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Long-term Patency (long-term + patency)

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Medical Sciences	100%

Terms modified by Long-term Patency

long-term patency rate

Selected Abstracts

Prospective assessment of hemodialysis access patency after percutaneous intervention: Cox proportional hazards analysis

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 3 2005
John A. Bittl MD
Abstract Vascular access failure is the greatest limitation of successful hemodialysis, but the factors associated with long-term patency have not been fully elucidated. Outcomes in a consecutive series of 294 thrombosed or failing accesses [128 fistulas (43.5%) and 166 grafts (56.5%) in 179 patients] were analyzed with life table and multivariable Cox proportional hazards analysis. Initial success was achieved in 275 of 294 accesses (95.6%). The median patency after intervention was 206 days (interquartile range, 79,457 days). Fistulas had longer median patency after intervention than grafts (286 vs. 170 days). Nonthrombosed accesses had longer median patency than thrombosed accesses (238 vs. 136 days), but thrombosed fistulas had similar median patency as thrombosed grafts (140 vs. 136 days). The selective use of stents as a bailout for failed balloon dilatation did not significantly reduce long-term patency (196 days for stented accesses vs. 210 days for unstented accesses). Long-term patency was inversely related to final access pressure, but access patency was not related to the presence of central venous occlusions, graft age, patient age, sex, or diabetes. Catheter-based intervention of thrombosed and failing dialysis accesses significantly prolongs patency and usefulness of dialysis accesses. The expanding use of fistulas, improved detection of early access failure, and selective use of bailout stents should enhance long-term access patency. © 2005 Wiley-Liss, Inc. [source]

Long-term results of endoureterotomy using a holmium laser

INTERNATIONAL JOURNAL OF UROLOGY, Issue 9 2007
Hastuki Hibi
Abstract: The long-term results of endoureterotomy using a holmium laser in cases of benign ureteral stricture, uretero-pelvic junction obstruction (UPJ-O) and ureteroenteric stricture were evaluated. Twenty procedures were carried out in 18 patients. Strictures were incised with a holmium laser using a fiber passed through the ureteroscope. Sixteen of the 20 procedures (80%) were successful at average follow-up of 60.5 months (range, 46,74). Stricture recurred in four cases. All failures occurred within 18 months. Although stricture length was not correlated with recurrence, all failures, with the exception of a single UPJ-O, involved middle ureteral strictures. Endoureterotomy using a holmium laser affords favorable results with respect to long-term patency. This procedure is recommended as a satisfactory therapeutic option for the initial management of patients presenting with ureteral stricture. [source]

Hepatic venous outflow obstruction in pediatric living donor liver transplantation using left-sided lobe grafts: Kyoto university experience,

LIVER TRANSPLANTATION, Issue 10 2010
Seisuke Sakamoto
The goals of this study were to evaluate the incidence of hepatic venous outflow obstruction (HVOO) in pediatric patients after living donor liver transplantation (LDLT) using left-sided lobe grafts and to assess the therapeutic modalities used for the treatment of this complication at a single center. Four hundred thirteen primary LDLT procedures were performed with left-sided lobe grafts between 1996 and 2006. All transplants identified with HVOO from a cohort of 380 grafts with survival greater than 90 days were evaluated with respect to the patient demographics, therapeutic intervention, recurrence, and outcome. Seventeen cases (4.5%) were identified with HVOO. Eight patients experienced recurrence after the initial balloon venoplasty. Two patients finally required stent placement after they experienced recurrence shortly after the initial balloon venoplasty. A univariate analysis revealed that a smaller recipient-to-donor body weight ratio and the use of reduced grafts were statistically significant risk factors. The cases with grafts with multiple hepatic veins had a higher incidence of HVOO. In conclusion, the necessity of repeated balloon venoplasty and stent placement was related to poor graft survival. Therefore, the prevention of HVOO should be a high priority in LDLT. When grafts with multiple hepatic veins and/or significant donor-recipient size mismatching are encountered, the use of a patch graft is recommended. Stent placement should be carefully considered because of the absence of data on the long-term patency of stents and stent-related complications. New stenting devices, such as drug-eluting and biodegradable stents, may be promising for the management of HVOO. Liver Transpl 16:1207,1214, 2010. © 2010 AASLD. [source]

Alcohol Pretreatment of Small-diameter Expanded Polytetrafluoroethylene Grafts: Quantitative Analysis of Graft Healing Characteristics in the Rat Abdominal Aorta Interposition Model

ARTIFICIAL ORGANS, Issue 7 2009
Erman Pektok
Abstract Long-term patency rates of small-diameter expanded polytetrafluoroethylene (ePTFE) vascular prostheses are unsatisfactory. Treatment of ePTFE grafts by alcohol before implantation was reported to increase hydrophilic properties, yielding better endothelialization and cellular in-growth, thus improving graft healing. The effect of alcohol pretreatment on ePTFE grafts and postoperative healing characteristics of wet ePTFE grafts were evaluated in this study. Ten sterile ePTFE grafts (2 mm ID, 30 µ thru-pore, 12 mm long) were implanted in the infrarenal aorta of male Sprague-Dawley rats (324,380 g). Five grafts were treated with ethanol 70% and soaked with saline solution before implantation (wet); five nontreated grafts served as control. All rats were sacrificed after digital subtraction angiography and sampling of the graft for histological investigation after 3 weeks. Histomorphometric analysis was performed for endothelial coverage, cellular in-growth, and intimal hyperplasia. All grafts were patent at the end of 3 weeks in both groups. Histological evaluation revealed significantly better endothelial coverage and prominent infiltration by fibroblasts and lymphocytes in the wet group. Endothelial coverage (31.03 ± 10.61% vs. 13.03 ± 9.46%, P = 0.03) and cellular infiltration of grafts (50.91 ± 8.55% vs. 39.29 ± 10.70%, P = 0.11) were higher in the wet group. Area of intimal hyperplasia per graft length was also higher in the wet group (5.32 ± 4.75 µm2/µm vs. 2.69 ± 3.41 µm2/µm, P = 0.36). Wetting of ePTFE grafts with ethanol 70% pretreatment before implantation might have a beneficial effect on long-term patency of small-diameter vascular grafts due to facilitated graft healing. [source]

Current status of metal stents for managing malignant ureteric obstruction

BJU INTERNATIONAL, Issue 8 2010
Petros Sountoulides
Obstruction of the ureters caused by extrinsic compression from a primary tumour or retroperitoneal lymph node masses is not unusual in the course of advanced pelvic malignancies. Most of the cases are of gynaecological or gastrointestinal origin, and the situation can be aggravated by peri-ureteric fibrosis, a long-term adverse event of previous chemotherapy or radiotherapy. Undoubtedly upper urinary tract decompression and maintenance of ureteric patency, even as a palliative measure, is important in managing these patients. Options for upper tract decompression include percutaneous nephrostomy, retrograde stenting and open urinary diversion. Plastic stents have long been used for managing malignant ureteric obstruction, but their overall success remains limited. Plastic stents often fail to be placed correctly, require regular exchange, and are faced with a high incidence of encrustation and migration. For these reasons plastic stents have been unsuccessful for long-term maintenance of ureteric patency. To overcome these limitations metal stents were introduced and recently developed in an effort to ensure better long-term patency of the obstructed ureter, fewer hospital admissions for stent change and better overall quality of life. In the present review the clinical applications of different types of metal stents are discussed, with a specific focus on the latest advances and the future options for managing malignant ureteric obstruction. [source]

Outcome following bypass, and proximal and distal ligation of popliteal aneurysms

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 2 2007
B. Box
Background: The aim of this study was to describe early and late results of proximal and distal ligation for popliteal aneurysm (PA), combined with bypass, with particular reference to the fate of the excluded aneurysm. Methods: Of a cohort of 116 patients with PAs, 66 were treated with bypass and ligation. Graft patency was determined by duplex surveillance. In addition, 17 patients with bypassed PAs underwent a total of 33 duplex scans to determine flow within the aneurysm and change in size. Results: For initially patent PAs, 3-, 5- and 8-year primary bypass graft patency was 78, 78 and 51 per cent respectively. These rates were not statistically significantly different from those following bypass for thrombosed PA, 3- and 5-year primary patency being 72 and 65 per cent respectively. No PA produced further symptoms after bypass and ligation. No flow was seen in any aneurysm at follow-up. Only one showed an increase in size. Conclusion: Proximal and distal ligation with bypass produced satisfactory long-term patency with good exclusion of the PA. Copyright © 2006 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. [source]

Prosthetic femoropopliteal bypass: randomized comparison of polytetrafluoroethylene and heparin-bonded Dacron

BRITISH JOURNAL OF SURGERY (NOW INCLUDES EUROPEAN JOURNAL OF SURGERY), Issue 4 2000
C. Devine
Background: Dacron was largely abandoned for femoropopliteal bypass 30 years ago as saphenous vein achieved better patencies. As patency in prosthetic above-knee (AK) femoropopliteal bypass in patients on aspirin is equivalent to that with saphenous vein, heparin-bonded Dacron (HBD) and polytetrafluoroethylene (PTFE) have been compared in a randomized trial involving ten hospitals which also included below-knee (BK) popliteal or tibioperoneal trunk bypass where the long saphenous vein was absent or inadequate. Methods: Over a 28-month recruitment period, 209 patients undergoing femoropopliteal bypass (180 AK, 29 BK) were randomized by the method of minimization to HBD (n = 106) or PTFE (n = 103). Aspirin 300 mg day,1 was started before surgery and continued unless the patient was intolerant. Results: Mean follow-up was 34 (range 19,48) months. Fifteen patients (7 per cent) died with patent grafts and three (1 per cent) infected grafts were removed. Patency (measured by Kaplan,Meier survival analysis) was 70, 63 and 55 per cent at 1, 2 and 3 years for HBD, compared with 56, 46 and 42 per cent respectively for PTFE (P = 0·0444). Patency at 3 years for AK bypass was significantly better than that for BK bypass. A total of 70 interventions were performed on 47 patients, achieving long-term patency in only three. Amputations were performed in 23 patients, six with HBD and 17 with PTFE grafts (P = 0·015, Fisher's exact test). Conclusion: In femoropopliteal bypass, primary patency was better with HBD than PTFE, and HBD was associated with a lower amputation rate. © 2000 British Journal of Surgery Society Ltd [source]

Efficacy and long-term patency of fenestrated amplatzer devices in children

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 4 2007
Astrid E. Lammers MD
Abstract Introduction: Novel transcatheter techniques to control interatrial communications exist. Devices with restrictive fenestrations can be implanted to maintain patency of an atrial septostomy, or reduce an interatrial communication. Experience with these devices in children is limited. Patients and Methods: Fenestrated atrial septal devices were implanted into 10 children (5 male, age 1.5,15.5 years). Devices were modified by the manufacturer (MM, n = 6), or by a modification of an atrial septal occlusion device by the operator (OM, n = 4). Seven devices were implanted after atrial septal puncture and septostomy for severe symptomatic pulmonary hypertension (PHT) [4 heart failure, 3 syncope], according to World Health Organisation Guidelines. Two devices were implanted to reduce left to right shunting through large atrial septal defects with associated PHT. One device was implanted acutely to offload the left atrium during extracorporal circulatory support prior to heart transplantation. Warfarin (n = 5), aspirin (n = 4), or heparin (n = 1) were used for prevention of fenestration thrombosis. Results: Symptoms in all patients with PHT improved after implantation; syncope recurred with fenestration occlusion in one patient. Nine patients were followed up to a mean of 26 months. Five devices (all MM; warfarin n = 4, aspirin n = 1) remained patent on echocardiography. Fenestrations occluded in 4 children after median follow-up of 10 months (MM n = 1, OM n = 3, warfarin n = 1, aspirin n = 3). Conclusions: Implantation of fenestrated atrial devices is feasible and effective; but the occlusion rate is high. Further research on fenestrated atrial septal devices with better long-term patency, and effective antithrombotic drug treatment is necessary. © 2007 Wiley-Liss, Inc. [source]

Prospective assessment of hemodialysis access patency after percutaneous intervention: Cox proportional hazards analysis

Crush stenting of bifurcational left subclavian-vertebral artery stenosis

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS, Issue 3 2004
Ariel Roguin MD
Abstract Left internal mammary artery (LIMA) has the best long-term patency in patients undergoing coronary artery bypass surgery. Stenosis of the proximal left subclavian artery (SA) may reduce flow to the LIMA, causing myocardial ischemia. We report a novel technique (crush stenting) for the treatment of a complex bifurcational left SA-vertebral artery (VA) stenosis in the presence of a patent LIMA bypass conduit. This technique limited plaque shifting, restored normal flow to all vessels, including the LIMA, and avoided devastating consequences of VA occlusion. Catheter Cardiovasc Interv 2004;62:393,395. © 2004 Wiley-Liss, Inc. [source]