A method is described in which we use a combined endovascular balloon-catheter technique and open microneurosurgical approach for clipping aneurysms of the proximal paraclinoidal intracranial segment of the internal carotid artery. By temporary occlusion of the cervical carotid artery and continuously retrograde sucking of blood from the distal vessel via ...

Balloon occlusion arteriography was performed in 38 lower limbs; reactive hyperemic arteriography was also performed in 16 of these limbs. To assess the safety and utility of this technique the balloon occlusion arteriograms of all 38 patients were reviewed retrospectively by a vascular surgeon and vascular radiologist who were unaware ...

OBJECTIVES: The aim of this study was to assess results 5 years after balloon pulmonary valvuloplasty. BACKGROUND: Since the technique of balloon pulmonary valvuloplasty was first reported in 1982, it has become the treatment of choice for pulmonary valve stenosis. In contrast to surgical valvotomy, the long-term outcome after balloon ...

To assess long-term femoral artery complications after aortic balloon valvuloplasty or coarctation balloon angioplasty, we examined 19 children who were 3 weeks to 21 years old (mean 7.6 years) at the time of catheterization. Two-dimensional and Doppler echocardiographic examinations of the common, superficial, and deep femoral arteries were performed at ...

Direct argon or thermal laser angioplasty (LA) was evaluated for thrombogenicity using angioscopy, and compared with balloon angioplasty (BA). In each of 8 dogs, 4 segments (both proximal and distal iliac arteries) were treated by laser-thermal and/or balloon angioplasty. One segment was treated by balloon angioplasty and 3 other segments ...

We developed a new procedure to close the entry of dissecting aneurysm in acute stage with a specially designed cylinder-shaped balloon catheter. The balloon catheter consists of 7F double lumen catheter and a silicone rubber balloon at the tip. The balloon has a central tube 14 mm caliber made of ...

The traditional nonoperative management of benign esophageal stenoses has been bougienage; recently, balloon dilatation has become available. Balloon dilatation can be accomplished with balloons that are passed over a guide-wire or with balloons that are passed through the working channel of an endoscope. In the present paper, the methodologies for ...

One hundred and forty-five patients were evaluated for the importance of fluoroscopic monitoring during Maloney esophageal dilation. In 35 patients (24%), fluoroscopy altered the dilation technique. Dilation of peptic strictures (27 of 75, 36%) was much more likely to be affected by fluoroscopy than Schatzki's rings (eight of 70, 11%, ...

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 persistent acute occlusion and/or severe intimal dissection during conventional angioplasty, were treated with ...

A 13-year-old boy with severe coronary stenosis due to Kawasaki disease underwent percutaneous transluminal coronary angioplasty (PTCA). The guide wire and the balloon catheter easily passed through the stenosis in the left anterior descending artery. However, effective dilatation could not be achieved even when the balloon size was increased to ...

We developed a new side-holed shunt sheath for inserting intraaortic balloon pumps to maintain lower limb perfusion in patients with stenotic and tortuous aortoiliac arteries. This sheath has a large internal diameter and several side holes, which act as an internal shunt. It was useful and effective in 11 patients ...

Attempts at retroperitoneoscopy have mostly failed in the past due to the inability to create an effective pneumoretroperitoneum because of the dense areolar tissue binding the fat in the retroperitoneum, which could not be broken down merely by pneumo-insufflation. The newly devised balloon breaks the septae, lifts the peritoneum atraumatically ...

The role of transcatheter methods in the management of pulmonary outflow tract obstruction are discussed in this review. Balloon pulmonary valvuloplasty for relief of isolated pulmonary valve stenosis has been successfully used by many investigators and is the procedure of choice for the management of these lesions. Supravalvar pulmonic stenosis, ...

The possibility of using an exclusively percutaneous strategy to deliver foreign DNA to normal and balloon-dilated atherosclerotic arteries was studied by analysis of transfection efficiency in a rabbit model. A total of 22 external iliac arteries from 22 rabbits (10 normal and 12 atherosclerotic) were transfected with a solution of ...

Detachable balloons, although widely used as an embolization material in neurovascular work, are rarely used outside the head. Yet they offer distinct advantages over other methods of embolization in certain situations. They can effect an instant and precise occlusion of large arteries and fistulae and unlike any other embolization technique ...

OBJECTIVES: The present study was designed to establish possible predictors of unfavorable outcome in infants with pulmonary valve stenosis. BACKGROUND: Balloon pulmonary valvuloplasty is the treatment of choice for typical pulmonary valve stenosis. Patients with dysplastic valves may be less suitable candidates for this procedure because they have morphologic abnormalities ...

Endovascular balloon occlusion is an alternative treatment for surgically unclippable cerebral aneurysms. The results of aneurysm occlusion with either a silicone or a latex balloon in a common carotid artery bifurcation aneurysm model are compared to determine which type of balloon was least likely to result in aneurysm recurrence. Five ...

In this series, we evaluated the use of rotational ablation in stenoses that were previously refractory to balloon angioplasty. Forty-one stenoses were treated; in 26, the balloon did not adequately expand within the lesion and in 15 the balloon could not be delivered to the stenosis. Rotational ablation was technically ...

Maxillary resection defects have traditionally been technically difficult to treat with conventional radiation therapy. The irregular contours of the defect lead to an uneven distribution of the radiation doses. The potential to undertreat defects of microscopic involvement may leave residual disease. Tissue morbidity is high at isolated "hot spots" or ...

In this review, the role of transcatheter methods in the management of cyanotic congenital heart defects is discussed. In patients with interventricular right-to-left shunting secondary to pulmonary outflow tract obstruction (most commonly tetralogy of Fallot), balloon dilatation may be an effective palliative procedure in a substantial proportion of patients, obviating ...

Balloon pulmonary valvuloplasty is a safe and effective treatment for congenital pulmonic valve stenosis. This report describes a child who developed complete atrioventricular (AV) block following balloon pulmonary valvuloplasty. The child was treated with a 10-day course of systemic corticosteroids. The heart block gradually resolved during the first week following ...

Previous clinical use of the Rotablator in coronary artery disease has involved a sequential increase in burr sizes up to 2 mm in diameter and has often utilized balloon adjunct to achieve an optimal result. We report our experience and describe our technique using a single, large burr (2.25, 2.5, ...

During a 2 1/2-year period, staged procedures of transventricular closed pulmonary valvotomy followed by balloon valvuloplasty were attempted in 12 babies with pulmonary atresia and an intact ventricular septum. All babies immediately underwent valvotomy when echocardiography revealed a tripartite right ventricle with adequate inflow and outflow dimensions and without sinusoidal-coronary ...

Wire-directed detachable balloons were used in embolization treatment of varicoceles in six patients. Advancement of the balloon over a guide wire allowed easy embolization of the internal spermatic vein at the level of the inguinal ring. Additional detachable balloons were used to occlude the collateral vessels to the varicocele. This ...

We attached a water-inflated balloon to a transesophageal probe to improve contact of the transducer with the esophageal wall and used it in 26 patients with congenital heart disease. Balloons for this study were made for use in hemostatic therapy for esophageal varix. The contact of the transducer with the ...

Bilateral, symmetrical, experimental aneurysms were produced with anastomosed vein flap in the carotid arteries of 24 mongrel dogs. Aneurysms were occluded with latex or silicone balloons on each side and observed angiographically from 2 weeks to 2 months. A histopathological study was performed subsequently using light and scanning electron microscopy. ...

To assess influences of intra-aortic balloon pumping (IABP) on superior mesenteric flow, 15 postoperative patients were examined, in whom distal aspects of balloons were distal to the superior mesenteric artery. Superior mesenteric flow velocity-time integral in systole (IntS), that in diastole (IntD), and the sum of IntS and IntD (IntS+IntD) ...

The risks and benefits of prolonged intraaortic balloon support for the management of refractory congestive heart failure and ischemia were studied in patients with end-stage heart disease who needed support for greater than or equal to 5 days. Fifty-two insertions were performed by the percutaneous femoral route in 49 patients. ...

The burden of pregnancy in patients with severe mitral stenosis continues to present a therapeutic challenge. We present two such cases successfully treated with balloon valvuloplasty using the Inoue balloon. The unique features of this balloon may render it the technique of choice for selected pregnant patients with severe mitral ...

To evaluate the potential of trend monitoring of end-tidal PCO2 (PETCO2) to detect pulmonary embolization, the capnograms of 24 mechanically ventilated patients were monitored during simulation of 1-ml pulmonary embolization by inflation of the balloons of their pulmonary artery catheters. Within 1 minute of balloon inflation, PETCO2 showed an exponential ...

Balloon valvuloplasty is widely practiced, but its result depends on the pathology considered. Percutaneous mitral balloon valvuloplasty evolved from the earlier development of percutaneous balloon valvotomy of the pulmonic valve into an effective method for the treatment of patients with mitral stenosis. Percutaneous aortic balloon valvotomy has been used as ...

BACKGROUND: Closed pulmonary valvotomy for critical pulmonary stenosis has no apparent advantage over the percutaneous balloon technique, though it is used when balloon valvuloplasty fails. Experience of this technique at the Heart Institute, Tel Hashomer, since it was first used in 1973 has been reviewed. METHODS: Thirty eight infants up ...

The positioning of balloon catheters for the percutaneous mitral valvuloplasty technique is critical to ensure an adequate result and minimize complications. Passage of two balloon catheters in parallel through a thickened atrial septum and maintenance of satisfactory positioning in the left ventricle can be difficult. We describe unsuspected malpositioning of ...

The (inflated) balloon is important to determine the extent of stretch (theoretical maximal gain in diameter or area during PTCA), elastic recoil (the loss in diameter or area immediately after PTCA), and whether under- or over-sizing (balloon-artery ratio) of the dilated lesion occurred. In these assessments, the inflated balloon is ...

We present a rare complication of balloon atrial septostomy in an infant with complete transposition of the great arteries and review the management of this problem. The balloon could not be deflated after the eighth pass across the atrial septum. We punctured the balloon with a stylet which was passed ...

Rapidly evolving angioplasty balloon techniques need continual evaluation for the type or frequency of balloon-related complications. We recently encountered a case where a new narrow shaft polyethylene terephthalate balloon completely separated from the catheter following circumferential rupture. The balloon was successfully retrieved using grasping forceps and a basket. Patterns of ...

Controlled dilation of the internal thoracic artery with a balloon catheter has been reported to effectively treat intraoperative arterial spasm. It has been shown in laboratory animals that dilation of the internal thoracic artery at prescribed shear force levels will not cause intimal damage. Using scanning electron and light microscopy, ...

Natural tapering of coronary arteries from larger proximal to smaller distal diameters often creates a dilemma for optimal balloon sizing during percutaneous transluminal coronary angioplasty (PTCA). To demonstrate the need for new dilating catheters suitable for tapered coronary anatomy, 100 consecutive coronary arteries were measured by videodensitometry, 1 cm proximal ...

In endovascular surgery, to permanently hinder blood inflow into an aneurysm for example, a catheter is percutaneously introduced into an artery and the balloon is positioned and inflated by a solidifying liquid and then released into the diseased part. A novel solidifying liquid for the inflated balloon curable under the ...

In the past three years, we have used a superfine fiberscope for endovasculoscopy, ventriculoscopy, and myeloscopy. Flexible superfine fiberscope, 0.75 mm in outer diameter, could visualize various intravascular findings. In in-vivo canine experiment, sequential changes of thrombus produced by endothelial abrasion by needle or balloon in the canine carotid artery ...

Perforation of an intraaortic balloon is a well recognised complication of the device and is usually due to abrasion by a calcified aortic atheromatous plaque. We report a case in which a replacement balloon also perforated and suggest that if continued balloon assistance is required, a lower perfill volume may ...

Recent technical advances in interventional neuroradiology have made it possible to dilate cerebral arteries showing vasospasm after a subarachnoid hemorrhage. Although the reported effects of dilatation in clinical cases have been dramatic, few experimental studies of the mechanism of action have been performed. It also is still unclear why dilated ...

A 3 Fr single lumen balloon catheter was successfully introduced for arterial infusion chemotherapy by percutaneous transfemoral arterial insertion. This balloon catheter was combined with a 6.3 Fr outer catheter coaxially. After placing the catheter into the target artery, the balloon was ruptured by injecting 1 ml of contrast medium. ...

A technique is described that allows insertion of a standard percutaneous intraaortic balloon without use of the larger 12F sheath. Standard 9.5-cm. Percor balloons were inserted in a series of patients without using the provided sheath. Elimination of the sheath reduced the potential vascular complications related to the extra bulk ...

Two patients with distal basilar aneurysms were treated with intra-aneurysmal balloon occlusion. After apparently successful therapy, follow-up angiograms demonstrated aneurysm enlargement with balloon migration distally in the sac. Geometric mismatch between the base of the balloons and the aneurysm neck together with transmitted pulsation through the 2-hydroxyl-ethylmethacrylate (HEMA)-filled balloon directly ...

A 22-yr-old pregnant woman with mitral, aortic, and tricuspid stenosis presented with accelerating dyspnea and shortness of breath at the end of her first trimester. She subsequently underwent percutaneous triple-valve balloon valvuloplasty at 22 weeks of gestation without complications and achieved marked clinical improvement. We conclude that percutaneous triple-valve balloon ...

Transesophageal echocardiography was used prospectively in 22 children scheduled for interventional cardiac catheterization (9 with pulmonary valvuloplasty, 5 with aortic valvuloplasty, 1 with pulmonary angioplasty, 2 with aortic angioplasty, 2 with patent ductus arteriosus occlusion and 3 with Mustard baffle dilation) to determine its potential value as a monitoring technique. ...

In selected patients with calcific aortic stenosis, balloon valvuloplasty is an intermediate alternative to surgery. The effect of balloon valvuloplasty to increase valve area, however, is limited and the restenosis rate is high during follow-up. To improve the results and reduce the complication rate, a new device for valvuloplasty of ...

Conventional therapy to treat peripheral pulmonary artery stenosis (surgery or balloon angioplasty) has been frustrating. Recently a variety of peripheral vascular stenoses, in which conventional approaches are disappointing, have become amenable to therapy with the use of a balloon-expandable endovascular stent. This experimental study was designed to assess the application ...

OBJECTIVE: To test the hypothesis that the dilatable pulmonary artery banding prosthesis is as effective and safe to use as conventional fixed fabric bands, and provides an additional nonsurgical option for dilation. DESIGN: Nonrandomized prospective human clinical trial. SETTING: British Columbia's Children's Hospital for tertiary care. PATIENTS: All patients admitted ...