Dentin-Pulp Complex Regeneration
Vincenzo Guarino, Marco Antonio Alvarez-Pérez in Current Advances in Oral and Craniofacial Tissue Engineering, 2020
Some terms have been used to identify clinical procedures in this field: Regenerative endodontics. Biologically based procedures designed to physiologically replace damaged tooth structures, including dentin and root structures, as well as cells of the dentin-pulp complex.Revascularization. The restoration of blood supply (Glossary of Endodontic Terms 2016).Revitalization. An ingrowth of tissue that may not be the same as the original lost tissue (Wang et al. 2010).
Peripheral Vascular Disease in Older Adults with Diabetes
Medha N. Munshi, Lewis A. Lipsitz in Geriatric Diabetes, 2007
Two general techniques of revascularization exist: open surgical procedures and endovascular interventions. The two approaches are not mutually exclusive and may be combined. Endovascular intervention tends to be more appropriate in patients with focal disease, especially of larger more proximal vessels, and is more commonly performed for claudication. In general, vascular surgeons tend to be more aggressive with endovascular therapy in patients with severe uncorrectable coronary artery disease, poor ventricular function, limited pulmonary reserve, advanced age, renal failure, or hostile abdominal anatomy (such as adhesive disease from prior operations). Thus, even very challenging lesions, which would ideally be treated with open surgery, will be pursued using endovascular techniques in the high-risk, elderly population. It is important to remember that endovascular procedures are not without risk. Complications such as dissection, embolization, pseudoaneurysm formation or thrombosis and the need for repeat interventions do occur.
Peripheral arterial intervention (lower and upper extremity)
Debabrata Mukherjee, Eric R. Bates, Marco Roffi, Richard A. Lange, David J. Moliterno, Nadia M. Whitehead in Cardiovascular Catheterization and Intervention, 2017
Revascularization is usually required in one of three scenarios: (1) lifestyle limiting IC with failure of medical and exercise therapy, (2) CLI, or (3) ALI. The decision to perform a revascularization procedure—surgical or endovascular— cannot be made exclusively on anatomic considerations. Patients should be selected on the basis of the severity of the symptoms, disability as assessed by the patient and physician, failure of medical therapy, and a favorable risk/ benefit ratio of intervention, including procedural success and long-term patency. In patients with lifestyle or vocational limiting IC or those who progress to ischemic rest pain, ulceration, or gangrene, revascularization attempts are warranted. Guidelines for the performance of endovascular revascularization (ERV) for claudication have been published by a joint American College of Cardiology (ACC)/American Heart Association (AHA) task force.4 In general, endovascular repair is most successful when utilized in larger inflow arteries with discrete lesions. Less favorable long-term outcomes are associated with endovascular repair of diffuse disease in smaller outflow and runoff vessels. Comorbid conditions also play a role in the decision process with more aggressive endovascular approaches being accepted in patients at higher risk for open surgical repair or without venous conduits. More recently, the Society for Cardiac Angiography and Interventions (SCAI) developed expert consensus statements on the appropriate use of femoral-popliteal arterial and aorto-iliac arterial interventions.19, 20
Spontaneous necrosis of a single digit: watershed necrosis
Published in Case Reports in Plastic Surgery and Hand Surgery, 2021
Alain J. Azzi, Gabriel Bouhadana, Fanyi Meng, Peter G. Davison
While our patient received a cephalic vein graft and a digital amputation at the middle phalanx, treatment options in similar situations can vary depending on the cause and chronicity of the ischemia. Medical management is reserved for chronic disease with no evidence of ischemia/ulceration and is targeted at mitigating sympathetic hyperactivity and vasospasm [11]. When the etiology is occlusive in nature, revascularization is the treatment of choice (e.g. thrombectomy, reconstruction of the radial/ulnar artery with vein grafts or reconstruction of the palmar arches using the dorsal venous arch, to name a few). A Digital Brachial Index of less than 0.7, inadequate collateral circulation and segmental occlusion with distal ‘run off’ all serve as indications for revascularization [12–14]. If irreversible damage has occurred and necrosis has developed, amputation is necessary. Allowing the digit to auto-amputate is a reasonable option in the absence of infection. However, if a ray amputation is indicated (third or fourth digit necrosis proximal to the proximal interphalangeal joint), it should be performed early to expedite recovery and return to work.
Major vessel invasion by thyroid cancer: a comprehensive review
Published in Expert Review of Anticancer Therapy, 2019
Michael S. Xu, Jennifer Li, Sam M. Wiseman
When reconstruction is required for cases that have gross invasion of or adhesion to the great veins, use of autologous tissues and synthetic grafts have also been described [49,97]. A case of venous reconstruction using autologous tissue was reported by Wada et al. who, after resection of the right BCV and SVC, adapted a left BCV interposition to repair the resected vessel [97]. Their technique involved an initial temporary synthetic graft that was placed between the left subclavian vein and right atrium to facilitate resection of a diseased right BCV and SVC. Venous continuity was then restored using a segment of normal left BCV to autologously graft the distal right BCV and the proximal SVC, and ensure optimal graft patency postoperatively. In this same report, the authors described a second patient presenting with extensive tumor thrombus involving the left BCV and SCV, which was managed by radical resection of bilateral BCVs and the SVC. Venous continuity was restored using an autologous pericardial patch that was placed between the BCV proximally, and the right atrium distally. Successful revascularization was achieved postoperatively. [97].
The use of high-sensitivity cardiac troponin T and creatinine kinase-MB as a prognostic markers in patients with acute myocardial infarction and chronic kidney disease
Published in Renal Failure, 2023
Yunxian Chen, Xiwen Zhou, Zhixin Chen, Jue Xia, Fenglei Guan, Yue Li, Yanrong Li, Yicai Chen, Yuanlin Zhao, Huayun Qiu, Jiarong Liang, Liangqiu Tang
Patients diagnosed with AMI received coronary intervention based on their condition, either as an emergency or delayed procedure, performed by three experienced interventional cardiologists. Typically, the surgeon performed simply revascularization of the culprit vessel. Complete revascularization depended on the location of the vascular lesion, its severity, the patient’s overall health, and the surgeon’s strategy. Patients treated with PCI generally received a dual antiplatelet drug regimen consisting of an initial loading dose (LD) of 300 mg aspirin and an LD of 300–600 mg clopidogrel or 180 mg ticagrelor (no history of taking antiplatelet drugs). Starting the following day, patients then took aspirin 100 mg once per day and clopidogrel 75 mg once per day or ticagrelor 90 mg twice per day indefinitely for at least one year. However, in cases where patients had risk factors for bleeding, a single antiplatelet therapy regimen could be considered, or the antiplatelet therapy could be temporarily suspended. In situations where patients were unable to take oral medication, intravenous GP IIbIIIa inhibitors were utilized. Additional medications, such as ACE inhibitors/ARBs, beta-blockers, and antithrombotic drugs, were selected based on the clinical assessment of each patient’s specific situation.
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