and therapeutic yields that allow evaluation of the small bowel. Because both interventions are relatively new to the world of gastroenterology, much research remains to be done regarding their overall efficacy, cost, and safety, as well as further indications for their use in the detection and treatment of diseases of the small bowel. PMID:27099585

  15. Assessment of Predictive Response Factors to Intragastric Balloon Therapy for the Treatment of Obesity. (United States)

    Madeira, Eduardo; Madeira, Miguel; Guedes, Erika Paniago; Mafort, Thiago Thomaz; Neto, Leonardo Vieira; de Oliveira Moreira, Rodrigo; de Pinho, Paulo Roberto Alves; Lopes, Agnaldo José; Farias, Maria Lucia Fleiuss


    Obesity is a worldwide epidemic that is difficult to control with non-invasive treatments, which usually present poor results. In this context, the intragastric balloon (IGB) is an important tool that presents a mean body weight loss (BWL) estimated at approximately 12%, although individual responses are highly variable. This study assesses whether there are factors that can predict responses to IGB therapy either before or early after placement of the device. A total of 50 obese patients underwent insertion of IGB placed endoscopically, and patients were monitored for 6 months. The evaluated predictive factors involved general characteristics and psychological, social, and dyspeptic aspects, and the preliminary results obtained in the first month after balloon placement. The mean weight loss was 11.5%, and 48% of the participants presented BWL >10%. Among the factors analyzed before IGB placement, only advanced age (P = .04) and higher scores obtained in the social relationships domain of a shorter version of the World Health Organization's Quality of Life questionnaire (P = .02) were significant. Analysis of the factors evaluated after IGB placement revealed that the BWL amounts observed in week 2 (P = .001) and week 4 (P < .001) and the intensity of dyspeptic symptoms in week 2 (P < .001) were positive predictive factors. The assessment of predictive factors may help to manage patients with IGB.

  16. Induction of labour by balloon catheter with extra-amniotic saline infusion (BCEAS): a randomised comparison with PGE2 vaginal pessaries

    DEFF Research Database (Denmark)

    Lyndrup, J; Nickelsen, Carsten Nahne Amtof; Weber, Tom


    OBJECTIVE: A new method for induction of labour--balloon catheter with extra-amniotic saline infusion (BCEAS)--is evaluated in randomised comparison with prostaglandin E2 (PGE2) in vaginal pessaries. STUDY GROUP: One-hundred and nine pregnant women with unfavourable cervices. MAJOR OUTCOME MEASURES...

  17. The way the intra-aortic balloon catheter moves within the aorta as a possible mechanism of balloon associated morbidity

    National Research Council Canada - National Science Library

    Parissis, Haralambos; Leotsinidis, Michael; Dougenis, Dimitrios; Richens, David


    ... *Corresponding author. Tel.: +353-1-4103000; fax: +353-1-8265024. E-mail address : hparissis{at} (H. Parissis). This study set off to investigate which mode of weaning of an intra-aortic balloon pump...

  18. Fluorescence Lyman-Alpha Stratospheric Hygrometer (FLASH): application on meteorological balloons, long duration balloons and unmanned aerial vehicles. (United States)

    Lykov, Alexey; Khaykin, Sergey; Yushkov, Vladimir; Efremov, Denis; Formanyuk, Ivan; Astakhov, Valeriy

    The FLASH instrument is based on the fluorescent method, which uses H2O molecules photodissociation at a wavelength lambda=121.6 nm (Lalpha - hydrogen emission) followed by the measurement of the fluorescence of excited OH radicals. The source of Lyman-alpha radiation is a hydrogen discharge lamp while the detector of OH fluorescence at 308 -316 nm is a photomultiplier run in photon counting mode. The intensity of the fluorescent light as well as the instrument readings is directly proportional to the water vapor mixing ratio under stratospheric conditions with negligible oxygen absorption. Initially designed for rocket-borne application, FLASH has evolved into a light-weight balloon sonde (FLASH-B) for measurements in the upper troposphere and stratosphere on board meteorological and small plastic balloons. This configuration has been used in over 100 soundings at numerous tropical mid-latitude and polar locations within various international field campaigns. An airborne version of FLASH instrument is successfully utilized onboard stratospheric M55-Geophysica aircraft and tropospheric airborne laboratory YAK42-Roshydromet. The hygrometer was modified for application onboard stratospheric long-duration balloons (FLASH-LDB version). This version was successfully used onboard CNES super-pressure balloon launched from SSC Esrange in March 2007 and flown during 10 days. Special design for polar long duration balloon PoGOLite was created for testing work during polar day in June 2013. Installation and measurement peculiarities as well as observational results are presented. Observations of water vapour using FLASH-B instrument, being of high quality are rather costly as the payload recovery is often complicated and most of the time impossible. Following the goal to find a cost-efficient solution, FLASH was adapted for use onboard Unmanned Aerial Vehicles (UAV). This solution was only possible thanks to compactness and light-weight (0.5 kg) of FLASH instrument. The

  19. Safer urethral catheters: how study of catheter balloon pressure and force can guide design. (United States)

    Wu, Alex K; Blaschko, Sarah D; Garcia, Maurice; McAninch, Jack W; Aaronson, David S


    To better define urethral catheter balloon pressures and extraction forces during traumatic placement and removal of urethral catheters. To help guide design for safer urethral catheters. Measurements of balloon pressure were made upon filling within the urethra vs the bladder. Extraction forces were measured upon removal of a catheter with a filled balloon from the bladder. Models for the bladder and urethra included an ex vivo model (funnel, 'bladder', attached to a 30 F tube, 'urethra') and fresh human male cadavers. The mean (SEM) balloon pressures and extraction forces were calculated. In the ex vivo model, the mean (SEM) pressures upon filling the balloon with 10 mL were on average three-times higher within the ex vivo'urethra' (177 [6] kPa) vs 'bladder' (59 [2] kPa) across multiple catheter types. In the human cadaver, the mean balloon pressure was 1.9-times higher within the urethra (139 [11] kPa) vs bladder (68 [4] kPa). Balloon pressure increased non-linearly during intraurethral filling of both models, resulting in either balloon rupture (silicone catheters) or 'ballooning' of the neck of the balloon filling port (latex catheters). Removal of a filled balloon per the ex vivo model 'urethra' and cadaveric urethra, similarly required increasing force with greater balloon fill volumes (e.g. 9.34 [0.44] N for 5 mL vs 41.37 [8.01] N for 10 mL balloon volume). Iatrogenic complications from improper urethral catheter use is common. Catheter balloon pressures and manual extraction forces associated with urethral injury are significantly greater than those found with normal use. The differences in pressure and force may be incorporated into a safer urethral catheter design, which may significantly reduce iatrogenic urethral injury associated with catheterization. © 2011 THE AUTHORS. BJU INTERNATIONAL © 2011 BJU INTERNATIONAL.

  20. Bronchoscopy and Fogarty Balloon Insertion of Distal Tracheo-Oesophageal Fistula for Oesophageal Atresia Repair With Video Illustration. (United States)

    Rinkel, Rico; Van Poll, Daan; Sibarani-Ponsen, Renate; Sleeboom, Christien; Bakx, Roel


    During repair of esophageal atresia with distal tracheo-esophageal fistula, air leakage through the fistula during mechanical ventilation can cause respiratory demise. From February 2012 until November 2014, all patients with esophageal atresia and distal tracheo-esophageal fistula were subjected to preoperative tracheobronchoscopy. Relatively distal fistulas were cannulated with a Fogarty catheter and blocked by insufflation (video illustration). Relatively proximal distal fistulas were sealed by precise placement of a cuffed ventilation tube. Nine of 12 patients received Fogarty balloon placement. The fistula of the remaining 3 patients were sealed by careful tube placement. No complications related to tracheobronchoscopy or Fogarty placement were noted. All procedures were uneventful. Preoperative tracheobronchoscopy to evaluate the usefulness of Fogarty balloon insertion or correct tube placement for distal tracheo-esophageal fistula is a safe and easy to perform procedure that can avoid complications in type C esophageal atresia repair. © The Author(s) 2016.

  1. Critical appraisal of paclitaxel balloon angioplasty for femoral–popliteal arterial disease

    Directory of Open Access Journals (Sweden)

    Herten M


    contraindicated until now (ie, bifurcation, ostial lesions, and in leaving no stent scaffold behind. Reinterventions are easier to perform because DCBs leave no metal behind. Various combinations of DCBs with other treatment modalities may prove to be viable options in future. The follow-up results of clinical studies will evaluate the long-term impact of DCBs. Keywords: drug-coated balloon, critical limb ischemia, peripheral artery disease, restenosis, atherectomy, stent restenosis

  2. Stability and Agreement of a Microtransducer and an Air-Filled Balloon Esophageal Catheter in the Monitoring of Esophageal Pressure. (United States)

    Augusto, Renan Maloni; Albuquerque, André Luis Pereira; Jaeger, Thomas; de Carvalho, Carlos Roberto Ribeiro; Caruso, Pedro


    The use of esophageal catheters with microtransducer promises advantages over traditional catheters with air-filled balloons. However, performance comparisons between these 2 types of catheters are scarce and incomplete. A catheter with a 9.5-cm air-filled balloon at the distal tip and a catheter with a microtransducer mounted within a flexible silicone rubber were tested in vitro and in vivo. In vitro, the response times of both catheters were compared, and the drift of the baseline pressure of the microtransducer catheter was evaluated over a 6-h period. In vivo, 11 healthy volunteers had both catheters inserted, and the drift of the baseline esophageal pressure was measured over a 3-h period. Also, the correlation and agreement of the baseline and changes in the esophageal pressure of both catheters were evaluated. In vitro, the microtransducer catheter had a response time significantly higher (262 × 114 Hz, P pressure stability, with a mean baseline pressure drift of 1.4 cm H2O. In vivo, both catheters presented a small and similar baseline esophageal pressure drift (P = 0.08). For measurements of baseline and changes in esophageal pressure, the correlation and agreement between the catheters were poor, with a large bias between them. The catheter with the microtransducer had a small baseline pressure drift, similar to the air-filled balloon catheter. The low agreement between the catheters does not allow the microtransducer catheter to be used as a surrogate for the traditional air-filled balloon catheter. Copyright © 2017 by Daedalus Enterprises.

  3. Cutting-Balloon Angioplasty Versus Balloon Angioplasty as Treatment for Short Atherosclerotic Lesions in the Superficial Femoral Artery: Randomized Controlled Trial

    Energy Technology Data Exchange (ETDEWEB)

    Poncyljusz, Wojciech, E-mail:; Falkowski, Aleksander, E-mail: [Pomeranian Medical University, Department of Interventional Radiology (Poland); Safranow, Krzysztof, E-mail:; Rac, Monika, E-mail: [Pomeranian Medical University, Department of Biochemistry and Medical Chemistry (Poland); Zawierucha, Dariusz, E-mail: [Interventional Radiology, Sacred Heart Medical Center, River Bend (United States)


    Purpose: To evaluate the treatments of a short-segment atherosclerotic stenosis in the superficial femoral arteries with the cutting balloon angioplasty (CBA) versus conventional balloon angioplasty [percutaneous transluminal angioplasty (PTA)] in a randomized controlled trial. Material and Methods: The study group comprised 60 patients (33 men, 27 women; average age 64 years) with a short ({<=}5 cm) focal SFA de novo atherosclerotic stenosis associated with a history of intermittent claudication or rest pain. The primary end point of this study was the rate of binary restenosis in the treated segment 12 months after the intervention. All patients were evenly randomized to either the PTA or CBA treatment arms. Follow-up angiograms and ankle-brachial index (ABI) measurements were performed after 12 months. The evaluation of the restenosis rates and factors influencing its occurrence were calculated by logistic regression analysis. Results: In the intention-to-treat analysis, restenosis rates after 2-month follow-up were 9 of 30 (30 %) in the PTA group and 4 of 30 (13 %) in the CBA group (p = 0.117). In the actual treatment analysis, after exclusion of patients who required nitinol stent placement for a suboptimal result after angioplasty alone (5 patients in the PTA group and none in the CBA group), restenosis rates were 9 of 25 (36 %) and 4 of 30 (13 %), respectively (p = 0.049). In the intention-to-treat analysis there were also significant differences in ABI values between the PTA and CBA groups at 0.77 {+-} 0.11 versus 0.82 {+-} 0.12, respectively (p = 0.039), at 12 months. Conclusion: Based on the presented results of the trial, CBA seems to be a safer and more effective than PTA for treatment of short atherosclerotic lesions in the superior femoral artery.

  4. Cutting-balloon angioplasty versus balloon angioplasty as treatment for short atherosclerotic lesions in the superficial femoral artery: randomized controlled trial. (United States)

    Poncyljusz, Wojciech; Falkowski, Aleksander; Safranow, Krzysztof; Rać, Monika; Zawierucha, Dariusz


    To evaluate the treatments of a short-segment atherosclerotic stenosis in the superficial femoral arteries with the cutting balloon angioplasty (CBA) versus conventional balloon angioplasty [percutaneous transluminal angioplasty (PTA)] in a randomized controlled trial. The study group comprised 60 patients (33 men, 27 women; average age 64 years) with a short (≤ 5 cm) focal SFA de novo atherosclerotic stenosis associated with a history of intermittent claudication or rest pain. The primary end point of this study was the rate of binary restenosis in the treated segment 12 months after the intervention. All patients were evenly randomized to either the PTA or CBA treatment arms. Follow-up angiograms and ankle-brachial index (ABI) measurements were performed after 12 months. The evaluation of the restenosis rates and factors influencing its occurrence were calculated by logistic regression analysis. In the intention-to-treat analysis, restenosis rates after 2-month follow-up were 9 of 30 (30 %) in the PTA group and 4 of 30 (13 %) in the CBA group (p = 0.117). In the actual treatment analysis, after exclusion of patients who required nitinol stent placement for a suboptimal result after angioplasty alone (5 patients in the PTA group and none in the CBA group), restenosis rates were 9 of 25 (36 %) and 4 of 30 (13 %), respectively (p = 0.049). In the intention-to-treat analysis there were also significant differences in ABI values between the PTA and CBA groups at 0.77 ± 0.11 versus 0.82 ± 0.12, respectively (p = 0.039), at 12 months. Based on the presented results of the trial, CBA seems to be a safer and more effective than PTA for treatment of short atherosclerotic lesions in the superior femoral artery.

  5. Primary obstructive megaureter: the role of high pressure balloon dilation. (United States)

    Romero, Rosa M; Angulo, Jose Maria; Parente, Alberto; Rivas, Susana; Tardáguila, Ana Rosa


    There is a growing interest in minimally invasive treatment of primary obstructive megaureter (POM) in children. The absence of long-term follow-up data, however, makes it difficult to establish the indication for an endoscopic approach. The aim of our study is to determine the long-term efficacy of endourologic high-pressure balloon dilation of the vesicoureteral junction (VUJ) in children with POM that necessitates surgical treatment. We retrospectively reviewed the clinical records from children with POM who were treated with endourologic high-pressure balloon dilation of the VUJ from March 2003 to April 2010. To determine the long-term, a cohort study was conducted in November 2011. Endourologic dilation of the VUJ was performed with a semicompliant high-pressure balloon (2.7 FG) with a minimum balloon size of 3 mm, followed by placement of a Double-J stent. We have treated 29 (32 renal units, left [n=16], right [n=10] and bilateral [n=3]) children with a diagnosis of POM within this period. The median age at the time of the endourologic treatment was 4.04 months (range 1.6-39 months). In three cases, an open ureteral reimplantation was needed, in two cases because of intraoperative technical failure and postoperative Double-J stent migration in one patient. The 26 children (29 renal units) who had a successful endourologic dilation of the VUJ were followed with ultrasonography and MAG-3-Lasix (furosemide) studies that showed a progressive improvement of both the ureterohydronephrosis and drainage in the first 18 months in 20 patients (23 renal units) (69%). In two patients who were treated with a 3 mm balloon, a further dilation was needed, with an excellent outcome. The cohort study (at a median follow-up of 47 months) showed that in all patients who had a good outcome at the 18-month follow-up after endourologic balloon dilation remained asymptomatic with resolution of ureterohydronephrosis on the US and good drainage on the renogram, in the children

  6. Safety and efficacy of balloon kyphoplasty at 4 or more levels in a single anesthetic session. (United States)

    Wang, Alan C; Fahim, Daniel K


    OBJECTIVE In this case series, the authors evaluated the safety of balloon kyphoplasty at 4 or more vertebral levels in a single anesthetic session. The current standard is that no more than 3 levels should be cemented at one time because of a perceived risk of increased complications. METHODS A retrospective chart review was performed for 19 consecutive patients who underwent ≥ 4-level balloon kyphoplasty between July 1, 2011, and December 31, 2015. Outcomes documented included kyphoplasty-associated complications and incidences of subsequent vertebral fracture. RESULTS Nineteen patients aged 22 to 95 years (mean 66.1 years, median 66 years; 53% male, 47% female) had 4 or more vertebrae cemented during the same procedure (mean 4.6 levels [62 thoracic, 29 lumbar]). No postoperative anesthetic complication, infection, extensive blood loss, symptomatic cement leakage, pneumothorax, or new-onset anemia was observed. Five patients experienced new compression fracture within a mean of 278 days postoperatively. One patient with metastatic cancer suffered bilateral pulmonary embolism 19 days after surgery, but no evidence of cement in the pulmonary vasculature was found. CONCLUSIONS In this case series, kyphoplasty performed on 4 or more vertebral levels was not found to increase risk to patient safety, and it might decrease unnecessary risks associated with multiple operations. Also, morbidity associated with leaving some fractures untreated because of an unfounded fear of increased risk of complications might be decreased by treating 4 or more levels in the same anesthetic session.

  7. Heterogeneity-corrected vs -uncorrected critical structure maximum point doses in breast balloon brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Leonard, E-mail: [Department of Radiation Oncology, Cancer Institute of New Jersey, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ (United States); Narra, Venkat; Yue, Ning [Department of Radiation Oncology, Cancer Institute of New Jersey, Robert Wood Johnson Medical School, University of Medicine and Dentistry of New Jersey, New Brunswick, NJ (United States)


    Recent studies have reported potentially clinically meaningful dose differences when heterogeneity correction is used in breast balloon brachytherapy. In this study, we report on the relationship between heterogeneity-corrected and -uncorrected doses for 2 commonly used plan evaluation metrics: maximum point dose to skin surface and maximum point dose to ribs. Maximum point doses to skin surface and ribs were calculated using TG-43 and Varian Acuros for 20 patients treated with breast balloon brachytherapy. The results were plotted against each other and fit with a zero-intercept line. Max skin dose (Acuros) = max skin dose (TG-43) ⁎ 0.930 (R{sup 2} = 0.995). The average magnitude of difference from this relationship was 1.1% (max 2.8%). Max rib dose (Acuros) = max rib dose (TG-43) ⁎ 0.955 (R{sup 2} = 0.9995). The average magnitude of difference from this relationship was 0.7% (max 1.6%). Heterogeneity-corrected maximum point doses to the skin surface and ribs were proportional to TG-43-calculated doses. The average deviation from proportionality was 1%. The proportional relationship suggests that a different metric other than maximum point dose may be needed to obtain a clinical advantage from heterogeneity correction. Alternatively, if maximum point dose continues to be used in recommended limits while incorporating heterogeneity correction, institutions without this capability may be able to accurately estimate these doses by use of a scaling factor.

  8. Heterogeneity-corrected vs -uncorrected critical structure maximum point doses in breast balloon brachytherapy. (United States)

    Kim, Leonard; Narra, Venkat; Yue, Ning


    Recent studies have reported potentially clinically meaningful dose differences when heterogeneity correction is used in breast balloon brachytherapy. In this study, we report on the relationship between heterogeneity-corrected and -uncorrected doses for 2 commonly used plan evaluation metrics: maximum point dose to skin surface and maximum point dose to ribs. Maximum point doses to skin surface and ribs were calculated using TG-43 and Varian Acuros for 20 patients treated with breast balloon brachytherapy. The results were plotted against each other and fit with a zero-intercept line. Max skin dose (Acuros) = max skin dose (TG-43) * 0.930 (R(2) = 0.995). The average magnitude of difference from this relationship was 1.1% (max 2.8%). Max rib dose (Acuros) = max rib dose (TG-43) * 0.955 (R(2) = 0.9995). The average magnitude of difference from this relationship was 0.7% (max 1.6%). Heterogeneity-corrected maximum point doses to the skin surface and ribs were proportional to TG-43-calculated doses. The average deviation from proportionality was 1%. The proportional relationship suggests that a different metric other than maximum point dose may be needed to obtain a clinical advantage from heterogeneity correction. Alternatively, if maximum point dose continues to be used in recommended limits while incorporating heterogeneity correction, institutions without this capability may be able to accurately estimate these doses by use of a scaling factor. Copyright © 2013 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  9. Successful Use of Balloon Ablation to Treat Menorrhagia Complicating Aplastic Anemia (United States)

    Kim, Nancy; Donohue, Theresa; Sloand, Elaine; Stratton, Pamela


    Background Aplastic anemia (AA) complicated by menorrhagia is treated with transfusion and hormonal therapy. When bleeding is life-threatening, balloon endometrial ablation can safely be used to treat menorrhagia in selected patients. Case A 56-year-old postmenopausal woman was diagnosed with AA after several weeks of menorrhagia and pancytopenia. She became heavily alloimmunized after extensive platelet transfusion. During treatment with antithymocyte globulin, vaginal bleeding increased and the platelet count fell to 1,000/µl on supportive measures. After bleeding stopped with use of intravenous Premarin, she was examined in the operating room. There, a clot was removed and appeared to be a uterine caste; hemostasis continued. Transvaginal ultrasound revealed a normal endometrial contour and thin endometrium; endometrial histology was benign. After she completed antithymocyte globulin and her platelet count could be maintained over 30,000/µl with matched platelets, endometrial ablation was performed without any complications. Conclusion Thermal balloon endometrial ablation is an effective alternative to hysterectomy for women with persistent menorrhagia and AA when supportive measures fail. Prior to endometrial ablation, evaluation should ensure normal endometrial contour and histology, and that sufficient blood products are available to maintain platelet counts above 30,000/µl during the healing process. PMID:18446042

  10. [Balloon pulmonary valvuloplasty, 15-year experience at the Siglo XXI IMSS National Medical Center]. (United States)

    Juárez Rodríguez, Mariano; Alva Espinosa, Carlos; Ledesma Velasco, Mariano; Lázala Rodríguez, Gustavo; Jiménez Arteaga, Santiago; Sánchez Soberanes, Agustín; Ortegón Cardeña, José; David Gómez, Felipe; Hernández González, Martha; Magaña Serrano, José


    To evaluate 15 years of experience with balloon pulmonary valvuloplasty in a single third level health care center. Hundred-fifty patients underwent the procedure, 73 (48%) men and 77 (52%) women, mean age 10.5 +/- 11.3 years. The initial systolic gradient decreased from 86 +/- 35 to 21.67 +/- 12.20 mm Hg, p < 0.001, whereas the initial right ventricular systolic pressure decreased from 106 +/- 34.8 to 53 +/- 27 mm Hg, p < 0.0001. At the end of the follow-up, 48 +/- 44 months, the systolic gradient was 13.43 +/- 8.73 mm Hg, p < 0.001. Major complications occurred in 9 (6.4%) patients. Immediate technical success was achieved in 111 (74%) patients and failure in 39 (26%). At the end of the follow-up period, successful outcomes were achieved in 104 (89.6%); in contrast, failures were present in 12 (10.4%) patients, p < 0.001. Death occurred in 2 (1.33%) patients. The predictors for failure were age < 1.5 +/- 1-33 years (p < 0.004), dysplastic valve (p < 0.001), high initial systolic gradient (p < 0.002), and high initial systolic right ventricular pressure (p < 0.0001). Balloon pulmonary valvuloplasty is an effective, safe, and first choice treatment for congenital pulmonary valve stenosis.

  11. Laparoscopic hepatectomy combined with endoscopic papillary balloon dilation for complex bile duct stones. (United States)

    Yang, Jian; Zhang, Fabiao; Du, Xuefeng; Wang, Aidong; Lv, Shangdong; Fang, Zheping


    We evaluated the feasibility and efficacy of laparoscopic hepatectomy (LH) combined with endoscopic papillary balloon dilation (EPBD) for removing intra- and extrahepatic bile duct stones. A total of 26 patients with intra- and extrahepatic bile duct stones underwent LH and EPBD. Selective hemi-hepatic vascular occlusion was used to complete the LH. EPBD was performed under the guidance of a guidewire, and stones were removed with a stone basket or balloon. A one-stage LH with EPBD lithotomy was successfully performed in 26 cases. No residual bile duct stones, intestinal or bile duct perforations were found. In addition, no severe post-operative bleeding, severe pancreatitis or mortality occurred. Post-operative hyperamylasemia was observed in five cases and bile leakage in one case. Post-operative hospital stays lasted 7-11 days. LH combined with EPBD applied to intra- and extrahepatic bile duct stones was feasible, effective and safe, resulting in rapid recovery and few post-operative complications. © 2017 Royal Australasian College of Surgeons.

  12. Safe balloon sizing for endoscopic dilatation of subglottic stenosis in children. (United States)

    Sharma, S D; Gupta, S L; Wyatt, M; Albert, D; Hartley, B


    To describe our experience and provide guidelines for maximum safe balloon sizes according to age in children undergoing balloon dilatation. A retrospective review was conducted of children undergoing balloon dilatation for subglottic stenosis in a paediatric tertiary unit between May 2006 and February 2016. A total of 166 patients underwent balloon dilatation. Mean ( ± standard deviation) patient age was 4.5 ± 3.99 years. The median balloon size was 8 mm, the median balloon inflation pressure was 10 atm, and the mean balloon inflation time was 65.1 ± 18.6 seconds. No significant unexpected events occurred. The Pearson correlation co-efficient for the relationship between patient age and balloon size was 0.85 (p = 0.001), suggesting a strongly positive correlation. This study demonstrated that balloon dilatation is a safe procedure for airway stenosis. The results suggest using a balloon diameter that is equal to the outer diameter of the age-appropriate endotracheal tube +1 mm for the larynx and subglottis and +2 mm for the trachea.

  13. Transjugular balloon mitral valvotomy in a patient with severe kyphoscoliosis

    Directory of Open Access Journals (Sweden)

    George Joseph


    Full Text Available Balloon mitral valvotomy (BMV performed by the conventional transfemoral approach can be difficult or even impossible in the presence of structural impediments such as severe kyphoscoliosis, gross cardiac anatomic distortion and inferior vena caval anomalies. A 25-year-old woman with severe thoracolumbar kyphoscoliosis due to poliomyelitis presented with symptomatic rheumatic mitral valve stenosis. After the failure of transfemoral BMV, the procedure was attempted from the right jugular access, using a modified septal puncture technique. The left atrium was entered from the jugular access and the mitral valve was crossed and dilated successfully using over the wire balloon technique. Transjugular BMV is an effective alternative in patients with kyphoscoliotic spine that preclude transfemoral approach. The detailed technique used for the procedure, its advantages as well as the other percutaneous treatment options are also discussed.

  14. Balloon-borne disposable radiometer for cloud detection. (United States)

    Nicoll, K A; Harrison, R G


    A low cost, disposable instrument for measuring solar radiation during meteorological balloon flights through cloud layers is described. Using a photodiode detector and low thermal drift signal conditioning circuitry, the device showed less than 1% drift for temperatures varied from +20 °C to -35 °C. The angular response to radiation, which declined less rapidly than the cosine of the angle between the incident radiation and normal incidence, is used for cloud detection exploiting the motion of the platform. Oriented upwards, the natural motion imposed by the balloon allows cloud and clear air to be distinguished by the absence of radiation variability within cloud, where the diffuse radiation present is isotropic. The optical method employed by the solar radiation instrument has also been demonstrated to provide higher resolution measurements of cloud boundaries than relative humidity measurements alone.

  15. Preparations for the Advanced Scintillator Compton Telescope (ASCOT) balloon flight (United States)

    Sharma, T.; Bloser, P. F.; Legere, J. S.; Bancroft, C. M.; McConnell, M. L.; Ryan, J. M.; Wright, A. M.


    We describe our ongoing work to develop a new medium-energy gamma-ray Compton telescope using advanced scintillator materials combined with silicon photomultiplier readouts and fly it on a scientific balloon. There is a need in high-energy astronomy for a medium-energy gamma-ray mission covering the energy range from approximately 0.4 - 20 MeV to follow the success of the COMPTEL instrument on CGRO. We believe that directly building on the legacy of COMPTEL, using relatively robust, low-cost, off-the-shelf technologies, is the most promising path for such a mission. Fortunately, high-performance scintillators, such as Cerium Bromide (CeBr3) and p-terphenyl, and compact readout devices, such as silicon photomultipliers (SiPMs), are already commercially available and capable of meeting this need. We are now constructing an Advanced Scintillator Compton Telescope (ASCOT) with SiPM readout, with the goal of imaging the Crab Nebula at MeV energies from a high-altitude balloon flight. We expect a 4-sigma detection at 1 MeV in a single transit. We present calibration results of the detector modules, and updated simulations of the balloon instrument sensitivity. If successful, this project will demonstrate that the energy, timing, and position resolution of this technology are sufficient to achieve an order of magnitude improvement in sensitivity in the medium-energy gamma-ray band, were it to be applied to a 1 cubic meter instrument on a long-duration balloon or Explorer platform.

  16. Coronagraphic Imaging of Exoplanets from a High Altitude Balloon Platform (United States)

    Unwin, S.


    Direct imaging of exoplanets orbiting nearby stars is a major observational challenge, demanding high angular resolution and extremely high dynamic range close to the parent star. Such a system could image and characterize the atmospheres of exoplanets, and also observe exozodiacal dust within the exoplanetary system. The ultimate experiment requires a space-based platform, but demonstrating much of the needed technology as well as performing valuable measurements of circumstellar debris disks, can be done from a high-altitude balloon platform. In this paper, we show how progress in key technologies leads to a balloon experiment as a logical future step toward a space mission. The HCIT testbed has shown ultra-high contrast using small optics in a vacuum testbed. A recent ground-based experiment has demonstrated the ability to control three active optics in series - a lightweight controllable primary mirror, and two deformable mirrors - to achieve close to the best wavefront correction possible with large optics in an in-air testbed. We briefly describe the Wallops Arcsecond Pointer (WASP), which as had a very successful first flight, showing the capability of a balloon platform to stably point to the accuracy required for a coronagraph payload experiment. A balloon-borne coronagraph mission would incorporate all of these advances in an instrument that verifies each one in a space-like environment, and enabling forefront science. Such an experiment would be a step toward mitigating the technical risks of a major space-based exoplanet coronagraph. This research was carried out at the Jet Propulsion Laboratory, California Institute of Technology, under a contract with the National Aeronautics and Space Administration. Copyright 2012. California Institute of Technology. Government sponsorship acknowledged.

  17. Double-balloon enteroscopy in detecting small intestinal bleeding

    Institute of Scientific and Technical Information of China (English)

    ZHI Fa-chao; PAN De-shou; ZHOU Dian-yuan; XIAO Bing; JIANG Bo; WAN Tian-mo; GUO Yu; ZHOU Dan; WANG Li-hui; CHEN Jin-feng; XIE Lu


    @@ Digestive tract hemorrhage is a common disease of the digestive system, but about 0.4%-5% intestinal bleeding can not be detected with gastroscope or colonscope.1 Since the intestine is long, tortuous, far away from both ends of the digestive tract and unfixed in position, clinical diagnosis of the bleeding is relatively difficult. Yamamoto and Sugano2 reported the clinical application of double-balloon enteroscope at American DDW in 2003.

  18. The 3 S's of the Sapien balloon expandable valve. (United States)

    Kornowski, Ran


    The Sapien 3 (S3) balloon expandable aortic valve equipped with an outer skirt to minimize paravalvular leakage (PVL) was built upon the predecessor Sapien XT (SXT) valve. There is scant comparative data of transcatheter aortic valve replacement using S3 versus SXT valve. The study shows that S3 valve is associated with reduced PVL rate compared with SXT, which is an important clinical advantage. © 2016 Wiley Periodicals, Inc.

  19. The Inflammatory Sequelae of Aortic Balloon Occlusion in Hemorrhagic Shock (United States)


    balloon occlusion and shock on the release of interleukin 6 (IL 6) and tumor necrosis factor alpha. Materials and methods: Anesthetized female Yorkshire...14F sheath was placed in the external iliac artery via a retroperitoneal surgical exposure in the 30 and 90 REBOA groups, whereas this was accomplished...Ochmann J. Dynamics of interkeukin 1, 2 and 6 and tumor necrosis factor alpha in multiple trauma patients. J Trauma 1994;36:336. [26] Ayala A, Wang P, Ba Z

  20. Deep sea water prevents balloon angioplasty-induced hyperplasia through MMP-2: an in vitro and in vivo study.

    Directory of Open Access Journals (Sweden)

    Pei-Chuan Li

    Full Text Available Major facts about the development of restenosis include vascular smooth muscle cells (VSMCs proliferation and migration. A previous study showed that in vitro treatment with magnesium chloride has the potential to affect the proliferation and migration of VSMCs. Magnesium is the major element in deep sea water (DSW and is a biologically active mineral. It is unclear whether DSW intake can prevent abnormal proliferation and migration of VSMCs as well as balloon angioplasty-induced neointimal hyperplasia. Thus, we attempted to evaluate the anti-restenotic effects of DSW and its possible molecular mechanisms. Several concentrations of DSW, based on the dietary recommendations (RDA for magnesium, were applied to a model of balloon angioplasty in SD rats. The results showed that DSW intake markedly increased magnesium content within the vascular wall and reduced the development of neointimal hyperplasia. The immunohistochemical analysis also showed that the expression of proteins associated with cell proliferation and migration were decreased in the balloon angioplasty groups with DSW supplement. Furthermore, in vitro treatment with DSW has a dose-dependent inhibitory effect on serum-stimulated proliferation and migration of VSMCs, whose effects might be mediated by modulation of mitogen-activated protein kinase (MAPK signaling and of the activity of matrix metalloproteinase-2 (MMP-2. Our study suggested that DSW intake can help prevent neointimal hyperplasia (or restenosis, whose effects may be partially regulated by magnesium and other minerals.

  1. Six-Month Results From the Initial Randomized Study of the Ranger Paclitaxel-Coated Balloon in the Femoropopliteal Segment. (United States)

    Bausback, Yvonne; Willfort-Ehringer, Andrea; Sievert, Horst; Geist, Volker; Lichtenberg, Michael; Del Giudice, Costantino; Sauguet, Antoine; Diaz-Cartelle, Juan; Marx, Claudia; Ströbel, Armin; Schult, Ingolf; Scheinert, Dierk


    To evaluate the performance of the Ranger paclitaxel-coated balloon vs uncoated balloon angioplasty for femoropopliteal lesions. Between January 2014 and October 2015, the prospective, randomized RANGER SFA study ( identifier NCT02013193) enrolled 105 patients with symptomatic lower limb ischemia (Rutherford category 2-4) and stenotic lesions in the nonstented femoropopliteal segment at 10 European centers. Seventy-one patients (mean age 68±8 years; 53 men) were enrolled in the Ranger drug-coated balloon (DCB) arm and 34 patients (mean age 67±9 years; 23 men) were assigned to the control group. Six-month analysis included angiographic late lumen loss and safety and clinical outcomes assessments. Baseline characteristics of the DCB and control groups were similar, as were lesion lengths (68±46 vs 60±48 mm; p=0.731), severity of calcification (p=0.236), and the prevalence of occlusions (34% vs 34%; p>0.999). At 6 months, late lumen loss was significantly less for the DCB group vs controls (-0.16±0.99 vs 0.76±1.4; p=0.002). The DCB group had significantly greater freedom from binary restenosis (92% vs 64%; p=0.005) and primary patency rates (87% vs 60%; p=0.014). Target lesion revascularization rates were 5.6% in the DCB group and 12% in the control group (p=0.475). No target limb amputations or device-related deaths occurred in either group. Six-month results suggest that Ranger DCB treatment effectively inhibited restenosis in symptomatic femoropopliteal disease, resulting in improved vessel patency and a low revascularization rate in the short term compared with uncoated balloon angioplasty.

  2. Conservative Management of Invasive Placenta Using Combined Prophylactic Internal Iliac Artery Balloon Occlusion and Immediate Postoperative Uterine Artery Embolization. (United States)

    D'Souza, Donna L; Kingdom, John C; Amsalem, Hagai; Beecroft, John R; Windrim, Rory C; Kachura, John R


    The objective of the study was to evaluate the efficacy and safety of combined prophylactic intraoperative internal iliac artery balloon occlusion and postoperative uterine artery embolization in the conservative management (uterine preservation) of women with invasive placenta undergoing scheduled caesarean delivery. Ten women (mean age 35 years) with invasive placenta choosing caesarean delivery without hysterectomy had preoperative insertion of internal iliac artery occlusion balloons, intraoperative inflation of the balloons, and immediate postoperative uterine artery embolization with absorbable gelatin sponge. A retrospective review was performed with institutional review board approval. Outcome measures were intraoperative blood loss, transfusion requirement, hysterectomy rate, endovascular complications, surgical complications, and postoperative morbidity. All women had placenta increta or percreta, and concomitant complete placenta previa. Mean gestational age at delivery was 36 weeks. In 6 women the placenta was left undisturbed in the uterus, 2 had partial removal of the placenta, and 2 had piecemeal removal of the whole placenta. Mean estimated blood loss during caesarean delivery was 1.2 L. Only 2 patients (20%) required blood transfusion. There were no intraoperative surgical complications, endovascular complications, maternal deaths, or perinatal deaths. Three women developed postpartum complications necessitating postpartum hysterectomy; the hysterectomy rate was therefore 30% and uterine preservation was successful in 70%. Combined bilateral internal iliac artery balloon occlusion and uterine artery embolization may be an effective strategy to control intraoperative blood loss and preserve the uterus in patients with invasive placenta undergoing caesarean delivery. Copyright © 2015 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

  3. The dwell time and survival rates of PICC placement after balloon angioplasty in patient with unexpected central venous obstruction. (United States)

    Kim, Ki Hyun; Park, Sang Woo; Chang, Il Soo; Yim, Younghee


    To evaluate the dwell time and actual survival rates of peripherally inserted central catheter (PICC) placements after balloon angioplasty in patients with unexpected central venous obstructions. Data were obtained on all PICC insertions performed in a tertiary care hospital from August 2008 to December 2013. Thirty-five PICCs attempted after balloon angioplasty in 25 patients (15 male and 10 female patients; mean age, 63 years). Fisher's exact test was used to test for differences in reasons for catheter removal between the groups of patients with stenosis or obstructions. Survival curves for PICC dwell time of all patients, stenosis group, and obstruction group were generated separately using Kaplan-Meier survival analysis and compared with log-rank tests. There were a total 21 obstructions and 14 stenoses. The overall technical success rate of PICC placement after balloon angioplasty was 94% (33 of 35 procedures). The PICC dwell time was determined for 27 PICCs and ranged from 4 to 165 days (mean, 39.6 days). Among all PICCs, 16 were removed early, resulting in an actual survival rate of 40.7% (11 of 27 PICCs). There were no significant differences in reasons for catheter removal between the stenosis and obstruction groups (p = 0.24). The dwell times for both groups were not significantly different by Kaplan-Meier analysis (p = 0.54). PICC placement after balloon angioplasty is a good treatment option for patients with unexpected central venous lesions, and offers high technical success rates. The actual survival rate was relatively lower (40.7%) than that from previous studies.

  4. A Sensitivity Analysis of fMRI Balloon Model

    KAUST Repository

    Zayane, Chadia


    Functional magnetic resonance imaging (fMRI) allows the mapping of the brain activation through measurements of the Blood Oxygenation Level Dependent (BOLD) contrast. The characterization of the pathway from the input stimulus to the output BOLD signal requires the selection of an adequate hemodynamic model and the satisfaction of some specific conditions while conducting the experiment and calibrating the model. This paper, focuses on the identifiability of the Balloon hemodynamic model. By identifiability, we mean the ability to estimate accurately the model parameters given the input and the output measurement. Previous studies of the Balloon model have somehow added knowledge either by choosing prior distributions for the parameters, freezing some of them, or looking for the solution as a projection on a natural basis of some vector space. In these studies, the identification was generally assessed using event-related paradigms. This paper justifies the reasons behind the need of adding knowledge, choosing certain paradigms, and completing the few existing identifiability studies through a global sensitivity analysis of the Balloon model in the case of blocked design experiment.

  5. The Rocket Balloon (Rocketball): Applications to Science, Technology, and Education (United States)

    Esper, Jaime


    Originally envisioned to study upper atmospheric phenomena, the Rocket Balloon system (or Rocketball for short) has utility in a range of applications, including sprite detection and in-situ measurements, near-space measurements and calibration correlation with orbital assets, hurricane observation and characterization, technology testing and validation, ground observation, and education. A salient feature includes the need to reach space and near-space within a critical time-frame and in adverse local meteorological conditions. It can also provide for the execution of technology validation and operational demonstrations at a fraction of the cost of a space flight. In particular, planetary entry probe proof-of-concepts can be examined. A typical Rocketball operational scenario consists of a sounding rocket launch and subsequent deployment of a balloon above a desired location. An obvious advantage of this combination is the additional mission 'hang-time' rendered by the balloon once the sounding rocket flight is completed. The system leverages current and emergent technologies at the NASA Goddard Space Flight Center and other organizations.

  6. The balloon-borne electron telescope with scintillating fibers (BETS)

    CERN Document Server

    Torii, S; Tateyama, N; Yoshida, K; Ouchi, Y; Yamagami, T; Saitô, Y; Murakami, H; Kobayashi, T; Komori, Y; Kasahara, K; Yuda, T; Nishimura, J


    we describe a new detector system developed for high-altitude balloon flights to observe the cosmic-ray electrons above 10 GeV. The balloon borne electron telescope with Scintillating (BETS) fibers instrument is an imaging calorimeter which is capable of selecting electrons against the large background of protons. The calorimeter is composed of a sandwich of scintillating optical-fiber belts and lead plates with a combination of three plastic scintillators for the shower trigger. The total thickness of lead is 40 mm (~7.1 r.l.) and the number of fiber belts is nine. In each belt, alternating layers are oriented in orthogonal (x and y) directions. Two sets of an intensified CCD camera are adopted for read-out of the scintillating fibers in the x and y direction, respectively. The accelerator beam tests were carried out to study the performance of detector for electrons in 1996 and for protons in 1997 at CERN-SPS. The instrument was successfully flown aboard high-altitude balloon in 1997 and 1998. It is demonst...

  7. Balloon Cell Urethral Melanoma: Differential Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    M. McComiskey


    Full Text Available Introduction. Primary malignant melanoma of the urethra is a rare tumour (0.2% of all melanomas that most commonly affects the meatus and distal urethra and is three times more common in women than men. Case. A 76-year-old lady presented with vaginal pain and discharge. On examination, a 4 cm mass was noted in the vagina and biopsy confirmed melanoma of a balloon type. Preoperative CT showed no distant metastases and an MRI scan of the pelvis demonstrated no associated lymphadenopathy. She underwent anterior exenterative surgery and vaginectomy also. Histology confirmed a urethral nodular malignant melanoma. Discussion. First-line treatment of melanoma is often surgical. Adjuvant treatment including chemotherapy, radiotherapy, or immunotherapy has also been reported. Even with aggressive management, malignant melanoma of the urogenital tract generally has a poor prognosis. Recurrence rates are high and the mean period between diagnosis and recurrence is 12.5 months. A 5-year survival rate of less than 20% has been reported in balloon cell melanomas along with nearly 20% developing local recurrence. Conclusion. To the best of our knowledge, this case is the first report of balloon cell melanoma arising in the urethra. The presentation and surgical management has been described and a literature review provided.

  8. Double Balloon Cervical Ripening Catheter for Control of Massive Hemorrhage in a Cervical Ectopic Pregnancy. (United States)

    Zambrano, Nabila; Reilly, James; Moretti, Michael; Lakhi, Nisha


    Cervical pregnancy can be complicated by perfuse vaginal bleeding. Mechanical compression directed at tamponing the cervical vessels can control hemostasis. There are several types of balloon catheters that have been described for cervical compression. However use of a double balloon catheter is a novel approach for cervical tamponade, as one balloon is positioned below the external cervical os and the second balloon is situated above in the internal cervical os. This compresses the cervix from internal os to external os between the two balloons, forming a "cervical sandwich." We describe this method of cervical tamponade using a silicone double balloon cervical ripening catheter that rapidly controlled hemorrhage in a patient that failed conservative management with methotrexate.

  9. Long-Term Follow-up After Embolization of Pulmonary Arteriovenous Malformations with Detachable Silicone Balloons

    DEFF Research Database (Denmark)

    Andersen, Poul Erik; Kjeldsen, Anette D


    Long-term follow-up results after embolization of 13 pulmonary arteriovenous malformations in 10 patients by use of 14 detachable silicone balloons are given. Patients were followed for a mean of 99 months (range, 63-123 months) with chest x-rays and for a mean of 62 months (range, 3-101 months......) with pulmonary angiography. Fifty-four percent of the balloons were deflated at latest radiographic chest film follow-up, but at pulmonary angiographic follow-up all embolized malformations were without flow irrespective of whether or not the balloons were visible. Detachable silicone balloons are not available...... anymore, but use of these balloons for embolization of pulmonary arteriovenous malformations has been shown to be a safe and precise method, with immediate occlusion of the feeding artery and with long-lasting occlusion, even though many balloons deflate with time, leaving a fibrotic scar replacing...

  10. A randomized, controlled clinical trial of an intravesical pressure-attenuation balloon system for the treatment of stress urinary incontinence in females. (United States)

    Wyndaele, Jean-Jacques; De Wachter, Stefan; Tommaselli, Giovanni A; Angioli, Roberto; de Wildt, Michel J; Everaert, Karel C M; Michielsen, Dirk P J; Van Koeveringe, Gommert A


    Evaluate the efficacy, safety, and tolerability of a novel pressure-attenuation balloon for the treatment of female stress urinary incontinence (SUI) using a prospective, randomized, single-blind, multi-center design, evaluated at 3 months. Sixty-three females with SUI were randomized 2:1 to treatment with a balloon (N = 41) or sham procedure (N = 22). The sham (control) entailed the same procedure without the deployment of a balloon. Endpoints were evaluated at 3 months and included a composite endpoint that required both ≥10 point increase in the 22-item Incontinence Quality of Life Survey (I-QOL) and ≥50% decrease in provocative pad weight. Additional endpoints included incontinence episode frequency, and PGII assessment. In an ITT analysis, 63% of women in the treatment group achieved the composite endpoint, compared to 31% in the Control Group (P = 0.0200). In a per protocol analysis, 81% of women in the treatment arm had a 50% decrease in pad weight test vs. 45% in the Control Group (P = 0.0143); 41.6% of the treatment patients were dry on pad weight test (≤1gram) vs. 0% in the Control Group (P < 0.001), and 58% of treated patients reported improvement on a PGII assessment versus 25% of women in the Control Group (P = 0.025). Adverse events in the treatment group included dysuria (14.6%), gross hematuria (9.8%), and UTI (7.3%). This minimally invasive treatment for female SUI with an intravesical pressure-attenuation balloon was safe and effective. The concept of pressure attenuation as a therapy for SUI is valid and feasible for those patients that can tolerate the balloon. © 2015 The Authors. Neurourology and Urodynamics published by Wiley Periodicals, Inc.

  11. Intragastric Balloon Treatment for Obesity: Review of Recent Studies. (United States)

    Tate, Chinara M; Geliebter, Allan


    The FDA recently approved three intragastric balloon (IGB) devices, ReShape, ORBERA™, and Obalon for treatment of obesity. Given the high cost, complication risk, and invasiveness of bariatric surgery, IGB treatment may present a safer and lower cost option for weight reduction. IGBs are generally placed in the stomach endoscopically for up to 6 months to reduce gastric capacity, enhance feelings of fullness, and induce weight loss. The mechanism of action likely involves stimulation of gastric mechanoreceptors triggering short-acting vagal signals to brain regions implicated in satiety. Balloon efficacy may be influenced by balloon volume, patient gastric capacity, and treatment duration. This review focused on eight recent (2006-present) randomized controlled trials (RCTs) comparing percentage total body weight loss (%TBWL) between IGB and control groups including three reviewed by the FDA. %TBWL based on the reviewed studies was also compared with bariatric surgery and pharmacotherapy. Of the eight IGB studies, five had balloon treatment duration of 6 months. Efficacy at 6 months, based on a pooled weighted-mean %TBWL, was 9.7%, and the control-subtracted %TBWL was 5.6%. When one study without SDs was removed, the weighted mean %TBWL was 9.3 ± 5.7% SD, and control-subtracted %TBWL was 5.5 ± 7.8%, which was statistically greater than controls. IGB showed lower efficacy than bariatric surgery (median weight loss of 27% for Rouen-Y gastric bypass (RYGB). The control-subtracted %TBWL over 6 months of 5.5-5.6% is less than the most efficacious FDA-approved weight loss drug, Qsymia. At the recommended dose, Qsymia has a placebo-subtracted %TBWL at 6 months of approximately 6.6%. The weighted mean reported incidence of serious adverse events (SAEs) in the IGB group across all eight studies was 10.5%. Only six of the eight reviewed studies reported adverse events (AEs) in the IGB group, with a pooled reported incidence of 28.2%. Recently, the FDA reported new

  12. Catchment-scale snow depth monitoring with balloon photogrammetry (United States)

    Durand, M. T.; Li, D.; Wigmore, O.; Vanderjagt, B. J.; Molotch, N. P.; Bales, R. C.


    Field campaigns and permanent in-situ facilities provide extensive measurements of snowpack properties at catchment (or smaller) scales, and have consistently improved our understanding of snow processes and the estimation of snow water resources. However, snow depth, one of the most important snow states, has been measured almost entirely with discrete point-scale samplings in field measurements; spatiotemporally continuous snow depth measurements are nearly nonexistent, mainly due to the high cost of airborne flights and the ban of Unmanned Aerial Systems in many areas (e.g. in all the national parks). In this study, we estimate spatially continuous snow depth from photogrammetric reconstruction of aerial photos taken from a weather balloon. The study was conducted in a 0.2 km2 watershed in Wolverton, Sequoia National Park, California. We tied a point-and-shoot camera on a helium-inflated weather balloon to take aerial images; the camera was scripted to automatically capture images every 3 seconds and to record the camera position and orientation at the imaging times using a built-in GPS. With the 2D images of the snow-covered ground and the camera position and orientation data, the 3D coordinates of the snow surface were reconstructed at 10 cm resolution using photogrammetry software PhotoScan. Similar measurements were taken for the snow-free ground after snowmelt, and the snow depth was estimated from the difference between the snow-on and snow-off measurements. Comparing the photogrammetric-estimated snow depths with the 32 manually measured depths, taken at the same time as the snow-on balloon flight, we find the RMSE of the photogrammetric snow depth is 7 cm, which is 2% of the long-term peak snow depth in the study area. This study suggests that the balloon photogrammetry is a repeatable, economical, simple, and environmental-friendly method to continuously monitor snow at small-scales. Spatiotemporally continuous snow depth could be regularly measured in

  13. Management of Intra-Aortic Balloon Pump Entrapment: A Case Report and Review of the Literature


    Fitzmaurice, Gerard J.; Collins, Anton; Parissis, Haralambos


    An intra-aortic balloon pump is one of the most valuable tools in the cardiac surgeon's armament to assist in the management of the failing heart. Despite its widespread use, there are associated risks and complications, one of which is balloon rupture with associated entrapment. Numerous approaches for dealing with this complication have been described; here we review the previous experience with intra-aortic balloon pump entrapment and discuss potential management, with particular reference...

  14. Sinus Balloon Dilation as Treatment for Acute Sphenoid Sinusitis with Impaired Vision for a Child

    Directory of Open Access Journals (Sweden)

    Yin Zhao


    Full Text Available This paper is about sinus balloon dilatation in treatment of acute left sphenoid sinusitis with left impaired vision in a child. Balloon catheter dilatation (BCD of the sinus ostia is a new technique. It has been shown to be a minimally invasive technique to manage chronic sinusitis. However, this method is rarely used in the treatment of acute sinusitis. So far, we know of no reported cases of sinus balloon dilatation in treatment of this case, especially for children.

  15. Non-touch, Quick Destruction of the Tracheal Occluding Balloon Using HIFU


    OSAWA Shunsuke:筆頭著者; SATO Tomoo; YAMASHITA Hiromasa; MOCHIZUKI Takashi; KITAZUMI Gontaro; JANI Jacques; TOKI Akira; CHIBA Toshio


    The technique of fetal endoscopic tracheal occlusion (FETO) was developed to totally occlude the fetal trachea using an intratracheal balloon in the treatment of congenital diaphragmatic hernia with lung hypoplasia. To improve this approach, we developed a method for non-contact, rapid destruction of the balloon using high intensity focused ultrasound (HIFU), a specific balloon injection fluid, and euthanized rabbits (1kg). In an initial experiment (5rabbits), we inflated an intratracheal bal...

  16. Status report on the activities of National Balloon Facility at Hyderabad (United States)

    Shankarnarayan, Sreenivasan; S, Sreenivasan; Shankarnarayan, Sreenivasan; Manchanda, R. K.; Subba Rao Jonnalagadda, Venkata; Buduru, Suneelkumar

    National balloon facility at Hyderabad has been mandated to provide launch support for Indian and International scientific balloon experiments and also perform the necessary research and development in the design and fabrication of plastic balloons. In the last 4 years, since our last report, NBF has launched many successful balloon flights for the astronomy payloads and a large number of high altitude GPS Sonde flights at different places in the country. We have also continued our efforts on qualification of raw materials for zero-failure performance of our balloons and major focus on upgrading of various facilities and load-line instrumentation for launching from remote sites. We foresee a surge of balloon based experimental activity for in-situ measurements in atmospheric sciences and concept validation payloads for future space based instruments. A new centre for research in Environmental Sciences and Payload Engineering (ESPE) has also been set up at the National Balloon Facility campus to develop and conduct research in various aspects of Environmental sciences in collaboration with other groups, with a specific goal to identify, development of advanced technologies leading to an improved understanding of the earth system. The Payload Engineering facility is geared to the Design and Fabrication of Micro and Nano Satellites and will act as Inter -University Centre for payload fabrication. In this paper we present an overview of the present and planned activities in scientific ballooning at National Balloon Facility Hyderabad.

  17. Cutting-balloon angioplasty of resistant ureteral stenosis as bridge to stent insertion

    Energy Technology Data Exchange (ETDEWEB)

    Iezzi, R., E-mail: [Department of Bioimaging and Radiological Sciences, Institute of Radiology, ' A. Gemelli' Hospital - Catholic University, L.go A Gemelli 8, 00168 Rome (Italy); Di Stasi, C.; Simeone, A.; Bonomo, L. [Department of Bioimaging and Radiological Sciences, Institute of Radiology, ' A. Gemelli' Hospital - Catholic University, L.go A Gemelli 8, 00168 Rome (Italy)


    Ureteral stenting is a routine, minimally invasive procedure performed for relief of benign or malignant obstruction. In case of ureteral stenosis, to allow a correct insertion of the stent, a predilatation of the ureter stenosis with a conventional balloon catheter can be necessary. In exceptional cases, it can be difficult to advance an 7-8 Fr JJ-catheter over a tight resistant ureter stenosis following unsuccessful high-pressure balloon dilatation. In the present report, we describe two cases of resistant ureter stenosis successfully dilated by a cutting-balloon following the failure of high-pressure balloon dilatation, allowing a correct and uncomplicated antegrade stent insertion.

  18. Reappraisal of endoscopic papillary balloon dilation for the management of common bile duct stones (United States)

    Lai, Kwok-Hung; Chan, Hoi-Hung; Tsai, Tzung-Jiun; Cheng, Jin-Shiung; Hsu, Ping-I


    Although endoscopic sphincterotomy (EST) is still considered as a gold standard treatment for common bile duct (CBD) stones in western guideline, endoscopic papillary balloon dilation (EPBD) is commonly used by the endoscopists in Asia as the first-line treatment for CBD stones. Besides the advantages of a technical easy procedure, endoscopic papillary large balloon dilation (EPLBD) can facilitate the removal of large CBD stones. The indication of EPBD is now extended from removal of the small stones by using traditional balloon, to removal of large stones and avoidance of lithotripsy by using large balloon alone or after EST. According to the reports of antegrade papillary balloon dilatation, balloon dilation itself is not the cause of pancreatitis. On the contrary, adequate dilation of papillary orifice can reduce the trauma to the papilla and pancreas by the basket or lithotripter during the procedure of stone extraction. EPLBD alone is as effective as EPLBD with limited EST. Longer ballooning time may be beneficial in EPLBD alone to achieve adequate loosening of papillary orifice. The longer ballooning time does not increase the risk of pancreatitis but may reduce the bleeding episodes in patients with coagulopathy. Slowly inflation of the balloon, but not exceed the diameter of bile duct and tolerance of the patients are important to prevent the complication of perforation. EPBLD alone or with EST are not the sphincter preserved procedures, regular follow up is necessary for early detection and management of CBD stones recurrence. PMID:25685263

  19. Wave power absorption by a submerged balloon fixed to the sea bed

    DEFF Research Database (Denmark)

    Kurniawan, Adi; Greaves, Deborah


    The possibility of absorbing wave energy using a submerged balloon fixed to the sea bed is investigated. The balloon is in the form of a fabric encased within an array of meridional tendons which terminate at a point at the top of the balloon and at some radius at the bottom. The expansion...... and contraction of the balloon in waves pump air via a turbine into and out of a chamber of constant volume. A more refined model than that used by Kurniawan and Greaves [Proc. 2nd Offshore Energy and Storage Symposium , 2015] predicts a similarly broad-banded response, but the maximum absorption is less than...

  20. Effects of Hemibridge with Ball and Balloon Exercise on Forced Expiratory Volume and Pain in Patients with Chronic Low Back Pain: An Experimental Study

    Directory of Open Access Journals (Sweden)

    Jorida Fernandes


    Full Text Available Background and objectives: Suboptimal breathing patterns and impairments of posture and trunk stability are often associated with musculoskeletal complaints such as low back pain. Respiration is also affected by poor neuromuscular control of core muscles. Immediate effects of hemibridge with ball and balloon exercise has been studied on chronic pain in athlete population. Objective: To evaluate the effects of hemibridge with ball and balloon exercise on pain, forced expiratory volume and functional abilities in patients with chronic low back pain using Visual Analogue Scale (VAS, Forced Expiratory Volume (FEV and Modified Oswestry Disability Questionnaire (MODQ. Methods: The present experimental study was conducted among 30 participants between the age of 21 to 55 years with chronic non-specific LBP. The participants were given a hemibridge with ball and balloon exercise. Pre-interventional and 3rd day Post-interventional outcome measurements were taken using VAS, FEV1 and FEV6 and MODQ. Results: The difference between pre-and post of VAS was statistically highly significant (p=0.0001. The p value of FEV6 and MODQ by paired t test was statistically significant with p value of 0.02 and 0.0007 respectively. Conclusion: The study concludes that there is an immediate effect of hemibridge with ball and balloon exercise on pain, FEV6 and functional ability in patients with chronic LBP.

  1. Hybrid balloon valvuloplasty through the ascending aorta via median sternotomy in infants with severe congenital valvular aortic stenosis: feasibility of a new method†. (United States)

    Pan, Xiang-Bin; Zhang, Feng-Wen; Hu, Sheng-Shou; Liu, Zhen-Guo; Ma, Kai; Pang, Kun-Jing; Yan, Fu-Xia; Wang, Xu; Ou-Yang, Wen-Bin; Wang, Yang; Li, Shou-Jun


    To evaluate a novel hybrid balloon valvuloplasty procedure for severe congenital valvular aortic stenosis in low-weight infants, performed through the ascending aorta via median sternotomy. Eighteen infants (Hybrid balloon valvuloplasty procedures were performed in a hybrid operating room. Patients were followed up at 3 months, 6 months, 1 year and then annually following the procedure. The hybrid balloon valvuloplasty procedure was successful in all patients. Eight patients were successfully rescued from left ventricular systolic dysfunction by cardiac compression under direct vision. The aortic valve pressure gradient decreased from 80.3 ± 20.8 mmHg preoperatively to 16.0 ± 3.6 mmHg immediately postoperatively (P valve pressure gradient remained low (21.7 ± 5.3 mmHg). Reintervention was not required in any of the patients. Hybrid balloon valvuloplasty through the ascending aorta via median sternotomy is an effective and safe procedure for infants with severe congenital aortic stenosis. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  2. Nuclear Phosphatidylcholine and Sphingomyelin Metabolism of Thyroid Cells Changes during Stratospheric Balloon Flight

    Directory of Open Access Journals (Sweden)

    Elisabetta Albi


    Full Text Available Nuclear sphingomyelin and phosphatidylcholine metabolism is involved in the response to ultraviolet radiation treatment in different ways related to the physiological state of cells. To evaluate the effects of low levels of radiation from the stratosphere on thyroid cells, proliferating and quiescent FRTL-5 cells were flown in a stratospheric balloon (BIRBA mission. After recovery, the activity of neutral sphingomyelinase, phosphatidylcholine-specific phospholipase C, sphingomyelin synthase, and reverse sphingomyelin synthase was assayed in purified nuclei and the nuclei-free fraction. In proliferating FRTL-5, space radiation stimulate nuclear neutral sphingomyelinase and reverse sphingomyelin synthase activity, whereas phosphatidylcholine-specific phospholipase C and sphingomyelin synthase were inhibited, thus inducing sphingomyelin degradation and phosphatidylcholine synthesis. This effect was lower in quiescent cells. The possible role of nuclear lipid metabolism in the thyroid damage induced by space radiations is discussed.

  3. Pulmonary artery dissection following balloon valvuloplasty in a dog with pulmonic stenosis. (United States)

    Grint, K A; Kellihan, H B


    A 3-month-old, 9.9 kg, male pit bull cross was referred for evaluation of collapse. A left basilar systolic heart murmur graded V/VI and a grade IV/VI right basilar systolic heart murmur were ausculted. Echocardiography showed severe pulmonic stenosis characterized by annular hypoplasia, leaflet thickening, and leaflet fusion. After 1 month of atenolol therapy, a pulmonic valve balloon valvuloplasty procedure was performed, and the intra-operative right ventricular pressure was reduced by 43%. Echocardiography, performed the following day, showed apparent rupture of a pulmonary valve leaflet and a membranous structure within the pulmonary artery consistent with a dissecting membrane. Short-term follow-up has shown no apparent progression of the pulmonary artery dissection and the patient remains free of clinical signs. Copyright © 2016 Elsevier B.V. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Daphna Fenyves


    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.

  5. Double-balloon enteroscopy-assisted dilatation avoids surgery for small bowel strictures: A systematic review (United States)

    Baars, Judith E; Theyventhiran, Ruben; Aepli, Patrick; Saxena, Payal; Kaffes, Arthur J


    AIM To evaluate the therapeutic role of double-balloon enteroscopy (DBE) in small bowel strictures and to propose a standard approach to small bowel strictures. METHODS Systematic review of studies involving DBE in patients with small bowel strictures. Only studies limited to small bowel strictures were included and those with ileo-colonic strictures were excluded. RESULTS In total 13 studies were included, in which 310 patients were dilated. The average follow-up time was 31.8 mo per patient. The complication rate was 4.8% per patient and 2.6% per dilatation. Surgery was avoided in 80% of patients. After the first dilatation, 46% were treated with re-dilatation and only 17% required surgery. CONCLUSION DBE-assisted dilatation avoids surgery in 80% of patients with small bowel strictures and is safe and effective. We propose a standardized approach to small bowel strictures. PMID:29259383

  6. [Cochrane Corner: Intra-aortic balloon pump in patients with cardiogenic shock following myocardial infarction]. (United States)

    Caldeira, Daniel; Pereira, Hélder; Costa, João; Vaz-Carneiro, António


    Improvement of hemodynamic parameters is the rationale for the use of intra-aortic balloon pump counterpulsation (IABP) in patients with cardiogenic shock following acute myocardial infarction (MI). This Cochrane systematic review evaluated the impact of this intervention in reducing mortality. Seven randomized controlled trials with a total of 790 patients were included (four using medical therapy as a comparator, and three comparing IABP with other ventricular assist devices). IABP did not reduce mortality in either the short or long term. Therefore, the systematic use of IABP in patients with cardiogenic shock following MI cannot be recommended. Copyright © 2015 Sociedade Portuguesa de Cardiologia. Published by Elsevier España. All rights reserved.

  7. On the ratio of expectation crossings of random-excited dielectric elastomer balloon

    Directory of Open Access Journals (Sweden)

    Xiaoling Jin


    Full Text Available The ratio of expectation crossings of dielectric elastomer balloon excited by random pressure is analytically evaluated in this letter. The Mooney–Rivlin model is adopted to describe the constitutive relation while the random pressure is described by Gaussian white noise. Through a specific transformation, the stochastic differential equations for the total energy and phase are derived. With the application of the stochastic averaging, the system total energy is then approximated by a one-dimensional diffusion process. Solving the associated Fokker–Planck–Kolmogorov (FPK equation yields the stationary probability density of the system total energy. The ratio of expectation crossings is then derived based on the joint stationary probability density of stretch ratio and its ratio of change. The efficacy and accuracy of the proposed procedure are verified by comparing with the results from Monte Carlo simulation (MCS.

  8. Calcium burden assessment and impact on drug-eluting balloons in peripheral arterial disease. (United States)

    Fanelli, F; Cannavale, A; Gazzetti, M; Lucatelli, P; Wlderk, A; Cirelli, C; d'Adamo, A; Salvatori, F M


    This study was designed to assess the effect of calcium on the efficacy of DEB during revascularization of steno-obstructive SFA lesions. Sixty patients with de novo lesions of the superficial femoral artery underwent endovascular treatment with drug eluting balloons (DEB). DEB was selected according to vessel reference diameter (1:1). In case of residual stenosis > 50 % or flow-limiting dissection, postdilatation with conventional balloon or provisional stenting was done. Patients were classified into eight groups according to circumferential distribution of calcium on CT-angiography axial images (from 0° to 360°) and to its length (length  3 cm) evaluated with digital-subtraction-angiography. Ankle-brachial index (ABI), late lumen loss (LLL), target lesion revascularization (TLR), primary (PP) and secondary (SP) patency, major adverse events (MAE), and Rutherford shift were evaluated at 1-year follow-up and correlated with the amount of calcium. Revascularization was successful in all cases. Flow-limiting dissection occurred in five cases (8.3 %) with a higher circumferential degree of calcium and solved in three cases with postdilatation and in the other two with provisional stenting. DEB effect was lower in patients with higher degree of calcium (>270° vs. <90°): ABI 0.71 ± 0.07 versus 0.92 ± 0.07; LLL 0.75 ± 0.21 versus 0.45 ± 0.1; PP 50 versus 100 %; SP 50 versus 100 %; TLR 25 versus 0 %; MAE 25 versus 0 %. Calcium represents a barrier to optimal drug absorption. Circumferential distribution seems to be the most influencing factor with the worst effect noticed in 360° calcium presence.

  9. ASTERIA: A Balloon-Borne Experiment for Infrasound Detection (United States)

    Young, Eliot; Wahl, Kerry; Ballard, Courtney; Daugherty, Emily; Dullea, Connor; Garner, Kyle; Heaney, Martin; Thom, Ian; Von Hendy, Michael; Young, Emma; Diller, Jed; Dischner, Zach; Drob, Douglas; Boslough, Mark; Brown, Peter


    ASTERIA (Aloft Stratospheric Testbed for Experimental Research on Infrasonic Activity) is a small (designed to measure infrasound disturbances from a balloon-borne platform at altitudes near 60,000 ft (~20 km). A balloon platform is expected to have two advantages over ground-based infrasound stations: a relatively benign wind environment and exposure to higher signal strengths within a stratospheric duct. ASTERIA's nominal sensitivity requirements are to measure waves between 0.1 to 20 Hz at the 0.1 Pa level with signal-to-noise ratios of 5 or better. At the time of this writing, we have tested wave sensors based on the differential pressure transducers recently flown by Bowman et al. (2014) on a NASA/HASP (High Altitude Student Payload); our modified pressure sensor was tested in a NOAA piston-bellows facility in Boulder, CO. Our goal of characterizing 0.1 Pa amplitude waves requires that combined noise sources are below the the 0.02 Pa rms level. ASTERIA carries five differential transducers with port inlets arranged a diamond-like pattern (one zenith- and one nadir-facing port, plus three horizontal ports equally spaced in azimuth). Baffling for these sensors is a hybrid of perforated tubing and porous barriers, as described in Hedlin (2014). Other noise sources of concern include the electronic amplification of the transducer voltages and low-frequency pressure waves caused by pendulum or twisting modes of the payload. We will report on our plans to characterize and reduce these noise sources. The ASTERIA payload is intended to fly on long-duration super-pressure balloons for intervals of ~100 days. We plan to conduct an experiment in the summer or fall of 2015 in which a calibrated disturbance is set off and detected simultaneously from stratospheric ASTERIA payloads and ground-based stations. References: 1) Bowman et al. 2014, "Balloons over Volcanoes Scientific Report," HASP 2014 final report. 2) Hedlin 2003, "Infrasonic Wind-noise Reduction by Barriers and

  10. Detachable balloon embolization of an aneurysmal gastroduodenal arterioportal fistula

    Energy Technology Data Exchange (ETDEWEB)

    Defreyne, Luc; De Schrijver, Ignace; Vanlangenhove, Peter; Kunnen, Marc [Department of Radiology and Medical Imaging, Ghent University Hospital (Belgium)


    Extrahepatic arteriovenous fistulas involving the gastroduodenal artery and the portal venous system are rare and almost always a late complication of gastric surgery. Secondary portal hypertension and mesenteric ischemia may provoke abdominal pain, upper and lower gastrointestinal hemorrhage, diarrhea, and weight loss. Until recently, surgical excision has been the therapy of choice with excellent results. The authors report a case of gastroduodenal arterioportal fistula with a rare large interpositioned aneurysm in a cardiopulmonary-compromised patient who was considered a non-surgical candidate. The gastroduodenal arterioportal fistula was occluded endovascularly by means of a detachable balloon. A survey of the literature of this rare type of arterioportal fistula is included. (orig.)

  11. Nonlinear saturation of ballooning modes in tokamaks and stellarators (United States)

    Bauer, F.; Garabedian, P.; Betancourt, O.


    The spectral code BETAS computes plasma equilibrium in a toroidal magnetic field B = [unk]s × [unk]Ψ with remarkable accuracy because the finite difference scheme employed in the radial direction allows for discontinuities of the flux function Ψ across the nested surfaces s = const. Instability of higher modes in stellarators like the Heliotron E can be detected in roughly an hour on the best supercomputers by calculating bifurcated equilibria that are defined over just one field period. The method has been validated by comparing results about nonlinear saturation of ballooning modes in tokamaks with numerical data from the PEST code. PMID:16593984

  12. First-in-Human Experience With the Gore Balloon-Expandable Covered Endoprosthesis in Iliac Artery Occlusive Disease. (United States)

    Holden, Andrew; Merrilees, Stephen; Buckley, Brendan; Connor, Brigid; Colgan, Frances; Hill, Andrew


    To report the first-in-human iliac artery experience of a new balloon-expandable covered endoprosthesis. A prospective, single-center pilot study recruited 30 symptomatic patients (mean age 64 years; 18 men) to evaluate the safety and early efficacy of the new Gore balloon-expandable covered endoprosthesis for the treatment of de novo or restenotic common and/or external iliac artery lesions. According to protocol, up to 2 discrete lesions could be treated with a maximum total treated length ≤110 mm. Follow-up included clinical evaluation with duplex ultrasound at 1, 6, and 12 months. Data are presented through 12-month follow-up. The primary safety endpoint was a composite of device- or procedure-related death, myocardial infarction, or amputation in the treated leg within 30 days of the index procedure. Multiple performance outcomes were also evaluated. The primary 30-day safety endpoint was 0%. Per-subject estimates of primary patency, freedom from target lesion revascularization, and freedom from target vessel revascularization were 100% at 1 and 6 months and 96.6% at 12 months. Estimates of assisted primary and secondary patency were both 100% at 12 months. Freedom from major adverse events at 12 months was 100%. Most patients experienced improvements in Rutherford category, ankle-brachial index, and functional status that were sustained to 12 months. This positive first-in-human experience with the Gore balloon-expandable covered endoprosthesis suggests this device will have an important role in the management of aortoiliac occlusive disease.

  13. Brachytherapy model with sodium pertechnetate-{sup 99m}Tc balloon (Na{sup 99m}TcO{sub 4}{sup -}) for breast cancer: evaluation of dosimetry and cell response; Modelo de braquiterapia com balao de pertecnetato de sodio-{sup 99m}Tc (Na{sup 99m}TcO{sub 4}{sup -}) para cancer de mama: avaliacao da dosimetria e resposta celular

    Energy Technology Data Exchange (ETDEWEB)

    Lima, Carla Flavia de


    Breast cancer is the most common type of cancer that affects more women worldwide. Among various treatment options, radiotherapy which is often used as a treatment for locoregional recurrences control or to decrease tumor size. In patients with breast cancer at an early stage, a booster dose (boost) in the primary tumor area can be applied after conventional radiation therapy. There are several drawbacks to applying this technique. In this work we aimed to perform a dosimetric analysis in a breast model, where it put a balloon filled with sodium pertechnetate-{sup 99m}Tc (Na{sup 99m}TcO{sub 4}{sup -}) which in future could be used in preference to other possible therapies. The methodology involved the development of dosimetry in water based on radiochromic films and in a computational voxel thorax model. Calibration protocol achieved a mathematical relation between absorbed dose versus optical density (OD) measured at a set of radiochromic sample films placed at the surface of the balloon plus 1 cm up to 10 cm far, in which theoretical dose values were provided by MCNP modeling, reproducing the water equivalent physical simulator. A voxel model of a female thorax, developed at the SISCODES/MCNP codes, received a filled balloon inside. Spatial dose distribution was generated, illustrating the dose received in the chest wall, glandular tissue, breast skin and lung. The dosimetric findings contribute to present the Na{sup 99m}TcO{sub 4}{sup -} balloon modality which provides a suitable spatial dose distribution in the tumor bed preserving adjacent health tissues. We also studied the radiobiological response radio resistant mammary adenocarcinoma cells (MDAMB231) by exposure of these cells to Na{sup 99m}TcO{sub 4}{sup -} balloon. The findings include the presence of apoptotic cells in the balloon around point out a favorable response. In conclusion, the balloon may represent a viable option in the supplementary therapy of breast cancer in patients who have appropriate

  14. Balloon-Assisted Chemoembolization Using a Micro-Balloon Catheter Alongside a Microcatheter for a Hepatocellular Carcinoma with a Prominent Arterioportal Shunt: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Hoshiai, Sodai, E-mail:; Mori, Kensaku; Ishiguro, Toshitaka; Konishi, Takahiro; Uchikawa, Yoko [University of Tsukuba Hospital, Department of Diagnostic and Interventional Radiology (Japan); Fukuda, Kuniaki [University of Tsukuba Hospital, Department of Gastroenterology (Japan); Minami, Manabu [University of Tsukuba Hospital, Department of Diagnostic and Interventional Radiology (Japan)


    Although transcatheter arterial chemoembolization is one of the established treatments for hepatocellular carcinoma (HCC), it is difficult to treat HCCs with prominent arterioportal (AP) shunts because anticancer drugs and embolic materials migrate into the non-tumorous liver through the AP shunts and may cause liver infarction. We developed a novel method of balloon-assisted chemoembolization using a micro-balloon catheter alongside a microcatheter simultaneously inserted through a single 4.5-Fr guiding sheath, comprising proximal chemoembolization with distal arterial balloon occlusion. We applied this method to treat an HCC with a prominent distal AP shunt induced by previous proton beam therapy and achieved successful chemoembolization without non-tumorous liver infarction under temporal balloon occlusion of a distal AP shunt.

  15. Cutting balloon and high-pressure balloon dilation for palliative treatment of congenital double-chambered right ventricle and primary infundibular stenosis in a Golden retriever dog. (United States)

    Schober, Karsten E; Rhinehart, Jaylyn; Kohnken, Rebecca; Bonagura, John D


    Combined cutting balloon and high-pressure balloon dilation was performed in a dog with a double-chambered right ventricle and severe infundibular stenosis of the right ventricular outflow tract. The peak systolic pressure gradient across the stenosis decreased by 65% after dilation (from 187 mmHg before to 66 mmHg after) affirming the intervention as successful. However, early re-stenosis occurred within 3 months leading to exercise intolerance, exercise-induced syncope, and right-sided congestive heart failure. Cutting balloon followed by high-pressure balloon dilation provided temporary but not long-term relief of right ventricular obstruction in this dog. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Effect of oxygen deficiency on response of CR-39 on board scientific balloons

    CERN Document Server

    Fujii, M; Osawa, A; Saitô, T; Yamamoto, K; Hasebe, T; Nakamura, T; Sasaki, H; Yanagita, T; Aglietta, M; Vernetto, S; Castellina, A; Fulgione, W; Saavedra, O; Trinchero, G C


    We should be careful about the effect of oxygen deficiency on polymeric track detectors even at balloon altitude. Results of balloon experiments and calibration experiments in a vacuum chamber at different pressures show that the effect of oxygen deficiency becomes serious at a pressure below 10 hPa.

  17. Balloon Dilatation of Iatrogenic Ureteral Strictures after Upper Urinary Tract Reconstruction

    Directory of Open Access Journals (Sweden)

    Enes Duman


    Conclusion: Balloon dilatation can be used safely in both antegrade and retrograde approaches because of lower profile of balloon catheters, so it could be considered as a first line treatment option after failed surgical treatment of upper urinary tract stenosis in children. [Cukurova Med J 2015; 40(2.000: 311-316

  18. Single-centre comparison of a novel single-step balloon inflation ...

    African Journals Online (AJOL)

    Objective. A new second-generation balloon dilatation device for percutaneous nephrolithotomy (PCNL) has been launched, promising to challenge the traditional Amplatz serial dilators (ASDs). This device allows for the polyurethane sheath to be deployed on balloon inflation. Our primary objective in this pilot study was to ...

  19. Solar energy collector including a weightless balloon with sun tracking means (United States)

    Hall, Frederick F.


    A solar energy collector having a weightless balloon, the balloon including a transparent polyvinylfluoride hemisphere reinforced with a mesh of ropes secured to its outside surface, and a laminated reflector hemisphere, the inner layer being clear and aluminized on its outside surface and the outer layer being opaque, the balloon being inflated with lighter-than-air gas. A heat collection probe extends into the balloon along the focus of reflection of the reflective hemisphere for conducting coolant into and out of the balloon. The probe is mounted on apparatus for keeping the probe aligned with the sun's path, the apparatus being founded in the earth for withstanding wind pressure on the balloon. The balloon is lashed to the probe by ropes adhered to the outer surface of the balloon for withstanding wind pressures of 100 miles per hour. Preferably, the coolant is liquid sodium-potassium eutectic alloy which will not normally freeze at night in the temperate zones, and when heated to 4, R exerts a pressure of only a few atmospheres.

  20. Membrane Ballooning in Aggregated Platelets is Synchronised and Mediates a Surge in Microvesiculation. (United States)

    Agbani, Ejaife O; Williams, Christopher M; Hers, Ingeborg; Poole, Alastair W


    Human platelet transformation into balloons is part of the haemostatic response and thrombus architecture. Here we reveal that in aggregates of platelets in plasma, ballooning in multiple platelets occurs in a synchronised manner. This suggests a mechanism of coordination between cells, previously unrecognised. We aimed to understand this mechanism, and how it may contribute to thrombus development. Using spinning-disc confocal microscopy we visualised membrane ballooning in human platelet aggregates adherent to collagen-coated surfaces. Within an aggregate, multiple platelets undergo ballooning in a synchronised fashion, dependent upon extracellular calcium, in a manner that followed peak cytosolic calcium levels in the aggregate. Synchrony was observed in platelets within but not between aggregates, suggesting a level of intra-thrombus communication. Blocking phosphatidylserine, inhibiting thrombin or blocking PAR1 receptor, largely prevented synchrony without blocking ballooning itself. In contrast, inhibition of connexins, P2Y12, P2Y1 or thromboxane formation had no effect on synchrony or ballooning. Importantly, synchronised ballooning was closely followed by a surge in microvesicle formation, which was absent when synchrony was blocked. Our data demonstrate that the mechanism underlying synchronised membrane ballooning requires thrombin generation acting effectively in a positive feedback loop, mediating a subsequent surge in procoagulant activity and microvesicle release.

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

    DEFF Research Database (Denmark)

    Heerwagen, Søren Thorup; Lönn, Lars; Schroeder, Torben V


    Cephalic arch stenosis is a known cause of hemodialysis access failure in patients with brachiocephalic fistulas (BCFs). Outcomes of endovascular treatment are affected by resistance of the stenosis to balloon dilation, a high vein rupture rate and the development of early restenosis. The purpose...... of this retrospective study was to report outcomes after cutting balloon angioplasty (CBA) of cephalic arch stenosis....

  2. Membranous duodenal stenosis: initial experience with balloon dilatation in four children

    NARCIS (Netherlands)

    van Rijn, R. R.; van Lienden, K. P.; Fortuna, T. L.; D'Alessandro, L. C. A.; Connolly, B.; Chait, P. G.


    INTRODUCTION: We present a novel approach to the treatment of membranous duodenal stenosis (MDS). To our knowledge this is the first paper to describe balloon dilatation for this entity. MATERIAL AND METHODS: Four children, 2 boys and 2 girls, aged between 8 and 28 days, underwent duodenal balloon

  3. Hemosuccus Pancreaticus in the Era of Capsule Endoscopy and Double Balloon Enteroscopy Complicated by Multifocal Mycobacterium chelonae/abscessus Infection

    Directory of Open Access Journals (Sweden)

    Shabana F. Pasha


    Full Text Available Hemosuccus pancreaticus is a rare etiology of obscure gastrointestinal bleeding characterized by bleeding into the pancreatic duct. The diagnosis may be delayed for months to years, due to the episodic nature of bleeding and failure to consider the diagnosis. Patients often undergo multiple endoscopies and radiologic evaluations prior to diagnosis. Incidental gastrointestinal findings may lead to unnecessary endoscopic and surgical interventions. This report describes a patient with hemosuccus pancreaticus diagnosed in the era of video capsule endoscopy and double balloon enteroscopy, whose management was complicated by multifocal Mycobacteria chelonae/abscessus infection.

  4. European Venus Explorer: An in-situ mission to Venus using a balloon platform (United States)

    Chassefière, E.; Korablev, O.; Imamura, T.; Baines, K. H.; Wilson, C. F.; Titov, D. V.; Aplin, K. L.; Balint, T.; Blamont, J. E.; Cochrane, C. G.; Ferencz, Cs.; Ferri, F.; Gerasimov, M.; Leitner, J. J.; Lopez-Moreno, J.; Marty, B.; Martynov, M.; Pogrebenko, S. V.; Rodin, A.; Whiteway, J. A.; Zasova, L. V.; the EVE Team


    Planetary balloons have a long history already. A small super-pressure balloon was flown in the atmosphere of Venus in the eighties by the Russian-French VEGA mission. For this mission, CNES developed and fully tested a 9 m diameter super-pressure balloon, but finally replaced it by a smaller one due to mass constraints (when it was decided to send Vega to Halley's Comet). Furthermore, several kinds of balloons have been proposed for planetary exploration [Blamont, J., in: Maran, S.P. (Ed.), The Astronomy and Astrophysics Encyclopedia. Cambridge University Press, p. 494, 1991]. A Mars balloon has been studied for the Mars-94 Russian-French mission, which was finally cancelled. Mars and Venus balloons have also been studied and ground tested at JPL, and a low atmosphere Venus balloon is presently under development at JAXA (the Japanese Space Agency). Balloons have been identified as a key element in an ongoing Flagship class mission study at NASA, with an assumed launch date between 2020 and 2025. Recently, it was proposed by a group of scientists, under European leadership, to use a balloon to characterize - by in-situ measurements - the evolution, composition and dynamics of the Venus atmosphere. This balloon is part of a mission called EVE (European Venus Explorer), which has been proposed in response to the ESA AO for the first slice of the Cosmic Vision program by a wide international consortium including Europe, Russia, Japan and USA. The EVE architecture consists of one balloon platform floating at an altitude of 50-60 km, one short lived probe provided by Russia, and an orbiter with a polar orbit to relay data from the balloon and probe, and to perform remote sensing science observations. The balloon type preferred for scientific goals is one, which would oscillate in altitude through the cloud deck. To achieve this flight profile, the balloon envelope would contain a phase change fluid. While this proposal was not selected for the first slice of Cosmic

  5. Ballooning-mirror instability and internally driven Pc 4--5 wave events

    Energy Technology Data Exchange (ETDEWEB)

    Cheng, C.Z.; Qian, Q.; Takahashi, K.; Lui, A.T.Y.


    A kinetic-MHD field-aligned eigenmode stability analysis of low frequency ballooning-mirror instabilities has been performed for anisotropic pressure plasma sin the magnetosphere. The ballooning mode is mainly a transverse wave driven unstable by pressure gradient in the bad curvature region. The mirror mode with a dominant compressional magnetic field perturbation is excited when the product of plasma beta and pressure anisotropy (P{sub {perpendicular}}/P{sub {parallel}} > 1) is large. From the AMPTE/CCE particle and magnetic field data observed during Pc 4--5 wave events the authors compute the ballooning-mirror instability parameters and perform a correlation study with the theoretical instability threshold. They find that compressional Pc 5 waves approximately satisfy the ballooning-mirror instability condition, and transverse Pc 4--5 waves are probably related to resonant ballooning instabilities with small pressure anisotropy.

  6. Beam tests of the balloon-borne ATIC experiment

    CERN Document Server

    Ganel, O; Ahn, H S; Ampe, J; Bashindzhagian, G L; Case, G; Chang, H; Ellison, S; Fazely, A; Gould, R; Granger, D; Gunasingha, R M; Guzik, T G; Han, Y J; Isbert, J; Kim, H J; Kim, K C; Kim, S K; Kwon, Y; Panasyuk, M Y; Panov, A; Price, B; Samsonov, G; Schmidt, W K H; Sen, M; Seo, E S; Sina, R; Sokolskaya, N; Stewart, M; Voronin, A; Wagner, D; Wang, J Z; Wefel, J P; Wu, J; Zatsepin, V


    The Advanced Thin Ionization Calorimeter (ATIC) balloon-borne experiment is designed to perform cosmic-ray elemental spectra measurements from 50 GeV to 100 TeV for nuclei from hydrogen to iron. These measurements are expected to provide information about some of the most fundamental questions in astroparticle physics today. ATIC's design centers on an 18 radiation length (X0) deep bismuth germanate (BGO) calorimeter, preceded by a 0.75λint graphite target. In September 1999, the ATIC detector was exposed to high-energy beams at CERN's SPS accelerator within the framework of the development program for the Advanced Cosmic-ray Composition Experiment for the Space Station (ACCESS). In December 2000–January 2001 and again in December 2002–January 2003, ATIC flew on the first two of a series of long-duration balloon (LDB) flights from McMurdo Station, Antarctica. We present here results from the 1999 beam tests, including energy resolutions for electrons and protons at several beam energies from 100 to 375 G...

  7. Polar Balloon Experiment for Astrophysics Research (Polar BEAR) (United States)

    Bashindzhagyan, G.; Adams, James H., Jr.; Bashindzhagyan, P.; Chilingarian, A.; Donnelly, J.; Drury, L.; Egorov, N.; Golubkov, S.; Grebenyuk, V.; Kalinin, A.; hide


    A new balloon experiment is proposed for a long duration flight around the North Pole. The primary objective of the experiment is to measure the elemental energy spectra of high-energy cosmic rays in the region up to 10(exp 15) eV. The proposed instrument involves the combination of a large collecting area (approximately 1 x 1 square m) KLEM (Kinematic Lightweight Energy Meter) device with an ionization calorimeter having a smaller collecting area (approximately 0.5 x 0.5 square m) and integrated beneath the KLEM apparatus. This combination has several important advantages. Due to the large aperture (greater than 2 square m sr) of the KLEM device a large exposure factor can be achieved with a long duration balloon flight (2-4 weeks). The calorimeter will collect about 10% of the events already registered by KLEM and provide effective cross-calibration for both energy measurement methods. Details of the experiment and its astrophysical significance will be presented.

  8. Clinical impact of balloon angioplasty for branch pulmonary arterial stenosis. (United States)

    Hosking, M C; Thomaidis, C; Hamilton, R; Burrows, P E; Freedom, R M; Benson, L N


    The clinical impact of percutaneous balloon angioplasty on the management of patients with native or postoperative pulmonary arterial stenosis was reviewed. Seventy-four patients underwent 110 angioplasty procedures. Mean age at dilation was 6.7 +/- 5.3 years (range 0.2 to 18.1), 17 patients were aged less than 1 year, mean follow-up was 37.7 +/- 22.8 months (range 16 to 96), and 34 patients (44%) had follow-up angiography. Pulmonary artery dilation was acutely successful in 53% of patients, 17% had recurrent stenosis, and 5% had complications. The impact on subsequent care was favorably influenced in 26 of 74 patients (35%) with either complete resolution of stenosis (n = 7), optimizing future surgical conditions (n = 14), reduction in right ventricular pressure by greater than 20% (n = 3), or improvement of ipsilateral lung perfusion (n = 2). No patient previously considered inoperable was subsequently considered suitable for surgical repair owing to the intervention. No correlation was found between success and cardiac diagnosis (p = 0.48), site of stenosis (p = 0.78), balloon-vessel ratio (p = 0.42), or whether the stenotic area consisted of native or synthetic material (p = 0.22). No predictive factors for success could be defined, and often there was only a transient clinical impact. Due to the low complication risk and potential for a beneficial result, it still appears prudent to offer angioplasty as an initial therapeutic modality in this setting.

  9. Leonids' Particle Analyses from Stratospheric Balloon Collection on Xerogel Surfaces (United States)

    Noever, David

    Recovered from a stratospheric balloon above 20 km on 17-18 November 1998, at least eight candidate microparticles were collected and analyzed from low-density silica xerogel collection plates. Capture time at Leonids' storm peak was validated locally along the balloon trajectory by direct video imaging of meteor fluence up to 24/hr above 98% of the Earth's atmosphere. At least one 30 micron particle agrees morphologically to a smooth, unmelted spherule and compares most closely in non-volatile elemental ratios (Mg/Si, Al/Si, and Fe/Si) to compositional data in surface/ocean meteorite collections. A Euclidean tree diagram based on composition makes a most probable identification as a non-porous stratospherically collected particle and a least probable identification as terrestrial matter or an ordinary chondrite. If of extraterrestrial origin, the mineralogical class would be consistent with a stony (S) type of silicate, olivine [(Mg,Fe)2SiO4] and pyroxene [(Mg, Fe)Si! O3)--or oxides, herecynite [(Fe,Mg) Al2O4].

  10. The Use of Zylon Fibers in ULDB Balloons (United States)

    Zimmerman, M.; Seely, L.; McLaughlin, J.

    Early in the development of the ULDB balloon, Zylon (PBO) was selected as the tendon material due to its favorable stress-strain properties. It is a next generation super fiber whose strength and modulus are almost double those of the p-Aramid fibers. In addition there are two versions of the Zylon, As Spun (AS) and High Modulus (HM). Data will be presented on why the HM was chosen. Early in the development process, it was learned that this material exhibited an unusual sensitivity to degradation by ambient light. This is in addition to the expected sensitivity to UV radiation (Ultraviolet). The fiber manufacturer reported all of these properties in their literature. Due to the operating environment of the ULDB (Ultra Long Duration Balloon) it is necessary to protect the tendons from both visible and UV radiation. Methods to protect the tendons will be discussed. In addition, information on the long term exposure of the braided tendon over a thirty-six month period in a controlled manufacturing plant will be provided.

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

    Directory of Open Access Journals (Sweden)

    Nogueira Júnior, João Flávio


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

  12. Two cases of apical ballooning syndrome masking apical hypertrophic cardiomyopathy. (United States)

    Roy, Ranjini Raina; Hakim, Fayaz A; Hurst, R Todd; Simper, David; Appleton, Christopher P


    Apical akinesis and dilation in the absence of obstructive coronary artery disease is a typical feature of stress-induced (takotsubo) cardiomyopathy, whereas apical hypertrophy is seen in apical-variant hypertrophic cardiomyopathy. We report the cases of 2 patients who presented with takotsubo cardiomyopathy and were subsequently found to have apical-variant hypertrophic cardiomyopathy, after the apical ballooning from the takotsubo cardiomyopathy had resolved. The first patient, a 43-year-old woman with a history of alcohol abuse, presented with shortness of breath, electrocardiographic and echocardiographic features consistent with takotsubo cardiomyopathy, and no significant coronary artery disease. An echocardiogram 2 weeks later revealed a normal left ventricular ejection fraction and newly apparent apical hypertrophy. The 2nd patient, a 70-year-old woman with pancreatitis, presented with chest pain, apical akinesis, and a left ventricular ejection fraction of 0.39, consistent with takotsubo cardiomyopathy. One month later, her left ventricular ejection fraction was normal; however, hypertrophy of the left ventricular apex was newly noted. To our knowledge, these are the first reported cases in which apical-variant hypertrophic cardiomyopathy was masked by apical ballooning from stress-induced cardiomyopathy.

  13. Estimation of tracheostomy tube cuff pressure by pilot balloon palpation. (United States)

    Faris, C; Koury, E; Philpott, J; Sharma, S; Tolley, N; Narula, A


    Two methods can be used to assess the intra-cuff pressure of tracheostomy tubes: digital palpation of the pilot balloon and use of a hand-held manometer. We conducted a telephone survey to determine the prevalence of both methods in intensive care units within 21 teaching hospitals across the United Kingdom. Forty-two per cent of the intensive care units surveyed used a protocol for monitoring cuff pressure with a manometer.A study to compare these two methods, using the manometer as the reference standard, was then carried out. The cuff pressure was correctly estimated in pre-inflated tracheostomy tubes, in a tracheal model, by 61 per cent of a cross-section of intensive care unit and otolaryngology staff.Using pilot balloon palpation is inaccurate and leaves a significant proportion of patients at risk of tracheal injury. We advocate the wider availability of hand-held pressure manometers in intensive care units and the institution of protocols for monitoring cuff pressure for any patient with a tracheostomy tube with an inflated cuff in situ.

  14. Leonid's Particle Analyses from Stratospheric Balloon Collection on Xerogel Surfaces (United States)

    Noever, David; Phillips, Tony; Horack, John; Porter, Linda; Myszka, Ed


    Recovered from a stratospheric balloon above 20 km on 17-18 November 1998, at least eight candidate microparticles were collected and analyzed from low-density silica xerogel collection plates. Capture time at Leonids' storm peak was validated locally along the balloon trajectory by direct video imaging of meteor fluence up to 24/hr above 98% of the Earth's atmosphere. At least one 30 micron particle agrees morphologically to a smooth, unmelted spherule and compares most closely in non-volatile elemental ratios (Mg/Si, Al/Si, and Fe/Si) to compositional data in surface/ocean meteorite collections. A Euclidean tree diagram based on composition makes a most probable identification as a non-porous stratospherically collected particle and a least probable identification as terrestrial matter or an ordinary chondrite. If of extraterrestrial origin, the mineralogical class would be consistent with a stony (S) type of silicate, olivine [(Mg,Fe)2SiO4] and pyroxene [(Mg, Fe)Si!O3)--or oxides, herecynite [(Fe,Mg) Al2O4].

  15. Balloon-Assisted Fistula Sealing Procedure for Symptomatic Tarlov Cysts. (United States)

    Zheng, Xuesheng; Li, Shiting; Sheng, Hansong; Feng, Baohui; Zhang, Nu; Xie, Chaoran


    Tarlov cyst is an abnormal expansion of the spinal nerve sleeve, and it communicates with the subarachnoid cavity via a perineural fistula. This study presents our experience of a balloon-assisted fistula sealing procedure in treating Tarlov cyst. Twenty-two patients with symptomatic Tarlov cysts were surgically treated. An emulsion balloon was placed into the lumbar subarachnoid cistern through a trocar, so as to temporarily block cerebrospinal fluid flow, then the thecal sac was opened and the inlet of the fistula was sealed by suture of a muscular patch and reinforced by fibrin glue. Finally, the cyst wall was imbricated and the bony cavity was filled with pedicled muscle flaps. Comparing the preoperative and postoperative pain scores according to visual analog scale, 2 patients were slightly improved and 18 patients were substantially improved, including 3 completely pain-free cases. Only 2 patients were unchanged in pain, and both of them had multiple cysts. As a whole, the postoperative pain score was much better than the preoperative score (2.4 vs. 7.5; P Tarlov cyst, especially for the single cyst. It is a good complement to the cyst wall imbricating procedure. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Balloon pulmonary angioplasty in chronic thromboembolic pulmonary hypertension

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    Irene Lang


    Full Text Available Chronic thromboembolic pulmonary hypertension (CTEPH is thought to result from incomplete resolution of pulmonary thromboemboli that undergo organisation into fibrous tissue within pulmonary arterial branches, filling pulmonary arterial lumina with collagenous obstructions. The treatment of choice is pulmonary endarterectomy (PEA in CTEPH centres, which has low post-operative mortality and good long-term survival. For patients ineligible for PEA or who have recurrent or persistent pulmonary hypertension after surgery, medical treatment with riociguat is beneficial. In addition, percutaneous balloon pulmonary angioplasty (BPA is an emerging option, and promises haemodynamic and functional benefits for inoperable patients. In contrast to conventional angioplasty, BPA with undersized balloons over guide wires exclusively breaks intraluminal webs and bands, without dissecting medial vessel layers, and repeat sessions are generally required. Observational studies report that BPA improves haemodynamics, symptoms and functional capacity in patients with CTEPH, but controlled trials with long-term follow-up are needed. Complications include haemoptysis, wire injury, vessel dissection, vessel rupture, reperfusion pulmonary oedema, pulmonary parenchymal bleeding and haemorrhagic pleural effusions. This review summarises the available evidence for BPA, patient selection, recent technical refinements and periprocedural imaging, and discusses the potential future role of BPA in the management of CTEPH.

  17. Beam Tests of the Balloon-Borne ATIC Experiment (United States)

    Ganel, O.; Adams, J. H., Jr.; Ahn, E. J.; Ampe, J.; Bashindzhagyan, G.; Case, G.; Chang, J.; Ellison, S.; Fazely, A.; Gould, R.


    The Advanced Thin Ionization Calorimeter (ATIC) balloon-borne experiment is designed to perform cosmic-ray elemental spectra measurement from 50 GeV to 100 TeV for nuclei from hydrogen to iron. These measurements are expected to provide crucial hints about some of the most fundamental questions in astroparticle physics today. ATTIC'S design centers on an 18 radiation length (X(sub Omnicron)) deep bismuth germanate (BGO) calorimeter, preceded by a 0.75 lambda(sub int) graphite target. In September 1999 the ATIC detector was exposed to high-energy beams at CERN's SPS accelerator, within the framework of the development program for the Advanced Cosmic-ray Composition Experiment for the Space Station (ACCESS). In December 2000 - January 2001, ATIC flew on the first of a series of long duration balloon (LDB) flights from McMurdo Station, Antarctica. We present here results from the 1999 beam-tests, including energy resolutions for electrons and protons at several beam energies from 100 GeV to 375 GeV, as well as signal linearity and collection efficiency estimates. We show how these results compare with expectations based on simulations, and their expected impacts on mission performance.

  18. Outcomes of peripheral perfusion with balloon aortic clamping for totally endoscopic robotic mitral valve repair. (United States)

    Ward, Alison F; Loulmet, Didier F; Neuburger, Peter J; Grossi, Eugene A


    Although the technique of totally endoscopic robotic mitral valve repair (TERMR) has been well described, few reports have examined the results of peripheral perfusion with balloon clamping. We analyzed the outcomes of TERMR performed using this strategy. A total of 108 consecutive patients underwent TERMR by a 2-surgeon team. The preoperative evaluation included chest computed tomography and abdominal and pelvis computed tomography. Additional procedures included appendage exclusion in 96, patent foramen ovale closure in 29, cryoablation in 16, tricuspid valve repair in 2, and septal myectomy in 2. The mean patient age was 59 years (range, 21-86). Central venous drainage was obtained with a long cannula. Arterial return was achieved with femoral cannulation, when possible. An endoballoon catheter was placed through the femoral artery. Transesophageal echocardiography was used to position all catheters. Femoral artery perfusion was possible in 103 of 108 patients (95.3%). The subclavian artery was used in 5 patients (4.6%) with contraindications to retrograde perfusion. An endoballoon clamp was placed by way of the femoral artery. In 105 of 108 patients (97.2%), endoaortic occlusion was successfully used; the mean crossclamp time was 87.4 minutes. The coronary sinus cardioplegia catheter was placed successfully in 81 of the 108 patients (75%). Postoperatively, no or mild inotropic support was needed in 94 (87%) and moderate support in 14 (13.0%). Of the 108 patients, 55 (50.9%) were extubated in the operating room. No hospital mortality, aortic injury, vascular complications, or wound infections occurred. Complications included 2 strokes (no residual deficit) (1.8%) and atrial fibrillation in 18 (16.7%). The median hospital stay was 4 days. Eighty patients (74.1%) were discharged by postoperative day 5. A preoperative image-guided perfusion strategy and aortic balloon clamping permit routine TERMR with excellent myocardial preservation and minimal complications

  19. Acute Success of Balloon Aortic Valvuloplasty in the Current Era: A National Cardiovascular Data Registry Study. (United States)

    Boe, Brian A; Zampi, Jeffrey D; Kennedy, Kevin F; Jayaram, Natalie; Porras, Diego; Foerster, Susan R; Armstrong, Aimee K


    The aim of this study was to evaluate practice patterns and outcomes of a contemporary group of patients undergoing balloon aortic valvuloplasty (BAV) for congenital aortic stenosis (AS). BAV is the most common treatment for isolated congenital AS. Within the IMPACT (Improving Pediatric and Adult Congenital Treatments) Registry, all BAV procedures performed between January 2011 and March 2015 were identified. Procedures were separated into those performed for critical versus noncritical AS. Outcomes were stratified into optimal, adequate, and inadequate, with optimal and adequate outcomes defining "successful" procedures. Multivariate logistic regression was used to identify patient and procedural characteristics associated with unsuccessful BAV. Mortality and adverse events rates were compared across patient cohorts. Of the 1,026 isolated BAV procedures captured in IMPACT, 718 (70%) were "successful." Success rates were 70.9% for noncritical AS (n = 916) and 62.7% for critical AS (n = 110). Multivariate analysis revealed that prior cardiac catheterization, mixed valve disease, baseline aortic valve gradient >60 mm Hg, baseline aortic insufficiency greater than mild, presence of a trainee, and multiple balloon inflations were associated with unsuccessful BAV in the noncritical AS cohort. There were no factors associated with unsuccessful procedures in the critical AS group. No procedural deaths occurred, but 2.4% of patients did not survive to hospital discharge. Adverse events occurred in 15.8% of all cases and were more frequent in procedures performed for critical AS (30.0% vs. 14.1%; p critical AS have a higher risk for procedure-related adverse events. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  20. Contura Multi-Lumen Balloon Breast Brachytherapy Catheter: Comparative Dosimetric Findings of a Phase 4 Trial

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


    Purpose: Final dosimetric findings of a completed, multi-institutional phase 4 registry trial using the Contura Multi-Lumen Balloon (MLB) breast brachytherapy catheter to deliver accelerated partial breast irradiation (APBI) in patients with early-stage breast cancer are presented. Methods and Materials: Three dosimetric plans with identical target coverage were generated for each patient for comparison: multilumen multidwell (MLMD); central-lumen multidwell (CLMD); and central-lumen single-dwell (CLSD) loading of the Contura catheter. For this study, a successful treatment plan achieved ideal dosimetric goals and included the following: ≥95% of the prescribed dose (PD) covering ≥95% of the target volume (TV); maximum skin dose ≤125% of the PD; maximum rib dose ≤145% of the PD; and V150 ≤50 cc and V200 ≤10 cc. Results: Between January 2008 and February 2011, 23 institutions participated. A total of 318 patients were available for dosimetric review. Using the Contura MLB, all dosimetric criteria were met in 78.93% of cases planned with MLMD versus 55.38% with the CLMD versus 37.66% with the CLSD (P≤.0001). Evaluating all patients with the full range of skin to balloon distance represented, median maximum skin dose was reduced by 12% and median maximum rib dose by 13.9% when using MLMD-based dosimetric plans compared to CLSD. The dosimetric benefit of MLMD was further demonstrated in the subgroup of patients where skin thickness was <5 mm, where MLMD use allowed a 38% reduction in median maximum skin dose over CLSD. For patients with rib distance <5 mm, the median maximum rib dose reduction was 27%. Conclusions: Use of the Contura MLB catheter produced statistically significant improvements in dosimetric capabilities between CLSD and CLMD treatments. This device approach demonstrates the ability not only to overcome the barriers of limited skin thickness and close rib proximity, but to consistently achieve a higher standard of dosimetric planning goals.

  1. Long-term results of percutaneous balloon valvuloplasty in pulmonary valve stenosis in the pediatric population. (United States)

    Merino-Ingelmo, Raquel; Santos-de Soto, José; Coserria-Sánchez, Félix; Descalzo-Señoran, Alfonso; Valverde-Pérez, Israel


    Percutaneous pulmonary valvuloplasty is the preferred interventional procedure for pulmonary valve stenosis. The aim of this study was to evaluate the effectiveness of this technique, assess the factors leading to its success, and determine the long-term results in the pediatric population. The study included 53 patients with pulmonary valve stenosis undergoing percutaneous balloon valvuloplasty between December 1985 and December 2000. Right ventricular size and functional echocardiographic parameters, such as pulmonary regurgitation and residual transvalvular gradient, were assessed during long-term follow-up. Peak-to-peak transvalvular gradient decreased from 74 mmHg [interquartile range, 65-100 mmHg] to 20 mmHg [interquartile range, 14-34 mmHg]. The procedure was unsuccessful in 2 patients (3.77%). The immediate success rate was 73.58%. Follow-up ranged from 10 years to 24 years (median, 15 years). During follow-up, all patients developed late pulmonary regurgitation which was assessed as grade II in 58.4% and grade III in 31.2%. There was only 1 case of long-term restenosis (2.1%). Severe right ventricular dilatation was observed in 27.1% of the patients. None of the patients developed significant right ventricular dysfunction. Pulmonary valve replacement was not required in any of the patients. Percutaneous balloon valvuloplasty is an effective technique in the treatment of pulmonary valve stenosis with good long-term results. Copyright © 2013 Sociedad Española de Cardiología. Published by Elsevier Espana. All rights reserved.

  2. Carbon Monoxide Releasing Molecule Accelerates Reendothelialization after Carotid Artery Balloon Injury in Rat. (United States)

    Hu, Qing Song; Chen, Yang Xin; Huang, Qing Sheng; Deng, Bing Qing; Xie, Shuang Lun; Wang, Jing Feng; Nie, Ru Qiong


    This study was aimed to investigate the effects of carbon monoxide releasing molecule (CORM-2), a novel carbon monoxide carrier, on the reendothelialization of carotid artery in rat endothelial denudation model. Male rats subjected to carotid artery balloon injury were treated with CORM-2, inactive CORM-2 (iCORM-2) or dimethyl sulfoxide (DMSO). The reendothelialization capacity was evaluated by Evans Blue dye and the immunostaining with anti-CD31 antibody. The number of circulating endothelial progenitor cells (EPCs) was detected by flow cytometry. The proliferation, migration, and adhesion of human umbilical vein endothelial cells (HUVECs) were assessed by using [3H]thymidine, Boyden chamber and human fibronectin respectively. The expressions of protein were detected by using western blot analysis. CORM-2 remarkably accelerated the re-endothelialization 5 d later and inhibited neointima formation 28 d later. In addition, the number of peripheral EPCs significantly increased in CORM-2-treated rats than that in iCORM-2 or DMSO-treated rats after 5 d later. In vitro experiments, CORM-2 significantly enhanced the proliferation, migration and adhesion of HUVECs. The levels of Akt, eNOS phosphorylation, and NO generation in HUVECs were also much higher in CORM-2 treated group. Blocking of PI3K/Akt/eNOS signaling pathway markedly suppressed the enhanced migration and adhesion of HUVECs induced by CORM-2. CORM-2 could promote endothelial repair, and inhibit neointima formation after carotid artery balloon injury, which might be associated with the function changes of HUVECs regulated by PI3K/Akt/eNOS pathway. Copyright © 2015 The Editorial Board of Biomedical and Environmental Sciences. Published by China CDC. All rights reserved.

  3. Comparison of patients’ tolerance between computed tomography enterography and double-balloon enteroscopy

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    Zhang M


    Full Text Available Maochen Zhang,* Tianyu Zhang,* Liwen Hong, Qiangqiang Wu, Yun Lin, Mengfan Xie, Rong Fan, Zhengting Wang, Jie Zhou, Jie Zhong Department of Gastroenterology, Ruijin Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, People’s Republic of China *These authors contributed equally to this work Background: Computed tomography enterography (CTE and double-balloon enteroscopy (DBE are widely used in diagnosis of small bowel diseases. Both of these examinations bring discomfort to patients. The aim of this study was to compare patients’ tolerance and preference between CTE and DBE. Methods: From August 1, 2014 to December 31, 2016, patients with suspected or known small bowel diseases who underwent both CTE and DBE were prospectively enrolled in our study. They were asked to fill out a questionnaire evaluating discomfort of the procedure after each examination. Results: One hundred and seven patients completed our study. Abdominal distension, painfulness, tenesmus, general discomfort, prolonged duration, difficulty in completing the test, and discomfort after the examination were significantly lower with CTE than with DBE (P<0.001, respectively. Mannitol intake (47.7%, bowel preparation (31.9%, and radiation exposure (15.0% were regarded as the three most intolerable burdens in CTE. Painfulness (38.3%, bowel preparation (26.2%, and invasiveness (16.8% were considered as the three most unacceptable parts of DBE. More patients (61.7% preferred to repeat CTE rather than DBE (P<0.001. Conclusion: Compared to DBE, CTE was a more tolerable and less burdensome examination and enjoyed higher preference by most patients. Keywords: computed tomography enterography, double-balloon enteroscopy, tolerance and preference

  4. Balloon dilatation in patients with gastric outlet obstruction related to peptic ulcer disease. (United States)

    Hamzaoui, Lamine; Bouassida, Mahdi; Ben Mansour, Imed; Medhioub, Mouna; Ezzine, Heykal; Touinsi, Hassen; Azouz, Mohamed M


    Gastric outlet obstruction (GOO) is a rare complication of peptic ulcer disease (PUD). The endoscopic balloon dilatation (EBD) associated with medical treatment of Helicobacter pylori is a successful method in the management of pyloric stenosis. The aim of this study was to describe epidemiological, clinical, and endoscopic characteristics of GOO related to PUD and to evaluate the effectiveness, safety, and outcome of EBD. In a retrospective study of patients seen between 1999 and 2009 with symptoms of GOO secondary to PUD, pyloro-bulbar stenosis was confirmed by endoscopic examination. Balloon dilatation was performed when obstruction persisted after treatment with double-dose proton-pump inhibitor (PPI) intravenously for 7-10days. The H. pylori status was assessed with histology, and eradication therapy was prescribed for infection. A total of 45 consecutive patients (38 males, 7 females median age, 51.9years; range, 20-58years) with symptoms of GOO secondary to PUD underwent EBD. Median follow-up time of the 45 patients was 32months (range, 4-126months). The immediate success rate of the procedure was 95.5%. Clinical remission was noted in 84.4% of the patients. Remission without relapse was observed in 55.8%, 30months after the dilatation. Pyloric stenosis relapsed in 15 patients (39.5%) after a median period of 22.9months. The dilatation was complicated in three patients (6.7%, two perforations and one bleeding). A total of 13 patients (29%) underwent surgery. H. pylori was found to be positive in 97.7% of the patients, and was eradicated in 78.4% of them. Smoking and failure of H. pylori eradication were associated with the relapse of the stenosis. EBD is a simple, effective, and safe therapy for the GOO related to PUD, producing short- and long-term remission. Copyright © 2015 Arab Journal of Gastroenterology. Published by Elsevier B.V. All rights reserved.

  5. Management of Benign Tracheal Stenosis by Small-diameter Tube-assisted Bronchoscopic Balloon Dilatation

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    Yi-Lin Liang


    Full Text Available Background: A limitation of bronchoscopic balloon dilatation (BBD is that airflow must be completely blocked for as long as possible during the operation. However, the patient often cannot hold his or her breath for a long period affecting the efficacy of the procedure. In this study, we used an extra-small-diameter tube to provide assisted ventilation to patients undergoing BBD and assessed the efficacy and safety of this technique. Methods: Bronchoscopic balloon dilatation was performed in 26 patients with benign tracheal stenosis using an extra-small-diameter tube. The tracheal diameter, dyspnea index, blood gas analysis results, and complications were evaluated before and after BBD. Statistical analyses were performed by SPSS version 16.0 for Windows (SPSS, Inc., Chicago, IL, USA. Results: Sixty-three BBD procedures were performed in 26 patients. Dyspnea immediately improved in all patients after BBD. The tracheal diameter significantly increased from 5.5 ± 1.5 mm to 13.0 ± 1.3 mm (P < 0.001, and the dyspnea index significantly decreased from 3.4 ± 0.8 to 0.5 ± 0.6 (P < 0.001. There was no significant change in the partial pressure of oxygen during the operation (before, 102.5 ± 27.5 mmHg; during, 96.9 ± 30.4 mmHg; and after, 97.2 ± 21.5 mmHg; P = 0.364, but there was slight temporary retention of carbon dioxide during the operation (before, 43.5 ± 4.2 mmHg; during, 49.4 ± 6.8 mmHg; and after, 40.1 ± 3.9 mmHg; P < 0.001. Conclusion: Small-diameter tube-assisted BBD is an effective and safe method for the management of benign tracheal stenosis.

  6. Are the American Society for Radiation Oncology Guidelines Accurate Predictors of Recurrence in Early Stage Breast Cancer Patients Treated with Balloon-Based Brachytherapy?

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    Moira K. Christoudias


    Full Text Available The American Society for Radiation Oncology (ASTRO consensus statement (CS provides guidelines for patient selection for accelerated partial breast irradiation (APBI following breast conserving surgery. The purpose of this study was to evaluate recurrence rates based on ASTRO CS groupings. A single institution review of 238 early stage breast cancer patients treated with balloon-based APBI via balloon based brachytherapy demonstrated a 4-year actuarial ipsilateral breast tumor recurrence (IBTR rate of 5.1%. There were no significant differences in the 4-year actuarial IBTR rates between the “suitable,” “cautionary,” and “unsuitable” ASTRO categories (0%, 7.2%, and 4.3%, resp., P=0.28. ER negative tumors had higher rates of IBTR than ER positive tumors. The ASTRO groupings are poor predictors of patient outcomes. Further studies evaluating individual clinicopathologic features are needed to determine the safety of APBI in higher risk patients.

  7. Paclitaxel Drug-eluting Tracheal Stent Could Reduce Granulation Tissue Formation in a Canine Model

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    Ting Wang


    Conclusions: The paclitaxel-eluting stent could safely reduce the granulation tissue formation after stent implantation in vivo, suggesting that the paclitaxel-eluting tracheal stent might be considered for potential use in humans in the future.

  8. Inquiry-Based Early Undergraduate Research Using High-Altitude Ballooning (United States)

    Sibbernsen, K.; Sibbernsen, M.


    One common objective for undergraduate science classes is to have students learn how to do scientific inquiry. However, often in science laboratory classes, students learn to take data, analyze the data, and come to conclusions, but they are told what to study and do not have the opportunity to ask their own research questions, a crucial part of scientific inquiry. A special topics class in high-altitude ballooning (HAB) was offered at Metropolitan Community College, a large metropolitan two-year college in Omaha, Nebraska to focus on scientific inquiry for the participants through support of NASA Nebraska Space Grant. A weather balloon with payloads attached (balloonSAT) was launched to near space where the balloon burst and fell back to the ground with a parachute. Students worked in small groups to ask their research questions, they designed their payloads, participated in the launch and retrieval of equipment, analyzed data, and presented the results of their research. This type of experience has potential uses in physics, physical science, engineering, electronics, computer programming, meteorology, astronomy, and chemistry classes. The balloonSAT experience can act as a stepping-stone to designing sounding rocket payloads and it can allow students the opportunity to participate in regional competitions and present at HAB conferences. Results from the workshop are shared, as well as student responses to the experience and suggestions for administering a high-altitude ballooning program for undergraduates or extending inquiry-based ballooning experiences into high-school or middle-school.

  9. Detection of inflating balloon in optical coherence tomography images of a porcine artery in a beating heart experiment (United States)

    Azarnoush, Hamed; Vergnole, Sébastien; Hewko, Mark; Boulet, Benoit; Sowa, Mike; Lamouche, Guy


    Suboptimal results of angioplasty procedures have been correlated to arterial damage during balloon inflation. We propose to monitor balloon inflation during the angioplasty procedure by detecting the balloon contours with intravascular optical coherence tomography (IVOCT). This will shed more light on the interaction between the balloon and the artery and to assess the artery's mechanical response. An automatic edge detection algorithm is applied for detection of the outer surface of an inflating balloon in a porcine artery in a beating heart experiment. A compliant balloon is inflated to deform the artery. IVOCT monitoring of balloon inflation is performed at a rate of 30 frames per second. During inflation, the balloon engages the arterial wall. Therefore, the characterization of the diameter of the inflated balloon leads to a characterization of the luminal diameter of the vessel. This provides precise information about the artery response to a simulated angioplasty procedure, information currently not provided by any other existing technique. In the current experiment, balloon inflation characterization is based on 356 IVOCT frames during which the estimated balloon diameter increases approximately from 1.8 mm to 2.9 mm.

  10. How much of the intraaortic balloon volume is displaced toward the coronary circulation? (United States)

    Kolyva, Christina; Pantalos, George M; Pepper, John R; Khir, Ashraf W


    During intraaortic balloon inflation, blood volume is displaced toward the heart (V(tip)), traveling retrograde in the descending aorta, passing by the arch vessels, reaching the aortic root (V(root)), and eventually perfusing the coronary circulation (V(cor)). V(cor) leads to coronary flow augmentation, one of the main benefits of the intraaortic balloon pump. The aim of this study was to assess V(root) and V(cor) in vivo and in vitro, respectively. During intraaortic balloon inflation, V(root) was obtained by integrating over time the aortic root flow signals measured in 10 patients with intraaortic balloon assistance frequencies of 1:1 and 1:2. In a mock circulation system, flow measurements were recorded simultaneously upstream of the intraaortic balloon tip and at each of the arch and coronary branches of a silicone aorta during 1:1 and 1:2 intraaortic balloon support. Integration over time of the flow signals during inflation yielded V(cor) and the distribution of V(tip). In patients, V(root) was 6.4% +/- 4.8% of the intraaortic balloon volume during 1:1 assistance and 10.0% +/- 5.0% during 1:2 assistance. In vitro and with an artificial heart simulating the native heart, V(cor) was smaller, 3.7% and 3.8%, respectively. The distribution of V(tip) in vitro varied, with less volume displaced toward the arch and coronary branches and more volume stored in the compliant aortic wall when the artificial heart was not operating. The blood volume displaced toward the coronary circulation as the result of intraaortic balloon inflation is a small percentage of the nominal intraaortic balloon volume. Although small, this percentage is still a significant fraction of baseline coronary flow. 2010 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  11. Balloon Dilation of the Ureter: A Contemporary Review of Outcomes and Complications. (United States)

    Kuntz, Nicholas J; Neisius, Andreas; Tsivian, Matvey; Ghaffar, Momin; Patel, Nishant; Ferrandino, Michael N; Sur, Roger L; Preminger, Glenn M; Lipkin, Michael E


    During ureteroscopy ureteral balloon dilation may be necessary to allow for passage of endoscopic instruments or access sheaths. We assessed the efficacy and complications associated with ureteral balloon dilation. We retrospectively reviewed the records at 2 institutions from 2000 to 2012 to identify patients who underwent ureteral balloon dilation during ureteroscopic treatment of upper tract stones. An 18Fr balloon dilator was used in all cases. Patients with documented ureteral stricture, radiation therapy or urothelial cancer were excluded from analysis. Primary outcomes were the stone-free rate, operative complications, balloon dilation failure and the postoperative ureteral stricture rate. Complications were divided into intraoperative and postoperative groups according to the Satava and Clavien-Dindo classifications, respectively. A total of 151 patients fulfilled study criteria. Median followup was 12 months. The stone-free rate was 72% and median time to first postoperative imaging was 2.8 months. Balloon dilation failed in only 8 patients (5%). Eight intraoperative ureteral perforations (5%) were identified, which were managed by a ureteral stent in 7 patients and a percutaneous tube in 1. Endoscopic re-treatment was required in 4 patients with Satava 2b postoperative complications. The postoperative complication rate was 8% (11 cases). A single ureteral stricture was attributable to balloon dilation. In this contemporary review balloon dilation of the ureter before endoscopic treatment of stone disease was associated with a high success rate and few complications. Ureteral balloon dilation may decrease the need for a secondary procedure in patients undergoing ureteroscopy to manage proximal ureteral and intrarenal stones. Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  12. Unique High Energy Experiment Initiative by ICSP with Weather Balloons (United States)

    Chakrabarti, S. K.; Bhowmick, D.; Sarkar, R.; Bhattacharyya, A.; Midya, S.


    With the advent of miniaturization of instruments, Indian Centre for Space Physics began exploring high energy Universe using weather balloons about six years ago. Several Payloads of mass within 4 kg have been flown to near space. Along with the main measurement unit which is usually a scintillator detector, attitude measurement unit, GPS tracking unit, video camera and parachute(s) are also flown. Using large duration flights unique to ICSP without using any valve or ballast and any extra cost, this inexpensive initiative brings back very rich scientific data on soft X-ray spectra of Cosmic Rays, Solar flares, Gamma Ray Bursts and Crab Pulsar. Some results are presented. The payloads are reusable, reducing the recurring cost per flight to be less that $500.00.

  13. Site testing study based on weather balloons measurements (United States)

    Aristidi, E.; Agabi, A.; Azouit, M.; Fossat, E.; Vernin, J.; Sadibekova, T.; Travouillon, T.; Lawrence, J. S.; Halter, B.; Roth, W. L.; Walden, V. P.

    We present wind and temperature profiles at Dome C measured during the polar summer by balloon born sonds. Data from 197 flights have been processed for 4 campaigns between 2000 and 2004. We show the exceptionnal wind conditions at Dome C: averaged ground wind speed is 3.6 m s-1. We noticed in mid-november the presence of high altitude strong winds (40 m s-1) probably due to the polar vortex which disappear in summer. These winds seem to have no effect on seeing measurements made with a DIMM at the same period. Temperature profiles exhibit a minimum at height 5500 m (over the snow surface) that defines the tropopause. Surface layer temperature profile has negative gradient in the first 50 m above ground in the afternoon and a strong inversion layer (5°C over 50 m) around midnight. Wind profiles are compared with other astronomical sites, and with a meteorological model from Meteo France.

  14. Ballooning Instability in Polar Caps of Accreting Neutron Stars (United States)

    Litwin, C.; Brown, Edward F.; Rosner, R.


    We assess the stability of Kruskal-Schwarzschild (magnetic Rayleigh-Taylor) type modes for accreted matter on the surface of a neutron star confined by a strong (>~1012 G) magnetic field. Employing the energy principle to analyze the stability of short-wavelength ballooning modes, we find that line-tying to the neutron star crust stabilizes these modes until the overpressure at the top of the neutron star crust exceeds the magnetic pressure by a factor ~8(a/h), where a and h are, respectively, the lateral extent of the accretion region and the density scale height. The most unstable modes are localized within a density scale height above the crust. We calculate the amount of mass that can be accumulated at the polar cap before the onset of instability.

  15. Single-balloon enteroscopy-assisted nasojejunal tube placement

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    Hsuan-Wei Chen


    Full Text Available Expertise in enteral nutrition is an important aspect of the skill set of clinical gastroenterologists. Feeding tubes can be placed by bedside, endoscopic, fluoroscopic, and surgical methods. Nasojejunal tube placement in patients with variations in anatomy or with a history of abdominal surgery was previously a difficult problem. Today, however, as a result of developments in enteroscopy, gastroenterologists can obtain a better understanding of the small intestine. This paper reports a new technique in nasojejunal tube insertion. The feeding tube was placed in the intestine using a guide wire which accessed the jejunum with the help of single-balloon enteroscopy. Using this new skill, the placement of an enteral tube is more comfortable and safer for patients.

  16. Balloon borne LIDAR measurements of stratospheric hydroxyl radical (United States)

    Heaps, W. S.; Mcgee, T. J.


    A balloon-borne laser radar (LIDAR) system for determining the stratospheric hydroxyl radical concentration constructed and flown by the Goddard Space Flight Center is discussed. The system measured hydroxyl in the altitude range of 34-37 km during an afternoon and early evening, producing the first post-sunset hydroxyl determination ever obtained. Daytime values (approximately 5 x 10 to the 6th/cu cm) are somewhat lower than previous measurements using in situ resonance fluorescence. Nighttime values (approximately 7 x 10 to the 5th/cu cm at 2100 CDT) are found to be higher than predicted by current one-dimensional models. Possible sources of these discrepancies, together with improvements possible in future systems, are outlined.

  17. Esophageal intramural pseudodiverticulosis treated by endoscopic balloon dilatation. (United States)

    Chino, Osamu; Makuuchi, Hiroyasu; Kondo, Yasumasa; Nakamura, Tomoki; Tanaka, Yoichi; Hanashi, Tomoko; Yokoyama, Daiki; Kajiwara, Hiroshi


    We here report a rare case of esophageal intramural pseudodiverticulosis with dysphagia. A 65-year-old man was suffering from intermittent dysphagia for 10 years, which had been worsening in recent months. Endoscopic examination revealed multiple, small, saccular diverticula and mild annular stricture with numerous white plaques from the cervical esophagus to the middle thoracic esophagus. Barium esophagography revealed stricture of the upper thoracic esophagus with multiple tiny flask-shaped outpouchings. Based on this characteristic appearance, we diagnosed esophageal intramural pseudodiverticulosis and inflammation of a narrow segment of the esophagus. Biopsy specimen showed acute and chronic esophagitis with Candida infection. Dysphagia persisted despite resolution of candidiasis, for which we successfully performed endoscopic balloon dilatation of the stricture. After the treatment, the patient has been well and has not been suffering from dysphagia.

  18. Impact of HIWIND balloon measurements on thermospheric density models (United States)

    Moe, Kenneth; Wu, Qian


    The recent HIWIND (High-Altitude Interferometer Wind Observations) balloon measurements have revealed persistent equatorward winds in the dayside thermosphere during geomagnetically quiet times. Although this result does not agree with some current thermospheric density models, it is consistent with an earlier thermospheric density model (M1975) which includes the energy input through the magnetospheric dayside cusps during geomagnetically quiet times. We show the thermospheric density distribution with and without the magnetospheric input to illustrate the effect of the density gradient on the winds at high latitudes. We review the early history of the development of our understanding of the energy input to the high-latitude thermosphere. Future HIWIND measurements can add to our understanding and lead to improved models of thermospheric densities and winds.

  19. High Altitude Balloon Real-time Landing Prediction (United States)

    Eckel, Robert


    With the success of Weber State University's high altitude balloon program, HARBOR, missions become more complex and payloads of higher value, the importance of being able to recover the payload quickly after landing has increased. By expanding the functionality of Weber State's Multi-Sensor Array, combined with an amateur radio terminal node controller, we will be able to accurately predict the landing zone while in flight. Analysis of previous flights indicates that velocity vector projections on a plane tangential to the earth's surface remain fairly constant at any given altitude during the ascent and descent. By differentiating position data from GPS and other instruments during the ascent, the descent profile can be integrated to produce an accurate landing position. This prediction is then able to be sent down wirelessly over existing ham radio infrastructure to plot the predicted landing zone in navigation and mapping software in real time.

  20. Probabilistic Motion Planning of Balloons in Strong, Uncertain Wind Fields (United States)

    Wolf, Michael T.; Blackmore, Lars; Kuwata, Yoshiaki; Fathpour, Nanaz; Elfes, Alberto; Newman, Claire


    This paper introduces a new algorithm for probabilistic motion planning in arbitrary, uncertain vector fields, with emphasis on high-level planning for Montgolfiere balloons in the atmosphere of Titan. The goal of the algorithm is to determine what altitude--and what horizontal actuation, if any is available on the vehicle--to use to reach a goal location in the fastest expected time. The winds can vary greatly at different altitudes and are strong relative to any feasible horizontal actuation, so the incorporation of the winds is critical for guidance plans. This paper focuses on how to integrate the uncertainty of the wind field into the wind model and how to reach a goal location through the uncertain wind field, using a Markov decision process (MDP). The resulting probabilistic solutions enable more robust guidance plans and more thorough analysis of potential paths than existing methods.

  1. Background measurements from balloon-born imaging CZT detectors (United States)

    Jenkins, Jonathan A.; Narita, Tomohiko; Grindlay, Jonathan E.; Bloser, Peter F.; Stahle, Carl M.; Parker, Bradford H.; Barthelmy, Scott D.


    We report detector characteristics and background measurements from two prototype imaging CdZnTe (CZT) detectors flown on a scientific balloon payload in May 2001. The detectors are both platinum-contact 10 mm × 10 mm × 5 mm CZT crystals, each with a 4 × 4 array of pixels tiling the anode. One is made from IMARAD horizontal Bridgman CZT, the other from eV Products high-pressure Bridgman CZT. Both detectors were mounted side-by-side in a flip-chip configuration and read out by a 32-channel IDE VA/TA ASIC preamp/shaper. We enclosed the detectors in the same 40o field-of-view collimator used in our previously-reported September 2000 flight. I-V curves for the detectors are diode-like, and we find that the platinum contacts adhere significantly better to the CZT surfaces than gold to previosu detectors. The detectors and instrumentation performed well in a 20-hour balloon flight on 23/24 May 2001. Although we discovered a significant instrumental background component in flight, it was possible to measure and subtract this component from the spectra. The resulting IMARAD detector background spectrum reaches ~5×10-3 counts cm-2s-1keV-1 at 100 keV and has a power-law index of ~2 at hgih energies. The eV Products detector has a similar spectrum, although there is more uncertainty in the enregy scale because of calibration complications.

  2. [Coronary angioplasty: efficacy of the new low profile balloon catheters]. (United States)

    Feres, F; Tanajura, L F; Pinto, I M; Cano, M N; Maldonado, G; Mattos, L A; de Araújo, E C; Sousa, A G; Sousa, J E


    New low profile balloon catheter have allowed the indication of percutaneous transluminal coronary angioplasty (PTCA) for more complex lesions. We report our initial experience with these systems in 50 out of 101 patients (50%) who underwent a PTCA from March 15 to May 15, 1989 in "Instituto Dante Pazzanese de Cardiologia". Mean age was 58.6 +/- 10.4 years and most of the patients were male (78%). We dilated 54 lesions. Single vessel disease was the case for 84% of the patients. As for the localization of the lesions in the coronary arteries, 56% of the lesions were in the proximal or mid segments of the coronary arteries and the mean diameter stenosis pre-PTCA was 84 +/- 10.2%. Left ventricular function was normal in 60% of the patients. Primary success rate (per patient) was 95% and the coronary stenosis was crossed in all the cases. The mean inflation number was 2.7 +/- 0.6 per patient, the mean highest pressure was 8 +/- 1.15 atm and the mean maximum time of inflation was 86.1 +/- 29.6 sec. The mean residual stenosis was 15.2 +/- 10.6%. There was only one major complication, namely an acute myocardial infarction of the lateral wall. There were no emergency CABG surgery or deaths. We conclude that the new low profile balloon catheters have broadened the indication for PTCA in more complicated lesions, showing a high rate of primary success (95%), but did not increase the number of procedural complications (2.5%).

  3. CNES super pressure balloons upgrade for Strateole-2 campaign (United States)

    Venel, Stephanie; Cocquerez, Philippe; Hertzog, Albert


    The French Space Agency, CNES, has developed, since about twelve years ago, super pressure balloons (SPB) that float on constant density (isopycnic) surfaces in the lowermost stratosphere, carrying 40 to 50 kg payloads, during typically three months. These SPB have been successfully deployed in flotilla of about 20 balloons for different scientific campaigns all over the world in different configuration sizes from 8,5 to 12 m diameter, mainly to document the chemistry and dynamics of the atmosphere, to study gravity waves, and to provide in-situ atmospheric profiles thanks to the NCAR driftsonde payload. The SPB housekeeping gondola used from 2005 to 2011 now needs to be upgraded in order to increase the flights' safety and to improve its performance with up to date equipment's. The control center will also be redesigned. These modifications take into account the experience acquired during the last SPB campaigns, mainly during CONCORDIASI, with 19 flights over Antarctica from September 2010 to January 2011. After a successful preliminary design review, the project is now conducting the detailed conception phase. This new system is developed for STRATEOLE-2, a project dedicated to the coupling processes between the troposphere and the stratosphere in the deep tropics, using several types of instruments, both for in situ and remote measurements in the atmosphere. STRATEOLE -2 includes two measurement campaigns, three years spaced to study the quasi biennial oscillation. Since the scientific payloads are fully self-standing, some technical solutions will be common with the CNES housekeeping gondola, such as the renewable power system. This paper will describe the STRATEOLE-2 project and the developments in progress for the SPB system upgrade.

  4. Predictors of increased mitral regurgitation after percutaneous mitral balloon valvotomy. (United States)

    Roth, R B; Block, P C; Palacios, I F


    Left ventriculography (LVG) was performed to assess severity of mitral regurgitation (MR) on a scale of 0-4+ in 157 patients before and immediately after percutaneous mitral balloon valvotomy (PMV). There were 129 women and 28 men aged 51 +/- 1 (range 13-87) yr. With PMV, mitral valve area increased from 0.9 +/- 0.1 cm2 to 2.0 +/- 0.1 cm2 (P less than .0001). Increase in mitral regurgitation (MR) occurred in 69 patients (44%). Patients were divided into two groups based on increase in MR after PMV. Group A (n = 136) had 0-1+ increase in MR. Group B (n = 20) had greater than or equal to 2+ increase in MR after PMV. The only predictor of increase in MR greater than or equal to 2+ was the ratio of effective balloon dilating area to body surface area (EBDA/BSA). EBDA/BSA was 4.0 +/- 0.1 cm2/m2 in Group A vs. 4.37 +/- 0.2 cm2/m2 in Group B (P = .02). Follow-up of patients in Group B showed: Four patients remained NYHA Class III and required mitral valve replacement 4.3 +/- 1.1 (range 5-21) mo after PMV. One patient who had undergone combined aortic and mitral valvotomy died in the hospital of worsening heart failure. One patient died 1 mo later of sepsis related to a dental abscess. Follow-up of the remaining 14 patients at 9.5 +/- 1.1 (range 2-7) mo showed 10 in NYHA Class I and four in NYHA Class II. Eight of 15 patients (53%) who had repeat left ventriculogram at 9.0 +/- 0.8 mo after PMV had a decrease in MR of one grade when compared to LVG immediately after PMV.

  5. Balloon Borne Infrasound Platforms for Remote Monitoring of Natural Hazards (United States)

    Lees, J. M.; Bowman, D. C.


    In the last three years several NASA supported balloon launches were instrumented with infrasound sensors to monitor acoustic wavefields in the stratosphere. Such high altitude platforms may detect geoacoustic phenomena at much greater ranges than equivalent ground stations, and perhaps record sound waves that rarely reach the Earth's surface. Since acoustic waves are a key diagnostic for several natural hazards (volcanic eruptions, severe storms, and tsunamis, for example), the increased range and spatial coverage of balloon borne arrays promise greater quantification and perhaps early warning of such events. Before this can be accomplished, the performance of stratospheric arrays must be compared to tthat of those on the ground. Here, we show evidence for 0.2 Hz infrasound associated with oceanic oscillations recorded during night time hours of the flights, consistent with concurrent ground recordings on the east and west coasts of North America. We also report numerous narrow band acoustic signals (5-30 Hz) that resemble recordings made in in the 1960's, the last time microphones were lofted into the stratosphere. Theoretical and ground based observational data from Rind(1977) indicate loss of acoustic energy in the thermosphere, where heating of the upper atmosphere is predicted to be on the order of 30-40 degrees Kelvin per day. We propose testing these ideas by using extensive ground arrays recently deployed in North America in conjunction with airborne platforms installed in the mid-stratosphere. New experiments scheduled for 2016 include circumnavigation of Antarctica (collected in June) as well as two proposed flights in New Mexico in September. The flights are designed to both capture known acoustic sources as well as events of opportunity.

  6. Design of the detectors for EBEX, a balloon-borne cosmic microwave background polarimeter (United States)

    Westbrook, Benjamin; Aboobaker, A. M.; Ade, P.; Aubin, F.; Baccigalupi, C.; Bandura, K.; Bao, C.; Borrill, J.; Chapman, D.; Didier, J.; Dobbs, M.; Gold, B.; Grain, J.; Grainger, W.; Hanany, S.; Helson, K.; Hillbrand, S. N.; Hilton, G.; Hubmayr, H.; Irwin, K.; Johnson, B.; Jaffe, A.; Jones, T. J.; Kisner, T.; Klein, J.; Korotkov, A.; Leach, S.; Lee, A. T.; Levinson, L.; Limon, M.; MacDermid, K.; Miller, A. D.; Milligan, M.; Pascale, E.; Raach, K.; Reichborn-Kjennerud, B.; Sagiv, I.; Smecher, G.; Stompor, R.; Tristram, M.; Tucker, G. S.; Zilic, K.


    The E and B Experiment (EBEX) is a balloon-borne polarimeter designed to make precision measurements of the polarization of the cosmic microwave background and the galactic foreground. We report on the design and first implementation of spiderweb-absorber transition edge sensor (TES) bolometer technology on a balloon-borne platform in EBEX. Spiderweb absorber TES bolometer technology was originally developed for the ground-based APEX-SZ and South Pole Telescope experiments and required optimization for the lower optical loading and higher frequency band operation in a balloon environment.

  7. Safety of balloon kyphoplasty in the treatment of osteoporotic vertebral compression fractures in Europe: a meta-analysis of randomized controlled trials. (United States)

    Bouza, Carmen; López-Cuadrado, Teresa; Almendro, Nuria; Amate, José María


    The study aims to evaluate the safety of balloon kyphoplasty in the treatment of painful osteoporotic vertebral compression fractures in Europe. Systematic review of the literature, until September 2013, and meta-analysis of randomized controlled trials performed in Europe assessing the safety of balloon kyphoplasty in patients with symptomatic osteoporotic vertebral fractures. Outcomes sought include cement leaks, serious clinical complications and new vertebral fractures. Six randomized controlled trials fulfilled the inclusion criteria. These studies included data on 525 treated levels in 424 patients. Cement leakages were detected in 18.3 % (95 % CI 11.6, 23.0) of fractures intervened. In about 0.5 % (95 % CI 0.1, 1.1) of fractures leakages proved to be symptomatic. Serious clinical complications were recorded in 11.5 % (95 % CI 1.1, 21.7) of patients treated with balloon kyphoplasty with several of these cases requiring intensive treatment or postoperative surgery. New vertebral fractures were detected in 20.7 % (95 % CI 0.4, 40.9) of patients treated but rates showed an upward pattern when the follow-up period increased. In 54 % of such cases, the fractures were located in regions adjacent to the treated level. The safety profile and associated complications of balloon kyphoplasty shown in this analysis, based on the evidence provided by existing randomized controlled trials, can be of help to the practicing clinician who must contrast them with the potential benefits of the technique. These data represent an important step towards a balanced evaluation of the intervention though, a better reporting and more reliable data on long-term assessment of potential sequelae are needed.

  8. Clinical outcomes after final kissing balloon inflation compared with no final kissing balloon inflation in bifurcation lesions treated with a dedicated coronary bifurcation stent. (United States)

    Grundeken, Maik J; Lesiak, Maciej; Asgedom, Solomon; Garcia, Eulogio; Bethencourt, Armando; Norell, Michael S; Damman, Peter; Woudstra, Pier; Koch, Karel T; Vis, M Marije; Henriques, Jose P; Tijssen, Jan G; Onuma, Yoshinobu; Foley, David P; Bartorelli, Antonio L; Stella, Pieter R; de Winter, Robbert J; Wykrzykowska, Joanna J


    We evaluated differences in clinical outcomes between patients who underwent final kissing balloon inflation (FKBI) and patients who did not undergo FKBI in bifurcation treatment using the Tryton Side Branch Stent (Tryton Medical, Durham, North Carolina, USA). Clinical outcomes were defined as target vessel failure (composite of cardiac death, any myocardial infarction and clinically indicated target vessel revascularisation), cardiac death, myocardial infarction (MI), clinically indicated target vessel revascularisation and stent thrombosis. Cumulative event rates were estimated using the Kaplan-Meier method. A multivariable logistic regression analysis was performed to evaluate which factors were potentially associated with FKBI performance. Follow-up data was available in 717 (96%) patients with a median follow-up of 190 days. Cardiac death at 1 year occurred more often in the no-FKBI group (1.7% vs 4.6%, respectively, p=0.017), although this difference was no longer observed after excluding patients presenting with ST segment elevation MI (1.6% vs 3.3%, p=0.133). No significant differences were observed concerning the other clinical outcomes. One-year target vessel failure rates were 10.1% in the no-FKBI group and 9.2% in the FKBI group (p=0.257). Multivariable logistic regression analysis identified renal dysfunction, ST segment elevation MI as percutaneous coronary intervention indication, narrow (<30°) bifurcation angle and certain stent platforms as being independently associated with unsuccessful FKBI. A lower cardiac death rate was observed in patients in whom FKBI was performed compared with a selection of patients in whom FKBI could not be performed, probably explained by an unbalance in the baseline risk profile of the patients. No differences were observed regarding the other clinical outcomes.

  9. Dosimetric Improvements in Balloon Based Brachytherapy Using the Contura® Multi-Lumen Balloon (MLB Catheter to Deliver Accelerated Partial Breast Irradiation

    Directory of Open Access Journals (Sweden)

    Thomas Julian


    Full Text Available Purpose: Preliminary dosimetric findings in patients managed with the Contura® Multi-Lumen Balloon (MLB breast brachytherapy catheter to deliver accelerated partial breast irradiation (APBI on a multi-institutional phase IV registry trial were reviewed. Material and methods: CT-based 3D planning with dose optimization was performed for all patients. For the study, new ideal dosimetric goals were developed: 1 ≥ 95% of the prescribed dose (PD covering ≥ 90% of the target volume (TV, 2 a maximum skin dose ≤ 125% of the PD, 3 maximum rib dose ≤ 145% of the PD, and 4 the V150 ≤ 50 cc and V200 ≤ 10 cc. The frequency of concurrently achieving these dosimetric goals using the Contura® MLB was investigated.Results: 194 cases were evaluable. Employing the MLB, all ideal dosimetric criteria were achieved in 76% of cases.Evaluating dosimetric criteria separately, 90% and 89% of cases met the new ideal skin and rib dose criteria, respectively. In 96%, ideal TV coverage goals were achieved and in 96%, dose homogeneity criteria (V150 and V200 were met. For skin spacing ≥ 5-7 mm, the median skin dose was 121% of the PD and when < 5 mm, the median skin dose was 124.4%. For rib distancees < 5 mm, the median rib dose was reduced to 136.4% of the PD. For skin spacing < 7 mm and distance to rib < 5 mm, the median skin and rib doses were concurrently limited to 121% and 142.8% of thePD, respectively. Conclusions: The Contura® MLB catheter provides potential improvements in dosimetric capabilities (i.e., reduced skin and rib doses and improved TV coverage in many clinical scenarios.

  10. Novel Ultralow-Weight Metal Rubber Sensor System for Ultra Long-Duration Scientific Balloons Project (United States)

    National Aeronautics and Space Administration — NanoSonic proposes to develop an innovative, ultralow mass density, and non-intrusive sensor system for ultra long duration balloons that will operate in the most...

  11. Private Pilot Practical Test Standards for Lighter-Than-Air Balloon, Airship (United States)


    The Private Pilot - Lighter-Than-Air (Balloon and Airship) Practical Test Standards (PTS) book has been published by the Federal Aviation Administration (FAA) to establish the standards for private pilot certification practical tests for the lighter-...

  12. Simple and Small De-orbiting Package for Nano-Satellites Using an Inflatable Balloon (United States)

    Nakasuka, Shinichi; Senda, Kei; Watanabe, Akihito; Yajima, Takashi; Sahara, Hironori

    The paper proposes a de-orbiting system using inflatable balloon especially dedicated for nano-satellites. The system consists of a balloon of laminated aluminum film, gas supply system and electronics system which inflates the balloon when a certain signal comes from the satellite at the end of its life time. The balloon, once deployed, keeps its shape even after the gas expires. The package can be very small, low-cost and requires very little power for activation, which makes this system very attractive especially for university education satellites for which the satellite weight/size as well as cost are major concern. The BBM system has been developed and several ground experiments have been performed including deployment in vacuum environment and thermal cycle tests. We recognized that this system concept is viable and very promising as a de-orbiting system in the future when the satellite is ordered to have some method to avoid becoming space debris.

  13. Cervical pregnancy: 13 cases treated with suction curettage and balloon tamponade

    National Research Council Canada - National Science Library

    Fylstra, Donald L


    With no single regimen recognized as the standard for the treatment of first trimester cervical pregnancy, this report offers a successful treatment option with suction curettage and balloon tamponade...

  14. Sub-Scale Re-entry Capsule Drop via High Altitude Balloons Project (United States)

    National Aeronautics and Space Administration — High-altitude balloon flights are an inexpensive method used to lift payloads to high altitudes. Federal Aviation Administration (FAA) regulations permit payloads...

  15. Balloon-Borne Electric-Field Observations Relevant to Models for Sprites and Jets

    National Research Council Canada - National Science Library

    Beasley, William


    We designed and built a new balloon-borne electric-field-change instrument and launched five of them into thunderstorms to observe changes in the vertical component of electric field caused by lightning...

  16. Demonstrating Classical Conditioning in Introductory Psychology: Needles Do Not Always Make Balloons Pop! (United States)

    Vernoy, Mark W.


    Describes a method of teaching classical conditioning to an introductory psychology class which involves demonstrating the conditioned response that occurs when a needle pierces, but does not pop, a balloon. (GEA)

  17. Long duration balloon flights - A probe for deep hard X-ray astronomy investigation (United States)

    Ubertini, P.

    An assessment is presented of the progress to date in hard X-ray astronomy, with attention to the use of long duration balloon flights carrying the sensitive and complex payloads needed for observations in the 15-300 keV range, and the comparative performance of balloon and satellite observational platforms. Both galactic and extragalactic balloon-borne observation results are considered. It is noted that the discovery of a cyclotron line emission at about 60 keV in the emission spectrum of Her-1 is of special significance, allowing direct measurement of the strong magnetic field surrounding the collapsed objects. Balloon observations are judged to be complementary to, rather than competitive with, satellite studies.

  18. Balloon-Borne, High-Energy Astrophysics: Experiences from the 1960s to the 1980s (United States)

    Fishman, Gerald J.


    Observational high-energy astrophysics in the hard-x-ray and gamma-ray regions owes its development and initial successes to the balloon-borne development of detector systems, as well as pioneering observations, primarily in the timeframe from the 1960s to the 1990s. I will describe some of the first observations made by the Rice University balloon group in the 1960s, including the impetus for these observations. The appearance of SN 1987a led to several balloon-flight campaigns, sponsored by NASA, from Alice Springs, Australia in 1987 and 1988. During the 1980s, prototypes of instruments for the Compton Gamma Ray Observatory were flown on many balloon flights, which greatly enhanced the success of that mission.

  19. Integrating BalloonSAT and Atmospheric Dynamic Concepts into the Secondary Classroom (United States)

    Fong, B. N.; Kennon, J. T.; Roberts, E.


    Arkansas BalloonSAT is an educational outreach and scientific research program that is part of Arkansas State University in Jonesboro, AR. The following is a unit of instruction to incorporate BalloonSAT measurements into secondary science classes. Students interpret graphs and identify several atmospheric trends and properties of a typical balloon flight. Students engage critical thinking skills in developing and answering their own questions relevant to the BalloonSAT program. Prerequisite concepts students should know are how to interpret graphs and unit conversions. Students should have a basic understanding of gravity, units of temperature and distance, and error in measurements. The unit is designed for one week after end-of-course exams and before the end of school. The unit may take two to five 50-minute periods, depending on how many activities are completed.

  20. Endoscopic balloon dilatation for Crohn's strictures of the gastrointestinal tract is feasible

    DEFF Research Database (Denmark)

    Karstensen, John Gásdal; Hendel, Jakob; Vilmann, Peter


    Despite optimized medical treatment, Crohn´s disease can cause gastrointestinal (GI) strictures, which requires surgical intervention. Lately, endoscopic balloon dilatation has been established as an alternative to surgery. In the following, we report our experiences with endoscopic dilatation...

  1. Fasting and meal-induced CCK and PP secretion following intragastric balloon treatment for obesity

    NARCIS (Netherlands)

    Mathus-Vliegen, Elisabeth M. H.; de Groot, Gerrit H.


    Satiety is centrally and peripherally mediated by gastrointestinal peptides and the vagal nerve. We aimed to investigate whether intragastric balloon treatment affects satiety through effects on fasting and meal-stimulated cholecystokinin (CCK) and pancreatic polypeptide (PP) secretion. Patients

  2. Refractivity Turbulence Observation Using a New Balloon-Ring Platform (Preprint)

    National Research Council Canada - National Science Library

    Eaton, Frank D; Kelly, Patrick R; Kyrazis, Demos T; Stokes, Sheldon S


    This paper presents new methodology to address critical refractivity turbulence issues for laser propagation using a new measurement system-a portable "balloon-ring" platform with multiple fine wire...

  3. ERCP with the Balloon-Assisted Enteroscopy Technique : A Systematic Review

    NARCIS (Netherlands)

    Koornstra, Jan J.; Fry, Lucia; Moenkemueller, Klaus


    Background: Endoscopic retrograde cholangiopancreatography (ERCP) is generally difficult with conventional instruments in patients with surgically altered gastrointestinal anatomy. Balloon-assisted enteroscopy is a relatively new technique that allows for access to the papilla of Vater or a

  4. 78 FR 36702 - Cardiovascular Devices; Reclassification of Intra-Aortic Balloon and Control Systems (IABP) for... (United States)


    ... Volume and Mortality in Acute Myocardial Infarction Complicated by Cardiogenic Shock,'' Circulation, vol... Balloon Counterpulsation in Patients With Cardiogenic Shock Complicating Acute Myocardial Infarction: Data... myocardial infarction (MI) and cardiogenic shock, which include the use of percutaneous coronary intervention...

  5. Unified theory of resistive and inertial ballooning modes in three-dimensional configurations (United States)

    Rafiq, T.; Hegna, C. C.; Callen, J. D.; Kritz, A. H.


    Analytic results for the stability of resistive ballooning modes (RBMs) and electron inertial ballooning modes are obtained using a two-scale analysis. This work generalizes previous calculations used for axisymmetric ŝ-α geometry [R. H. Hastie, J. J. Ramos, and F. Porcelli, Phys. Plasmas 10, 4405 (2003)] to general three-dimensional geometry. A unified theory is developed for RBMs and inertial ballooning modes, in which the effects of both ideal magnetohydrodynamic free energy (as measured by the asymptotic matching parameter Δ') and geodesic curvature drives in the nonideal layer are included in the dispersion relation. This unified theory can be applied to determine the stability of drift-resistive-inertial ballooning modes in the low temperature edge regions of tokamak and stellarator plasmas where steep density gradients exist.

  6. Intra-atrial thrombolytic therapy for dissolution of chronic left atrial thrombi in patients undergoing balloon mitral commissurotomy. (United States)

    Chiang, Cheng-Wen; Chu, Po-Hsien; Hsu, Long-An


    The purpose of this study was to evaluate the solubility of left atrial thrombi to thrombolytics after failure of long-term anticoagulant therapy in patient with mitral stenosis. One hundred and eighty-one consecutive patients with mitral valve area thrombi. Follow-up echocardiography performed 7.4 +/- 5.6 months after warfarin therapy revealed that 8/30 of patients had complete dissolution and 3/30 had partial dissolution of the thrombi. Thirteen patients with residual isolated appendageal thrombi underwent balloon mitral commissurotomy and were randomized into four groups at the end of balloon mitral commissurotomy: group A, receiving intra-atrial infusion of heparin and tissue plasminogen activator (t-PA; n = 4); group B, heparin and streptokinase (n = 3); group C, heparin (n = 3); and group D, acting as control (n = 3). It was found that only two patients in the t-PA group had their thrombi either completely or partially dissolved within 48 hr. Thus, this study suggests that t-PA may have the potential of dissolving chronic left atrial thrombi. Copyright 2002 Wiley-Liss, Inc.

  7. Treatment of symptomatic high-grade intracranial stenoses with the balloon-expandable Pharos stent: initial experience

    Energy Technology Data Exchange (ETDEWEB)

    Kurre, W.; Berkefeld, J.; Mesnil de Rochemont, R. du [University of Frankfurt, Department of Neuroradiology, Frankfurt (Germany); Sitzer, M. [Klinikum Herford, Department of Neurology, Herford (Germany); Neumann-Haefelin, T. [University of Frankfurt, Department of Neurology, Frankfurt (Germany)


    We report our first clinical experience with a CE-marked flexible monorail balloon-expandable stent for treatment of high-grade intracranial stenoses. Between April 2006 and November 2007 21 patients with symptomatic intracranial stenoses (>70%) were treated with the PHAROS stent. In seven patients, the procedure was performed during acute stroke intervention. Procedural success, clinical complication rates and mid-term follow-up data were prospectively recorded. During a median follow-up period of 7.3 months one additional patient died of an unknown cause 3 months after the intervention. A patient with a significant residual stenosis presented with a new stroke after further progression of the residual stenosis. None of the successfully treated patients experienced ipsilateral stroke. Recanalization of intracranial stenoses with the balloon-expandable Pharos stent is technically feasible. The periprocedural complication rate and mid-term follow-up results were in the range of previously reported case series. This pilot study was limited by the small sample size and severe morbidity of the included patients. Final evaluation of the efficacy of Pharos stent treatment demands further investigation. (orig.)

  8. Digoxin as a rescue drug in intra aortic balloon pump and inotrope dependent patients. (United States)

    Naqvi, Shahab; Ahmed, Iftikhar; Siddiqi, Rashad; Hussain, Syed Aqeel


    In absence of cardiac transplant program in our country, when patients with poor left ventricular (LV) functions undergo coronary revascularisation surgery, they are on one or more inotropic supports with intra aortic balloon pump (IABP) at the time of weaning off from cardiopulmonary bypass (CPB). Post-operatively, due to the poor LV function, many of these patients become dependent on inotropic supports and IABP and eventually have a poor outcome. We used digoxin in these patients as a rescue drug, where more than one attempts to wean them off IABP and inotropic support had failed. Objective of the study was to evaluate the efficacy of digoxin as a rescue drug in intra-aortic balloon pump (IABP) and inotropic support-dependent, post-CABG patients in terms of improvement in their left ventricular ejection fraction (LVEF), serum lactate and mixed venous oxygen saturation. It is a descriptive case series conducted at Department of Cardiac Anesthesia & Intensive Care, Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi, Pakistan, from 1 Nov 2002 to 31 Dec 2007. Thirty post-coronary re-vascularisation patients who were inotrope and IABP dependant and could not be weaned off from supports were given a trial of digoxin to see any improvement in the cardiac functions. Mixed venous oxygen saturation (SvO2), serum lactate levels and left ventricular ejection fraction (LVEF) in the bed side echo were monitored at predigoxin stage and then at three intervals: at serum digoxin level of up to 0.5 nanog/ml; then up to 1.0 nanog/ml and then up to 1.5 nanog/ml. Paired sample t-test was applied and 2-tailed significance was calculated. Significant improvement was seen in the mean SvO2, serum lactate levels and LVEF when patient's serum digoxin level were around 1.5 nanog/dL. Clinically, 20 out of 30 patients (66.67%) improved with digoxin administration and were ultimately weaned off from IABP and inotropic supports. There was no significant

  9. Predictive factor of local recurrence after balloon-occluded TACE with miriplatin (MPT in hepatocellular carcinoma.

    Directory of Open Access Journals (Sweden)

    Toru Ishikawa

    Full Text Available Miriplatin (MPT is a novel platinum complex used in TACE that shows promise for the treatment of hepatocellular carcinoma (HCC. However, rapid washout has been reported in some cases. Therefore, various methods of administration with MPT have been attempted to increase its therapeutic efficacy. One hopeful method is balloon-occluded TACE (B-TACE, but the therapeutic efficacy of B-TACE with MPT has not been evaluated.To investigate the treatment outcomes and factors involved in local recurrence after B-TACE with MPT in HCC.This study included 51 patients (55 nodules with HCC lesions equal or less than 5 cm in diameter who underwent B-TACE with MPT between January 2012 and June 2013. Local recurrence after B-TACE with MPT and factors associated with local recurrence were evaluated.The overall local recurrence rate was 11.1% at 6 months and 26.2% at 12 months. The local recurrence rate did differ significantly depending on CT values immediately after B-TACE with MPT. Multivariate analysis also showed that the CT value after B-TACE with MPT was the only factor related to local recurrence after B-TACE.B-TACE with MPT achieves relatively good local control of HCC. The plain CT value immediately after B-TACE with MPT is a predictive factor for local recurrence. In patients with unsatisfactory CT values, locoregional therapy or additional treatment is required.

  10. Percutaneous balloon kyphoplasty of osteoporotic vertebral compression fractures with intravertebral cleft

    Directory of Open Access Journals (Sweden)

    Bao Chen


    Full Text Available Background: Intravertebral cleft is a structural change in osteoporotic vertebral compression fractures (OVCF, which is the manifestation of ischemic vertebral osteonecrosis complicated with fracture nonunion and pseudoarthrosis and appears in the late stage of OVCF. Despite numerous studies on OVCF, few aim to evaluate the clinicoradiological characteristics and clinical significance of intravertebral cleft in OVCF. This study investigates clinicoradiological characteristics of intravertebral cleft in OVCF and the effect on the efficacy of percutaneous balloon kyphoplasty (PKP. Materials and Methods: PKP was performed on 139 OVCF patients without intravertebral cleft (group A and 44 OVCF patients with intravertebral cleft (group B. The frequency distribution of the affected vertebral body, bone cement infusion volume, imaging manifestation, leakage rate and type, preoperative and postoperative height of the affected vertebral body, visual analog scale (VAS and Oswestry disability index (ODI score were evaluated. Results: Significant differences were found in the frequency distribution of the affected vertebral body and bone cement leakage type between the two groups ( P 0.05 were not detected. In both groups, the postoperative height of the affected vertebral body was significantly improved ( P 0.05. Conclusion: Intravertebral cleft exhibits specific clinical and imaging as well as bone cement formation characteristics. PKP can effectively restore the affected vertebral body height, alleviate pain, and improve daily activity function of patients.

  11. Design and construction of a carbon fiber gondola for the SPIDER balloon-borne telescope


    Soler, J. D.; Ade, P. A. R.; Amiri, M.; Benton, S. J.; Bock, J. J.; Bond, J. R.; Bryan, S. A.; Chiang, C.; Contaldi, C. C.; Crill, B. P.; Doré, O. P.; Farhang, M.; Filippini, Jeffrey P.; Fissel, L.M; Fraisse, A. A.


    We introduce the light-weight carbon fiber and aluminum gondola designed for the SPIDER balloon-borne telescope. SPIDER is designed to measure the polarization of the Cosmic Microwave Background radiation with unprecedented sensitivity and control of systematics in search of the imprint of inflation: a period of exponential expansion in the early Universe. The requirements of this balloon-borne instrument put tight constrains on the mass budget of the payload. The SPIDER gondola is designed t...

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

    Directory of Open Access Journals (Sweden)

    Barkat M


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

  13. Environmental effects of the US Antarctic Program`s use of balloons in Antarctica

    Energy Technology Data Exchange (ETDEWEB)

    McCold, L.N.; Eddlemon, G.K.; Blasing, T.J.


    The USAP uses balloons in Antarctica to conduct scientific research, to facilitate safe air transport, and to provide data for global weather predictions. However, there is the possibility that balloons or their payloads may adversely affect Antarctic fauna or flora. The purpose of this study is to provide background information upon which the USAP may draw when complying with its responsibilities under the National Environmental Policy Act of 1969, the Antarctic Treaty, and the Madrid Protocol.

  14. The glider balloon: a useful device for the treatment of bifurcation lesions. (United States)

    Briguori, Carlo; Visconti, Gabriella; Donahue, Michael; Chiariello, Giovanni Alfonso; Focaccio, Amelia


    Final kissing balloon dilatation (FKBD) is a recommended final step in case of treatment of bifurcation lesions by two stents approaches. Furthermore, dilatation of the side branch (SB) may be necessary following main vessel (MV) stenting. Occasionally, recrossing the stent struts with a balloon is hampered because the tip hits a stent strut. The Glider (TriReme Medical, Pleasanton, CA) is a dedicated balloon designed for crossing through struts of deployed stents toward a SB. From October 2010 to January 2012, FKBD was attempted in 236 consecutive bifurcation lesions treated in our Institution. FKBD was successfully performed by conventional balloon catheters in 221 (93.5%) lesions (Conventional group). In the remaining 15 (6.5%) lesions, where a conventional balloon failed to cross the stent strut, the Glider balloon was attempted (Glider group). The angle beta (between the axis of the MV after the branch point and the SB axis at the point of divergence) was wider in the Glider group (83±17° versus 65±27°; p=0.032). A trend toward an higher rate of the true bifurcation lesions was observed in the Glider group (93% versus 70.5%; p=0.07). The Glider balloon successfully crossed through MV stent struts toward a SB in 12 patients (80%), whereas failed in the remaining 3 patients. The Glider balloon represents an unique bail-out device which offers an effective rescue strategy for recrossing stent struts during complex bifurcation stenting. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. Bakri balloon as a uterus preserving treatment of uncontrollable haemorrhage one month post-partum

    DEFF Research Database (Denmark)

    Bonnici, Mia; Markauskas, Algirdas; Munk, Torben


    In this case Bakri balloon was used to stop haemorrhage one month post-partum. The case introduces the use of this device outside usual indications. A 27-year-old woman was admitted several times with vaginal bleeding after caesarean section. She was treated pharmacologically and with curettage....... One month post-partum hysteroscopic removal of placental tissue was done. During this uncontrollable haemorrhage occurred and hysterectomy was considered. An attempt to save the uterus with Bakri balloon was made succesfully....

  16. Balloon dilatation and outcome among patients undergoing trans-femoral aortic valve replacement. (United States)

    Fink, Noam; Segev, Amit; Kornowski, Ran; Finkelstein, Ariel; Assali, Abid; Rozenbaum, Zach; Vaknin-Assa, Hana; Halkin, Amir; Fefer, Paul; Ben-Shoshan, Jeremy; Regev, Ehud; Konigstein, Maayan; Orvin, Katia; Guetta, Victor; Barbash, Israel M


    Balloon pre-dilatation before transcatheter aortic valve replacement (TAVR) is performed at the discretion of the treating physician. Clinical data assessing the implications of this step on procedural outcomes are limited. We conducted a retrospective analysis of 1164 consecutive TAVR patients in the Israeli multicenter TAVR registry (Sheba, Rabin, and Tel Aviv Medical Centers) between the years 2008 and 2014. Patients were divided to those who underwent balloon pre-dilation (n=1026) versus those who did not (n=138). Rates of balloon pre-dilation decreased from 95% in 2008-2011 to 59% in 2014 (p for trend=0.002). Baseline characteristics between groups were similar except for more smoking (22% vs. 8%, p=0.008), less past CABG (18% vs. 26%, p=0.016), less diabetes mellitus (35% vs. 45%, p=0.01), and lower STS mortality scores (5.2±3.7 vs. 6.1±3.5, p=0.006) in the pre-dilatation group. The pre-dilation group included less patients with moderate to severely depressed LVEF (7% vs. 16%, p<0.001) and higher aortic peak gradients (76.9±22.7mmHg vs. 71.4±24.3mmHg, p=0.01). Stroke rates were comparable in both groups (2.5% vs. 3%, p=0.8), but pre-dilation was associated with lower rates of balloon post-dilatation (9% vs. 26%, p<0.001). On multivariate analysis, balloon pre-dilatation was not a predictor of device success or any post-procedural complications (p=0.07). Balloon pre-dilatation was not associated with procedural adverse events and may decrease the need for balloon post-dilatation. The results of the present study support the current practice to perform liberally balloon pre-dilatation prior to valve implantation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Test of Re-Entry Systems at Estrange Using Sounding Rockets and Stratospheric Balloons (United States)

    Lockowandt, C.; Abrahamsson, M.; Florin, G.


    Stratospheric balloons and sounding rockets can provide an ideal in-flight platform for performing re-entry and other high speed tests off different types of vehicles and techniques. They are also ideal platforms for testing different types of recovery systems such as airbrakes and parachutes. This paper expands on some examples of platforms and missions for drop tests from balloons as well as sounding rockets launched from Esrange Space Center, a facility run by Swedish Space Corporation SSC in northern Sweden.

  18. First report of a life-threatening cardiac complication after percutaneous balloon kyphoplasty. (United States)

    Tran, Ina; Gerckens, Ulrich; Remig, Jürgen; Zintl, Guido; Textor, Jochen


    We report the first case of life-threatening cardiac tamponade after percutaneous balloon kyphoplasty and its treatment with pericardiac drainage and percutaneous retrieval of cement embolus. To sensitize clinicians to the occurrence of perforation on the right side of the heart, with intracavity cement leakage as a potential complication after balloon kyphoplasty. Balloon kyphoplasty is a minimal invasive technique for symptomatic vertebral fractures. Cement leakage after kyphoplasty is a rare complication compared with vertebroplasty. A 68-year-old female patient underwent balloon kyphoplasty after a recent third and fourth lumbar verlebral fracture was diagnosed. The day after balloon kyphoplasty, the patient complained of dyspnea and chest pain. Her hemodynamic status rapidly deteriorated. Acute occlusion of coronary vessels was excluded by coronary angiography. Pericardial tamponade was documented by echocardiography, and pericardial effusion was urgently drained. Computed tomographic scan revealed the presence of cement embolus inside the right ventricle due to right ventricle perforation during the kyphoplasty procedure. The cement embolus was successfully retrieved percutaneously with a snare catheter. Balloon kyphoplasty is a minimal invasive technique with low rate of complications. In case of postprocedural chest symptoms, it is mandatory to exclude right ventricle perforation, cardiac tamponade, and embolism into pulmonary vessels because of cement embolism. 5.

  19. Anomalous bulging behaviors of a dielectric elastomer balloon under internal pressure and electric actuation (United States)

    Wang, Fangfang; Yuan, Chao; Lu, Tongqing; Wang, T. J.


    When a clamped membrane of elastomer is subject to a lateral pressure, it bulges into a hemispherical balloon. However, for a clamped membrane of dielectric elastomer (DE) under a lateral pressure as well as a voltage through the thickness, it may bulge into a regular hemispherical balloon or an irregular shape. This work focuses on the anomalous bulging behaviors (i.e. the irregular bulging shape) of a DE balloon under electromechanical coupling loading. The full set of the equilibrium configurations of the DE balloon is theoretically derived within the framework of thermodynamics, based on which we find that with the increase of the applied voltage, the pressure-volume relationship changes from the single-N shape for the case of purely mechanical loading to a double-N shape, where five or more equilibrium configurations exist including both regular and irregular bulging shapes. Through stability analysis we find that the anomalous bulging is a common behavior for the DE balloon under electromechanical coupling loading and all types of irregular bulging shapes can be achieved by following carefully designed loading paths. Besides, the irregular bulging region usually has the largest local strain which may initiate the failure of the DE membrane. Guided by the theoretical analysis, we conducted experiments on a DE balloon under the internal pressure and electrical actuation. Typical irregular shapes were successfully observed and the entire evolution of the shape changing agrees very well with theoretical predictions. These findings enrich understandings of highly nonlinear behaviors for soft materials under electromechanical coupling loading.

  20. Double-balloon aortic valvuloplasty at Queen Sirikit National Institute of Child Health. (United States)

    Sangtawesin, Chaisit; Layangool, Thanarat; Kirawitaya, Tawatchai; Promphan, Worakan


    Balloon aortic valvuloplasty is the treatment of choice in moderate and severe valvular aortic stenosis. In order to reduce the risk of vascular complications, a double-balloon technique has been used with good results. To present the results od double-balloon aortic valvuloplasty at QSNICH. Consecutive cases of severe valvular aortic stenosis treated with double-balloon aortic valvuloplasty at QSNICH were recruited in the study. Data were obtained from the medical records starting from the day of presentations to December 2011. There were six cases of severe valvular aortic stenosis treated with double-balloon aortic valvuloplasty at QSNICH from 2004 to 2011. The age and weight ranged from 7 months to 12 years and 6 to 53.8 kilograms, respectively. The presenting symptoms were dyspnea in 3 (50%) and asymptomatic heart murmur in 3 cases (50%). Peak-to-peak pressure gradient (PG) before the procedure ranged from 48-104 mmHg (mean 70.00, SD 18.92 mmHg). Immediately after the procedure, PG significantly decreased to 15-52 mmHg (mean 34.33, SD 14.98 mmHg, p aortic regurgitation in any of the cases. Double-balloon aortic valvuloplasty can be performed safely with very good intermediate term outcome in selected patients. Long-term outcome in Thai children should be further studied.