PURPOSE: To study retrospectively the prognostic factors for acute basilar artery occlusion treated with intraarterial thrombolysis and stent placement. MATERIALS AND METHODS: Within 3-48 hours of disease onset, 52 patients with basilar artery occlusion were treated with emergency intraarterial thrombolysis with recombinant tissue plasminogen activator (rtPA) or urokinase (UK) or ...

PURPOSE: This study retrospectively assesses whether significantly accelerating thrombolysis with ultrasound affects fibrinogen levels in the treatment of peripheral arterial occlusions. MATERIALS AND METHODS: Between December 2005 and August 2007, 38 limbs in 38 patients (17 women; mean age, 60.5 +/- 19.7 years; age range, 17-94 years) were treated with ...

Although endovascular therapy for peripheral arterial disease has undergone tremendous changes, chronic total occlusion (CTO) remains a significant challenge for interventionalists. Failed CTO recanalization is predominately due to unsuccessful guidewire crossing. In particular, the unique characteristics of tortuous and deeply located large vessels in the retroperitoneal cavity create challenging endovascular ...

Surgical management of Sturge Weber-associated glaucoma is challenging. Choroidal effusion and expulsive choroidal hemorrhage are commonly cited potential risks. We report a case of a cilioretinal artery occlusion associated with glaucoma drainage device surgery in a child with refractory Sturge Weber-associated glaucoma.

Background Aneurysm occlusion after subarachnoid haemorrhage (SAH) aims to improve outcome by reducing the rebleeding risk. With increasing age, overall prognosis decreases, and the complications of aneurysm occlusion increase. The balance of risks for aneurysm occlusion in elderly SAH patients in different age categories and clinical conditions is unknown. Methods ...

OBJECTIVE: Microcirculatory dysfunction contributes to morbidity and mortality in vascular diseases. Here, we aimed at establishing a sensitive and valid method to measure microvascular reactivity during post-occlusive reactive hyperemia (PORH) using scanning laser Doppler perfusion imaging (LDPI) of the forearm. METHODS: In a first series, LDPI was methodologically evaluated on ...

BACKGROUND: Free tissue transfer necessitates vigilant postoperative monitoring for vessel occlusion. Unfortunately, most monitoring methods require experienced personnel and are expensive to use. Furthermore, many tests have low sensitivity, low specificity, or significant delay between vessel occlusion and detection. The authors report on a novel method of tissue monitoring that ...

One of the mechanisms of technical failure in the treatment of tibial artery occlusive disease includes an inability to re-enter the true lumen of the tibial vessel distal to the occlusion following tracking of the interventional wire into the subintimal space. We report the first case using a coronary 0.014'' ...

ABSTRACT BACKGROUND AND PURPOSE Early reocclusion of intracranial arteries can lead to poor clinical outcome. We report reocclusion detection after endovascular clot aspiration, followed by administration of GPIIb-IIIa antagonist under continuous ultrasound monitoring. CASE DESCRIPTION A 73-year-old man developed the right middle cerebral artery (MCA) occlusion with NIHSS 17 points, ...

Scimitar syndrome is a rare condition often with a separate systemic arterial supply from the abdominal aorta. Occlusion of this systemic arterial supply is frequently performed, though it can be difficult in small patients or in those with tortuous vessels. This case documents use of the new Amplatz vascular plug ...

Critical limb ischemia (CLI), defined as chronic ischemic rest pain, ulcers, or gangrene attributable to objectively proven arterial occlusive disease, is the most advanced form of peripheral arterial disease. Traditionally, open surgical bypass was the only effective treatment strategy for limb revascularization in this patient population. However, during the past ...

The artery of Adamkiewicz is the most significant tributary of the anterior spinal artery in the midthoracic region; the occlusion of this artery results in a well-described phenomenon consisting of paraplegia with loss of the sensation of pain, temperature, and touch as well as loss of sphincter control. Proprioception and ...

Purpose: To report experience with aggressive recanalization approaches in chronic total arterial occlusion (CTO). Methods: Chronic total arterial occlusion recanalization was attempted on 112 limbs in 99 consecutive patients between January 1999 and December 2006. Results: There were 63 iliac arteries, 45 femoropopliteal arteries, and 4 occluded stents. Mean occlusion ...

BACKGROUND AND PURPOSE: Mechanical thrombectomy in ischemic stroke is of increasing interest as it is a promising strategy for fast and efficient recanalization. Several thrombectomy devices have been introduced to the armentarium of mechanical thrombectomy. Currently, new devices are under development and are continuously added to the neurointerventional tool box. ...

BACKGROUND AND PURPOSE: Use of the Merci retriever is increasing as a means to reopen large intracranial arterial occlusions. We sought to determine whether there is an optimum number of retrieval attempts that yields the highest recanalization rates and after which the probability of success decreases. MATERIALS AND METHODS: All ...

OBJECTIVE: The purpose of this study was to evaluate our experience with the use of a R?sch-Uchida needle technique to recanalize central vein occlusion that cannot be traversed with a guidewire. MATERIALS AND METHODS: We retrospectively evaluated 33 recanalization procedures performed with a R?sch-Uchida needle on 20 men and 13 ...

OBJECTIVE: To examine changes in gravity fluctuation caused by experimentally altering the area of occlusal contact. MATERIALS AND METHODS: Subjects consisted of 15 adult Japanese males with normal stomatognathic function, no missing teeth except for the third molars, and equivalent occlusal contact in the anterior and bilateral posterior regions. Silicon ...

We report the novel application of the Controlled Antegrade and Retrograde subintimal Tracking technique for the endovascular treatment of occlusions of the external iliac artery (EIA). We hypothesized that this technique would limit the extent of subintimal dissection to the length of the EIA occlusion, thus preserving patency of the ...

The aim of this study was to assess the efficacy of enoxaparin for prevention of radial artery (RA) occlusion after transradial access for diagnostic and interventional cardiac procedures. RA occlusion is a potential complication of transradial cardiac catheterization. Conventionally, unfractionated heparin is used for prevention of RA occlusion. Effectiveness of ...

Nonatherosclerotic etiologies of arterial insufficiency are uncommon but important causes of chronic lower extremity ischemia. We report a patient with multiple hereditary exostoses (MHE) presenting with lifestyle-limiting lower extremity claudication and popliteal artery occlusion secondary to a large osteochondroma. The presence of MHE with associated osteochondroma resulting in arterial occlusion ...

We described a novel transradial retrograde wiring technique to treat chronic total occlusion (CTO) of the left anterior descending artery. When both retrograde wire and kissing wire technique failed to cross the CTO lesion, an antegrade microcatheter was placed in the CTO lesion. Then, a retrograde wire was manipulated into ...

This report describes a retrograde wiring technique, using intravascular ultrasound, for a blunt chronic total occlusion with a side branch at the site of occlusion of which the operator has difficulty of awareness of the proper re-entry point with the retrograde wire angiographically.

Targeted vascular occlusion is desirable for clinical therapies such as in the treatment of esophageal and gastric varices and varicose veins. The feasibility of ultrasound-mediated endothelial damage for vascular occlusion was studied. A segment of a rabbit auricular vein was treated in vivo with low duty cycle, high peak rarefaction ...

Angio-Seal is a frequently used vascular closure device after arterial catheterisation. Major complications are infrequently reported. We present four cases occurring within a 2-month period in our hospital with dislodgement of an Angio-Seal causing acute arterial occlusion, resulting in loss of limb in one case. Surgical intervention was necessary in ...

PURPOSE: To present the safety and short-term outcomes of using controlled blunt microdissection catheter-assisted revascularization of symptomatic chronic total occlusions of the lower extremity. MATERIALS AND METHODS: A retrospective study was performed on 61 patients (46 men) with a mean age of 72.3 years +/- 9.4 who underwent 67 procedures ...

BACKGROUND: Percutaneous coronary intervention (PCI) for chronic total occlusions (CTO) remains a challenge. Multislice computed tomographic coronary angiography (CTCA) allows noninvasive evaluation of the coronary artery by visualizing vessel trajectory and morphological features at the occluded site. The aim of this study was to assess the value of CTCA to ...

PURPOSE: Renal vascular clamping with ensuing warm ischemia is typically needed during robotic or laparoscopic partial nephrectomy. We developed a technique for angiographic delivery of the novel intra-arterial reverse thermoplastic polymer LeGoo-XL that allows temporary selective vascular occlusion with normal perfusion of the remaining kidney. MATERIALS AND METHODS: Eight pigs ...

The Amplatzer vascular plug has been used as an embolic device in a variety of cardiovascular interventions. The present report describes successful transrenal ureter occlusion with an Amplatzer plug inserted into an excised latex cover. The procedure led to immediate ureter occlusion in a patient with vesicovaginal fistula. Further investigation ...

Peripheral artery disease continues to increase in an ever-aging society and consumes a significant part of health resources. Chronic total occlusions account for a significant portion of the lesions encountered by endovascular interventionalists. Unlike the coronary circulation, these occlusions are often long and associated with other features of complexity. The ...

OBJECTIVE: To investigate the clinical characteristics and treatment strategy of lower extremity arterial occlusive disease in patients with Crohn's disease (CD). METHODS: Clinical information of 9 cases suffering from lower extremity arterial occlusion and CD was investigated retrospectively. RESULTS: All the cases were less than 50 years old and the ...

The thalami of the human brain obtain their blood supply from many perforating arteries, which exhibit complex distribution and many variations. One rare variation is the artery of Percheron that supplies the paramedian thalami bilaterally. This artery arises from the first segment of the posterior cerebral artery and gives rise ...

Internal iliac artery stenosis or occlusion has been documented to cause hip pain, erectile dysfunction, and buttock claudication. Endovascular repair for patients with significant stenosis has been well documented, but chronic total occlusion revascularizations have not been reported in the literature. The reluctance to attempt percutaneous intervention may be in ...

PURPOSE: This study aimed to correlate computed tomography (CT) findings and outcomes in patients affected by bowel infarction. MATERIALS AND METHODS: Twenty-seven patients with bowel infarction due to vascular obstruction were evaluated with multidetector CT (MDCT) to establish the prognostic value of CT findings and their correlation with the origin ...

OBJECTIVE: To report a case of successful recanalization using the combination technique of reverse flow and downstream filtering in chronic total occlusion of the bilateral vertebral artery (VA). CLINICAL PRESENTATION: A 59-year-old man had experienced attacks consisting of vertigo and/or dysarthria more than 1 year before presentation. He experienced symptoms ...

Increasing prevalence of diabetes mellitus is frequently associated with complex tibioperoneal obstructive disease and a high rate of amputations. Endovascular therapy of arteries below the knee has emerged as a promising revascularization technique for patients with critical limb ischemia. Recent advances in catheter technology applied below the knee will increase ...

Aims: To evaluate the safety and efficacy of the CiTop Expander guidewire in attempting to cross through chronic total occlusion in CAD patients with various coronary dimensions and morphology. Although chronic total occlusions are encountered frequently in patients with coronary artery disease, an effective strategy to deal with them has ...

BACKGROUND AND PURPOSE: We report a preclinical study of a second-generation endoluminal device (Pipeline Embolization Device [PED-2] for aneurysmal occlusion and compare the PED-2 with its first-generation predecessor (PED-1). MATERIALS AND METHODS: Our Institutional Animal Care and Use Committee approved all studies. The PED-2 is a braided endoluminal, flow-diverting device ...

RATIONALE AND OBJECTIVES: Existing density- and gradient-based automated centerline-extraction algorithms fail in severely diseased or occluded arterial segments for the generation of curved planar reformations (CPRs). We aimed to quantitatively and qualitatively assess the precision of a knowledge-based centerline-extraction algorithm in patients with occluded femoro-popliteal artery (FPA). MATERIAL AND METHODS: ...

BACKGROUND AND PURPOSE: The outcome of patients with occlusion by cervical dissection (OCD) is considered to be better than of those with atherosclerotic occlusion (ATO) of cervical arteries. The present observational retrospective study investigates whether there are also differences in the occurrence of seizures between OCD and ATO patients. METHODS: ...

PURPOSE: To assess the frequency of diaphragmatic weakness and its determinant factors after transcatheter arterial chemoembolization of the right inferior phrenic artery (IPA) in patients with hepatocellular carcinoma (HCC). MATERIALS AND METHODS: From June 2006 to October 2006, 60 patients (48 men, 12 women; mean age, 59 years) who had ...

BACKGROUND: Temporary occlusion of an intracranial artery during microvascular anastomosis is a major risk factor in cerebrovascular surgery. A new laser vascular welding technique that minimizes the occlusion time of the recipient vessel has been developed and is described in this report. METHOD: A new minimally occlusive technique of end-to-side ...

Lower limb peripheral arterial occlusive disease (PAOD) is highly prevalent and causes disability and poor quality of life. The purpose of our study was to evaluate the pattern of proximal and distal occlusion and collateral circulation of lower limb arteries using combined contrast arteriography and color doppler ecography. The study ...

Bilateral paramedian thalamic and mesencephalic infarcts are infrequently reported in adults, and to our knowledge, has never been reported in a child. The presumed etiology is an occlusion of the artery of Percheron, an uncommon vascular variation, in which a single common trunk from one of the P1 segments of ...

The Rotarex(R) and Aspirex(R) are newly developed over-the-wire rotational thrombectomy catheters. These devices combine mechanical clot fragmentation and active negative-pressure removal of thrombus particles to prevent distal embolization. Several successful in vitro studies have been followed by the pursuit of different applications, and the device has been used successfully in ...

Thrombolysis with recombinant tissue plasminogen activator is the only established treatment for acute ischemic stroke. Recurrent ischemic stroke involving an initially unaffected arterial territory during the course of thrombolysis has been reported but remains exceptionally rare. Here we report a 75-year-old woman with acute left middle cerebral artery occlusion who ...

We report a case of idiopathic pulmonary veno-occlusive disease (PVOD). The patient experienced progressively worsening dyspnea. Heart catheterization revealed severe pulmonary hypertension. High-resolution computed tomography (HRCT) showed diffuse, poorly identified centrilobular ground-glass opacities. Surgical lung biopsy led to the diagnosis of PVOD. A microscopic examination revealed occlusions of pulmonary veins ...

Several investigators have used murine models to investigate the pathophysiology of brain ischemia. The focal ischemic model is a closer approximation to human stroke which includes a necrotic core, penumbra, and undamaged tissue. Occlusion of a unilateral artery, especially the middle cerebral artery (MCA), is performed in this model, but ...

PURPOSE: The present study investigated early recanalization rate of major occluded arteries after tissue plasminogen activator (t-PA) infusion using serial magnetic resonance angiography (MRA) studies. METHODS: Consecutive stroke patients treated with t-PA within 3 h of onset were prospectively studied. Four serial MRA studies were conducted: before, immediately, 24 h ...

BACKGROUND: Most current animal models of hindlimb ischemia use acute arterial occlusion that does not accurately reflect the pathogenesis of gradual arterial occlusion in humans. We, therefore, developed the first mouse model of gradual arterial occlusion and tested the hypothesis that the mechanisms regulating blood flow recovery are critically dependent ...

OBJECT: Clipping of complex cerebral aneurysms often requires temporary vessel occlusion. The risk of stroke, however, increases exponentially with occlusion time. The authors hypothesized that prolonged temporary occlusion might be tolerated if the occluded vessels were perfused with cold physiological saline solution (CPSS). A low-flow perfusion rate would permit surgical ...