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Ho Young Song - One of the best experts on this subject based on the ideXlab platform.
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balloon catheter dilation in common canalicular Obstruction of the lacrimal system safety and long term effectiveness
Radiology, 2000Co-Authors: Giyoung Ko, Kyubo Sung, Hyunki Yoon, Ho Young SongAbstract:PURPOSE: To evaluate the safety and long-term effectiveness of balloon catheter dilation in the treatment of common canalicular Obstruction of the lacrimal system. MATERIALS AND METHODS: Fluoroscopically guided dilation with a 3-mm-diameter balloon catheter was attempted in 195 eyes of 148 patients (26 men, 122 women; mean age, 57 years; age range, 33-78 years) with epiphora due to common canalicular Obstruction. Eighty-four of 195 eyes had Complete Obstruction, and 111 had partial Obstruction. RESULTS: Complications were self-limited nasal bleeding (n = 8), false passage (n = 7), and extravasation of contrast material (n = 6). Initial technical success was achieved in 76 (90%) of 84 eyes with Complete Obstruction and in 104 (94%) of 111 eyes with partial Obstruction. In the 180 eyes with technical success, immediate clinical improvement was achieved in 76 eyes with Complete Obstruction and in 100 eyes with partial Obstruction. The mean follow-up period was 36 weeks (range, 4-168 weeks). The cumulative patency rates were 51% at 6-month, 43% at 12-month, and 40% at 24-month follow-up. CONCLUSION: Although the long-term recurrence rate is relatively high, balloon catheter dilation is a safe and effective therapeutic technique to be used initially in common canalicular Obstruction.
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nasolacrimal duct Obstruction treated nonsurgically with use of plastic stents
Radiology, 1994Co-Authors: Ho Young Song, Kyubo Sung, Yong Han Jin, Jae Ho Kim, Young Min Han, Nam Chun ChoAbstract:PURPOSE: To evaluate the clinical utility of plastic stents in treatment of Complete Obstruction of the nasolacrimal duct. MATERIALS AND METHODS: Nineteen plastic stents were successfully placed under fluoroscopic guidance in 16 consecutive patients with epiphora due to Complete Obstruction of the nasolacrimal duct. After balloon dilation of the obstructed area, the stents were placed in the lacrimal system with the head portion lying in the dilated lacrimal sac and the body in the nasolacrimal duct and projecting into the inferior meatus of the nasal cavity. RESULTS: Complete resolution of epiphora was accomplished in 15 (79%) of 19 eyes and partial resolution in the remaining four (21%) eyes. CONCLUSION: These preliminary results with use of plastic nasolacrimal stents are encouraging.
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Complete Obstruction of the nasolacrimal system. Part I. Treatment with balloon dilation.
Radiology, 1993Co-Authors: Ho Young Song, Hyosook Ahn, Cheon-kyu Park, Sam-hyun Kwon, Chong-soo Kim, K C ChoiAbstract:Fluoroscopically guided balloon dilation in treatment of Complete Obstruction of the nasolacrimal system was assessed in 39 eyes of 35 patients. All patients had severe epiphora. With nasal endoscopic guidance, a 0.018-inch guide wire was introduced through the superior punctum into the inferior meatus of the nasal cavity and was pulled out through the nasal aperture with a hemostat. A deflated angioplasty balloon catheter was passed retrograde over the guide wire through the inferior meatus until it straddled the stricture. Balloons were dilated with water-soluble contrast medium. No major complications occurred. At 7 days after balloon dilation, epiphora decreased in 22 of 39 eyes; 17 demonstrated Complete resolution of severe epiphora, and five showed inComplete resolution. At 2 months, improvement had not been maintained in 10 of the 22 eyes. This technique for treatment of Complete Obstruction of the nasolacrimal system is simple and safe, but the high failure and recurrence rates in this study are n...
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Complete Obstruction of the nasolacrimal system. Part II. Treatment with expandable metallic stents.
Radiology, 1993Co-Authors: Ho Young Song, Hyosook Ahn, Cheon-kyu Park, Sam-hyun Kwon, Chong-soo Kim, K C ChoiAbstract:To evaluate the clinical usefulness of expandable metallic stents for maintenance of the dilated nasolacrimal sac and duct, double stents were implanted under fluoroscopic guidance in seven patients with severe epiphora after failed balloon dacryocystoplasty. Stents were constructed of 0.25-mm stainless steel wire in a cylindrical zigzag configuration of 10 bends. A single stent was 4 mm in diameter when fully expanded and 10 mm long. The stent was placed accurately in all but one patient, in whom a second stent was placed accurately after removal of the dislodged stent with a hemostat under endoscopic guidance. After stent placement, all patients demonstrated Complete resolution of epiphora. During follow-up of 4-20 weeks, Complete blockage of the stent occurred in one patient. This was treated with intrastent balloon dacryocystoplasty. No stents migrated. Although the long-term validity of this treatment has not been proved, expandable metallic stents seem to be of value in the treatment of Complete Obstruction of the lacrimal sac and nasolacrimal duct.
Martin Goetz - One of the best experts on this subject based on the ideXlab platform.
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rendezvous endoscopic recanalization for Complete esophageal Obstruction
Surgical Endoscopy and Other Interventional Techniques, 2018Co-Authors: Stefano Fusco, T Kratt, Cihan Gani, Dietmar Stueker, Daniel Zips, Nisar P Malek, Martin GoetzAbstract:Background and study aim Complete esophageal Obstruction after (chemo)radiation for head and neck cancers is rare. However, inability to swallow one’s own saliva strongly inflicts upon quality of life. Techniques for endoscopic recanalization in Complete Obstruction are not well established. We assessed the efficacy and safety of rendezvous recanalization.
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rendezvous endoscopic recanalization for Complete esophageal Obstruction
Surgical Endoscopy and Other Interventional Techniques, 2018Co-Authors: Stefano Fusco, T Kratt, Cihan Gani, Dietmar Stueker, Daniel Zips, Nisar P Malek, Martin GoetzAbstract:Complete esophageal Obstruction after (chemo)radiation for head and neck cancers is rare. However, inability to swallow one’s own saliva strongly inflicts upon quality of life. Techniques for endoscopic recanalization in Complete Obstruction are not well established. We assessed the efficacy and safety of rendezvous recanalization. We performed a retrospective review of all patients who underwent endoscopic recanalization of Complete proximal esophageal Obstruction after radiotherapy between January 2009 and June 2016. Technical success was defined as an ability to pass an endoscope across the recanalized lumen, clinical success by changes in the dysphagia score. Adverse events were recorded prospectively. 19 patients with Complete Obstruction (dysphagia IV°), all of whom had failed at least one trial of conventional dilatation, underwent recanalization by endoscopic rendezvous, a combined approach through a gastrostomy and perorally under fluoroscopic control. Conscious sedation was used in all patients. In 18/19 patients (94.7%), recanalization was technically successful. In 14/18 patients (77.8%), the post-intervention dysphagia score changed to ≤ II. Three patients had their PEG removed. Factors negatively associated with success were Obstruction length of 50 mm; and tumor recurrence for long-term success. No severe complications were recorded. Rendezvous recanalization for Complete esophageal Obstruction is a reliable and safe method to re-establish luminal patency. Differences between technical and clinical success rates highlight the importance of additional functional factors associated with dysphagia. Given the lack of therapeutic alternatives, rendezvous recanalization is a valid option to improve dysphagia.
B Hasanreisoglu - One of the best experts on this subject based on the ideXlab platform.
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transluminal balloon dilatation of the lacrimal drainage system for the treatment of epiphora
American Journal of Roentgenology, 1995Co-Authors: Erhan T Ilgit, D Yuksel, Mehmet Unal, Sergin Akpek, S Isik, B HasanreisogluAbstract:OBJECTIVE: The purpose of this study was to evaluate the efficacy of transluminal balloon dilatation done under digital subtraction fluoroscopic monitoring in the treatment of inComplete and Complete Obstruction of the lacrimal drainage system (LDS) in patients with epiphora. SUBJECTS AND METHODS: Transluminal balloon dilatation of the LDS was attempted in 19 eyes with inComplete and 61 eyes with Complete Obstruction, including six cases of anastomotic Obstruction after failed dacryocystorhinostomy. A soft plastic arterial sheath over a stump-guiding metal probe was introduced through the superior canaliculus into the nasolacrimal apparatus. A 0.016-in. specially angled steerable guidewire was introduced through the sheath and across the site of Obstruction, advanced into the nasal cavity, and brought forward through the external nare. A low-profile angioplasty balloon dilatation catheter was passed retrograde over the guidewire through the nasal aperture to the site of Obstruction and inflated for dilatation. RESULTS: Technical success was achieved in all 19 eyes with inComplete Obstruction and in 46 (75%) of 61 eyes with Complete Obstruction. Initial success was achieved in all 19 eyes with inComplete Obstruction and in 36 (59%) of 61 eyes with Complete Obstruction. In a follow-up period of 6-18 months (mean, 13 months), reObstruction occurred in none of the eyes with inComplete and in two eyes with Complete Obstruction. CONCLUSION: Our experience shows that transluminal balloon dilatation is an effective treatment for inComplete Obstruction of the LDS. The procedure has a high failure and recurrence rate when the Obstruction is Complete.
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transluminal balloon dilatation of the lacrimal drainage system for the treatment of epiphora
American Journal of Roentgenology, 1995Co-Authors: Erhan T Ilgit, D Yuksel, Mehmet Unal, Sergin Akpek, S Isik, B HasanreisogluAbstract:The purpose of this study was to evaluate the efficacy of transluminal balloon dilatation done under digital subtraction fluoroscopic monitoring in the treatment of inComplete and Complete Obstruction of the lacrimal drainage system (LDS) in patients with epiphora.Transluminal balloon dilatation of the LDS was attempted in 19 eyes with inComplete and 61 eyes with Complete Obstruction, including six cases of anastomotic Obstruction after failed dacryocystorhinostomy. A soft plastic arterial sheath over a stump-guiding metal probe was introduced through the superior canaliculus into the nasolacrimal apparatus. A 0.016-in. specially angled steerable guidewire was introduced through the sheath and across the site of Obstruction, advanced into the nasal cavity, and brought forward through the external nare. A low-profile angioplasty balloon dilatation catheter was passed retrograde over the guidewire through the nasal aperture to the site of Obstruction and inflated for dilatation.Technical success was achieve...
Stefano Fusco - One of the best experts on this subject based on the ideXlab platform.
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rendezvous endoscopic recanalization for Complete esophageal Obstruction
Surgical Endoscopy and Other Interventional Techniques, 2018Co-Authors: Stefano Fusco, T Kratt, Cihan Gani, Dietmar Stueker, Daniel Zips, Nisar P Malek, Martin GoetzAbstract:Background and study aim Complete esophageal Obstruction after (chemo)radiation for head and neck cancers is rare. However, inability to swallow one’s own saliva strongly inflicts upon quality of life. Techniques for endoscopic recanalization in Complete Obstruction are not well established. We assessed the efficacy and safety of rendezvous recanalization.
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rendezvous endoscopic recanalization for Complete esophageal Obstruction
Surgical Endoscopy and Other Interventional Techniques, 2018Co-Authors: Stefano Fusco, T Kratt, Cihan Gani, Dietmar Stueker, Daniel Zips, Nisar P Malek, Martin GoetzAbstract:Complete esophageal Obstruction after (chemo)radiation for head and neck cancers is rare. However, inability to swallow one’s own saliva strongly inflicts upon quality of life. Techniques for endoscopic recanalization in Complete Obstruction are not well established. We assessed the efficacy and safety of rendezvous recanalization. We performed a retrospective review of all patients who underwent endoscopic recanalization of Complete proximal esophageal Obstruction after radiotherapy between January 2009 and June 2016. Technical success was defined as an ability to pass an endoscope across the recanalized lumen, clinical success by changes in the dysphagia score. Adverse events were recorded prospectively. 19 patients with Complete Obstruction (dysphagia IV°), all of whom had failed at least one trial of conventional dilatation, underwent recanalization by endoscopic rendezvous, a combined approach through a gastrostomy and perorally under fluoroscopic control. Conscious sedation was used in all patients. In 18/19 patients (94.7%), recanalization was technically successful. In 14/18 patients (77.8%), the post-intervention dysphagia score changed to ≤ II. Three patients had their PEG removed. Factors negatively associated with success were Obstruction length of 50 mm; and tumor recurrence for long-term success. No severe complications were recorded. Rendezvous recanalization for Complete esophageal Obstruction is a reliable and safe method to re-establish luminal patency. Differences between technical and clinical success rates highlight the importance of additional functional factors associated with dysphagia. Given the lack of therapeutic alternatives, rendezvous recanalization is a valid option to improve dysphagia.
G B Bulkley - One of the best experts on this subject based on the ideXlab platform.
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Current management of small-bowel Obstruction.
Advances in surgery, 1997Co-Authors: K N Bass, B Jones, G B BulkleyAbstract:In conclusion, most of the recent advances in the management of small bowel Obstruction consist of developments in the imaging modalities available to assist in the diagnosis itself, particularly with regard to the distinction between partial and Complete Obstruction. Unfortunately, little progress has been made to enable physicians to detect early, reversible strangulation, and therefore the surgical management of small-bowel Obstruction has changed very little over the past 10 years. Because of the inability to detect reversible ischemia, there is a substantial risk of progression to irreversible ischemia (and an inherent rise in morbidity and mortality) when surgery is delayed for an extended period of time, especially in the setting of suspected Complete Obstruction. However, almost all patients do benefit from an initial 12 to 24 hours of resuscitation and decompression in cases of Complete Obstruction; resuscitation and decompression can usually be extended for a longer period of time in those patients with partial Obstruction who exhibit no signs of progression (Fig 6). It is encouraging, however, that some advances have been made in understanding the pathophysiology and prevention of adhesion formation. Research efforts in the future should continue to focus on these issues as well as on the development of methods to better recognize early signs of strangulation.