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Adhesive Biomaterials for Tissue Repair and Reconstruction
Published in Severian Dumitriu, Valentin Popa, Polymeric Biomaterials, 2020
Beyond their approved indications for external skin closure and vascular anastomotic closure, cyanoacrylate-based tissue adhesives have also been applied off-label in a variety of surgical fields. Cyanoacrylates have found utility in ophthalmology for treatment of corneal perforations [104] sealing of corneal incisions [105], and closure of scleral tunnel incisions [106]. Cyanoacrylate glues have been utilized in hernia repair surgery to secure polypropylene hernia meshes [107]. In gastroenterology, cyanoacrylates have been injected endoscopically to control bleeding from gastric varices [108]. The cyanoacrylate glues have been employed in urology to seal nephrostomy tube sites [109] and treat urinary fistulas [110]. In thoracic surgery, cyanoacrylate adhesives have been used in endoscopic repair of bronchial dehiscence following lung transplantation surgery [111]. In orthopedic surgery, there are case reports of cyanoacrylate glues for the fixation of osteochondral fractures of the knee [112], as well as fixation of talar osteochondral fractures [113]. Bone repair with cyanoacrylates has also been accomplished in head and neck surgery, where the glues have been delivered endoscopically for fixation of zygomatic fractures [114]. Cyanoacrylate glues have additionally been employed in tympanoplasty and myringoplasty surgeries for repair of the tym-panic membrane [115].
Diagnostic accuracy of liver stiffness on two-dimensional shear wave elastography for detecting clinically significant portal hypertension: a meta-analysis
Published in Expert Review of Medical Devices, 2023
Bingtian Dong, Yuping Chen, Yongjian Chen, Huaming Wang, Guorong Lyu
Portal hypertension (PH) is one of the primary consequences of liver fibrosis/cirrhosis [1], and it can lead to devastating clinical problems, especially formation of esophageal or gastric varices, variceal bleeding, and ascites, which may represent the most common cause of mortality in cirrhotic patients [2–4]. Traditionally, hepatic venous pressure gradient (HVPG) measurement is the gold standard to evaluate PH, with a HVPG ≥ 10 mmHg considered diagnostic for clinically significant portal hypertension (CSPH) [5,6]. However, HVPG is an invasive procedure with potential complications, and is not readily available and difficult to perform in routine medical institutions [7]. Recently, much effort has been devoted to develop an alternative, noninvasive tool for accurate detecting PH in order to avoid the invasiveness of HVPG in cirrhotic patients.