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Vascular Disease Management - ISSN: 1553-8036 - Volume 3 - Issue 1 Jan/Feb - January 2006 | |
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| Frank J. Criado, Editor-in-Chief |
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| Ron Waksman, MD, Pramod K. Kuchulakanti, MD, John R. Laird, MD, Robert S. Dieter, MD, Rebecca Torguson, BS, Roswitha Wolfram, MD, •Rosanna Chan, PhD, •R. Larry White, MD, Donna Whitman, MS |
Purpose. The incidence of in-stent restenosis (ISR) after renal artery stenting is 12 to 21%, yet there is no standard treatment method for this problem. Our aim was to assess the safety and efficacy of gamma brachytherapy (g-BT) for the treatment of ISR in renal arteries.
Materials and Methods. Eleven patients who presented with renal ISR from January 2003 to March 2004, documented by selective renal angiography, were assigned to treatment with g-BT using Ir-192, followed by balloon angioplasty, laser or re-stenting. Patients were followed clinically at 1, 3, 6, and 9 months, and duplex ultrasound was conducted at 9 months.
Results. All patients were hypertensive and on a mean of 2.3 antihypertensive medications. Mean age was 64 ± 8.68 years, 45.5% were males, 36.4% had diabetes mellitus, and 64% were smokers. The mean RVD was 5.4 ± 0.58 mm. The prescribed dose of radiation was 22.8 ± 0.6 Gy, with a dwell time 30.25 ± 1.92 minutes, and was well-tolerated by all
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Adjunctive Bioengineered Bi-layered Cell Therapy (Apligraf®) With Excimer Laser Revascularization Improves Wound Healing and Limb Salvage in Critical Limb Ischemia |
| David E. Allie, MD, Chris J. Hebert, RT, RCIS, Mitchell D. Lirtzman, MD, Charles H. Wyatt, MD, V. Antoine Keller, MD, Krishnamoorthy Vivekananthan, MD, Sonja E. Allie, MBA, Elena V. Mitran, MD, PhD, Adam A. Allie, MD, Michael W. McElderry, MD, Esmond A. Barker, MD, Craig M. Walker, MD |
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Effects of Global Renal Artery Stenting on Chronic Renal Failure |
| Roberto Rivolta, MD, Claudio Bazzi, MD, Paola Stradiotti, MD |
Background. The efficacy of renal artery stenting (RAS) in preserving renal function (RF) is controversial. This prospective study examines the effects of RAS in patients with global renal stenosis and chronic renal insufficiency.
Methods. Successful RAS was performed in 30 patients with renal impairment (creatinine > 1.5 mg/dL) and global atherosclerotic obstruction (bilateral artery stenosis or unilateral stenosis in the presence of a solitary or single functional kidney). To assess a significant change of RF, we compared the slopes of the regression lines derived from the reciprocal of creatinine versus time, and plotted before and after stent deployment. We also evaluated changes in renal length and interlobar resistive index (RI).
Results. Before stenting, all patients showed a negative slope, indicating progression of renal failure. During a median follow-up of 24 months, the slope mean became positive (pre -0.0249 ± 0.0527 versus post 0.0050 ± 0.0194 d
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Hemodynamic Instability After Carotid Artery Angioplasty and Stening is Associated With Increased Age and Female Gender |
| Peter L. Faries, MD, Susan M. Trocciola, MD, Brian De Rubertis, MD, Rabih A. Chaer, MD,
Stephanie C. Lin, MD, K. Craig Kent, MD |
Introduction. Systemic hypotension has been observed for up to 72 hours in response to stimulation of the carotid baroreceptor by carotid angioplasty and stenting (CAS). This study sought to identify risk factors and cardiac outcomes for post procedural hypotension after carotid artery angioplasty and stenting.
Methods. Between 2003 and 2005, 143 patients (87 men, mean age 75) with high-grade carotid artery stenosis (mean, 87.3%) were treated with CAS. Atropine and appropriate intravenous crystalloid solution were administered during CAS. Hypotension was treated with vasopressors (dopamine, phenylephrine or norepinphrine). Patients were stratified into three groups based on hypotension (systolic blood pressure < 90) requiring vasopressors for 0 hours ( no vasopressors ), ? 24 hours (short duration) and > 24 hours (prolonged duration). Risk factors for hypotension requiring vasopressors were analyzed by univariate and multivariate logistic regression analysis.
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Sexual Dysfunction Following Abdominal Aortic Aneurysm |
| Ian G. Murphy, MB, BAO, BCh, Ronan A. Cahill, AFRCSI, Mary C. Barry, FRCSI, Dennis Mehigan, MCh, FRCSI |
Erectile dysfunction represents a serious and prevalent, but all too often unrecognized, complication of open repair of abdominal aortic aneurysms, particularly in the emergency setting. This report describes the case of a 72-year-old man in whom, despite his age, diminished postoperative sexual function was having a considerable impact. Despite its frequency, there is still reluctance on both the part of the doctor and the patient to discuss the issue. The aetiologies in patients who undergo aneurysm repair and the treatments available are discussed.
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