China
Africa
Explore chapters and articles related to this topic
Complications of hemodialysis access
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
Mia Miller, Prakash Jayanthi, William Oppat
Treatment for symptomatic venous hypertension secondary to central venous stenosis includes endovascular angioplasty and stenting versus open surgical management. Endovascular approach harvests concern that angioplasty may not be as effective in vessels with increased elasticity and recoil. Angioplasty has even been shown to accelerate restenosis, with recurrent lesions showing a more aggressive neointimal hyperplasia.66 Therefore, close follow-up for non- or mildly symptomatic CVS is recommended, with judicious use of PTA as needed. However, when requiring treatment, PTA is the first-line approach recommended by KDOQI, with stenting reserved for angioplasty failure.67 The caveat with angioplasty alone is an excellent early technical result but a poor long-term primary patency with patency outcomes of 50% at 6 months and 25% at 12 months. There are significant variabilities, however, in the reporting of the nature and severity of lesion, outcomes, patient populations, instruments, and techniques used. Secondary patency can be significantly better with repeated angioplasty, even without use of stent.66
Paper 4
Published in Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw, The Final FRCR, 2020
Amanda Rabone, Benedict Thomson, Nicky Dineen, Vincent Helyar, Aidan Shaw
The case is describing findings of right renal artery stenosis, which in this patient is an incidental finding identified on an ultrasound performed for another clinical indication. Sonographic findings include a size discrepancy in the kidneys, a renal artery to aortic velocity ratio of >3.5, a renal artery peak systolic velocity >180 cm/sec, increased resistive index (>0.7) and a slow rising parvus and tardus waveform distal to the stenosis. The most common cause for renal artery stenosis is atheroma, which affects the proximal renal artery close to its origin; however this is most common in older patients. In young patients, such as in this case, the most common cause is fibromuscular dysplasia, which causes multiple short stenoses leading to a ‘string of beads’ appearance. This tends to affect the mid-distal renal artery; however other arteries such as carotid, iliac and mesenteric arteries can also be affected. Treatment is with angioplasty and tends to have good results.
Angioplasty Balloons and Technique
Published in Vikram S. Kashyap, Matthew Janko, Justin A. Smith, Endovascular Tools & Techniques Made Easy, 2020
Angioplasty is performed using a catheter with a balloon mounted on the end of the shaft. The balloon is inflated inside a vessel within the stenotic region, thereby, dilating the specific lesion. When performed in an atherosclerotic arterial plaque, it causes a controlled longitudinal fracture within the plaque-lined intima, separating it from the media and adventitia. The arterial lumen increases by flattening the plaque and stretching the media and adventitia. This yields a controlled dissection which then initiates a remodeling process, starting with platelet deposition and ending with re-endothelialization (3).
Contemporary review of management techniques for cephalic arch stenosis in hemodialysis
Published in Renal Failure, 2023
Gift Echefu, Shivangi Shivangi, Ramanath Dukkipati, Jon Schellack, Damodar Kumbala
Surgical intervention for the management of CAS is reserved for recurrent CAS failing angioplasty [61]. It reduces rates of reintervention compared to angioplasty however they have a similar patency rate after 2 years. There is evidence of improved patency rates with surgery after failed angioplasty without increasing complication rates. Cephalic vein transposition involves surgically ligating the cephalic vein at the deltopectoral groove and transposing the remaining segment onto the distal axillary vein. Alternatively, interposition graft may be surgically transposed from the cephalic to the jugular vein other than the axillary vein [62]. Studies investigating cephalic vein turn down as initial intervention in the management of CAS prior to angioplasty have reported poor outcomes [63,64]. Furthermore, CVT precludes future creation of basilic vein fistula in certain populations [65].
Primary balloon dacryoplasty for nasolacrimal duct obstruction in adults: a systematic review
Published in Orbit, 2021
Barthélémy Poignet, Philippe Sultanik, Pauline Beaujeux, Edouard Koch, Hakim Benkhatar
DCR is currently the gold standard treatment of acquired NLDO in adults.1,2 However, BD has gained increasing interest in recent years, as it is a minimally invasive lacrimal procedure that can be performed under local anesthesia with sedation.5,6,16 It has been firstly described by Becker and Berry in 1989.8 In its early development, BD mainly consisted of retrograde insertion of an catheter under fluoroscopic guidance.9 However, the need for radiological expertise and the related irradiation prevented the widespread use of the technique. Nowadays, BD uses a specially designed balloon targeted at the nasolacrimal duct after anterograde insertion of a balloon catheter, under endoscopic endonasal control.6 Angioplasty catheters have been used in the first described procedures but are still considered to be an alternative to dacryoplasty balloon.22
Low back pain and calf pain in a recreational runner masking peripheral artery disease: A case report
Published in Physiotherapy Theory and Practice, 2021
Fabrizio Brindisino, Denis Pennella, Giuseppe Giovannico, Giacomo Rossettini, John D. Heick, Filippo Maselli
In accordance with the clinical guideline of Gerhard-Herman et al. (2017) an angioplasty was performed (Figures 7 and 8). The surgical procedure led to a return of an optimal perfusion of the left limb. The patient had a 2-day hospitalization without complications and was discharged from the hospital. Ten days post-operation, the surgeon noted blood perfusion control with the CDU and reported: “follow-up of popliteal artery angioplasty. Bilaterally loose the femuro-popliteal arterial flows, with atheroma and three-phasic flows” (Figures 9 and 10). Secondary to the excellent results of clinical observation of the patient and corresponding CDU results, the surgeon recommended a follow-up visit in 6 months and initiated physiotherapy for a progressive and gradual resumption of working and sporting activities.