The Experts below are selected from a list of 1539 Experts worldwide ranked by ideXlab platform

Chester R. Jarmolowski - One of the best experts on this subject based on the ideXlab platform.

  • Intravascular stents in the management of superior vena cava syndrome.
    Catheterization and cardiovascular diagnosis, 1991
    Co-Authors: Neil Solomon, Mark H. Wholey, Chester R. Jarmolowski
    Abstract:

    Superior vena cava syndrome can be effectively palliated with the use of intravascular stents. Adjunctive modalities which may be utilized prior to stent placement are thrombolytic therapy and balloon angioplasty. Six patients with an underlying malignancy were treated with these modalities. Complete resolution of symptoms occurred in five patients, and partial resolution occurred in the sixth. Two of the patients who had initial, complete resolution of symptoms had recurrences. One involved rethrombosis of the superior vena cava which occurred twice and required Percutaneous Thrombectomy, and the second involved restenosis requiring a Percutaneous transluminal angioplasty of the SVC just distal to the stent. Both of these patients with second procedures, again, had complete resolution of symptoms. Intravascular stents are a valuable additional treatment of superior vena cava syndrome.

Rolf W. Günther - One of the best experts on this subject based on the ideXlab platform.

  • Evaluation of a newly developed Percutaneous Thrombectomy basket device in sheep with central pulmonary embolisms.
    Investigative radiology, 2006
    Co-Authors: Rajeev K. Verma, J Pfeffer, Rolf W. Günther, Tadek Stopinsky, Thomas Schmitz-rode
    Abstract:

    Objective: The authors studied the development of a Thrombectomy device that is adequately steerable and quickly placeable in case of extensive pulmonary embolism. Materials and Methods: The device consists of a self-expandable nitinol basket mounted at a catheter-tip, which allows suction and extraction of thrombus material. Five in vitro tests were performed followed by tests in 6 sheep. In vivo thrombus material was introduced through a jugular vein to produce pulmonary embolism. After catheter insertion over the right femoral vein, the basket was placed adjacent to the pulmonary embolus and the extraction procedure was performed. Results: In in vitro tests, the extracted thrombus amount varied between 60% and 95%. In animal experiments, the extracted amount varied between 30% and 95% as determined angiographically. Limiting factors were steerability and optimal positioning of the basket in relation to the embolus. Conclusions: Extraction of pulmonary embolism with the self-expanding suction basket is feasible. However, successful recanalization is limited by catheter maneuverability in the pulmonary arterial system.

  • Mechanical Thrombectomy of Iliocaval Thrombosis Using a Protective Expandable Sheath
    CardioVascular and Interventional Radiology, 2004
    Co-Authors: Tri H. Truong, Elmar Spuentrup, Gundula Staatz, Joachim E. Wildberger, Thomas Schmitz-rode, Claus C.a. Nolte-ernsting, Rolf W. Günther, Patrick Haage
    Abstract:

    We report a case of successful Percutaneous treatment of a subacute ilio-caval venous thrombosis in a 64-year-old female patient by using a novel combination of a rotatory fragmentation device (Percutaneous Thrombectomy device: PTD) and large wire basket (temporary Günther basket filter) under temporary caval filter protection using an expandable sheath. Because the patient had multiple myeloma with increased risk for contrast media-induced renal failure, the therapeutic angiographic procedure was performed without iodinated contrast medium. Non-contrast-enhanced MR venography (high-resolution True FISP) confirmed the effective thrombus removal by the Percutaneous mechanical Thrombectomy procedure.

  • Percutaneous Thrombectomy of the acutely thrombosed dialysis graft:In Vitro evaluation of four devices
    CardioVascular and Interventional Radiology, 1993
    Co-Authors: Thomas Schmitz-rode, Jochen G. Pfeffer, Klaus Bohndorf, Rolf W. Günther
    Abstract:

    Percutaneous recanalization of completely thrombosed hemodialysis grafts was simulated in a flow model. Thrombus removal was performed by 1) a Trac-Wright catheter; 2) an ultrasound-driven, oscillating probe aspiration Thrombectomy (US-OAT) device; 3) an electric motor-driven oscillating probe aspiration Thrombectomy (EM-OAT) device; and 4) a rotating spiral aspiration Thrombectomy (RAT) device. All devices were able to restore a continuous lumen of the shunt model within 1–5 min, but residual layers of wall-adherent adherent thrombi remained attached, particularly to the inner curvature of the shunt loop. Clot removal rate was 95% for the Trac-Wright catheter, 73% for the US-OAT device, 68% for the EM-OAT device (straight tip catheter), 88% for the EM-OAT device (angulated tip catheter), and 51% for the RAT device. Effluent particle rates for particles >100 μm were 3.6% for the Trac-Wright catheter, 0.6% for US-OAT, and less than 0.1% for the other devices. Compared with the Trac-Wright catheter, the balance of clot-removing efficiency and creation of effluent particles favored the electric oscillating device with the angulated tip catheter, which had a slightly reduced, but still efficient, clot-removing capability and produced almost no effluent particles.

  • Percutaneous Thrombectomy of the acutely thrombosed dialysis graft: in vitro evaluation of four devices.
    Cardiovascular and interventional radiology, 1993
    Co-Authors: Thomas Schmitz-rode, J Pfeffer, Bohndorf K, Rolf W. Günther
    Abstract:

    Percutaneous recanalization of completely thrombosed hemodialysis grafts was simulated in a flow model. Thrombus removal was performed by 1) a Trac-Wright catheter; 2) an ultrasound-driven, oscillating probe aspiration Thrombectomy (US-OAT) device; 3) an electric motor-driven oscillating probe aspiration Thrombectomy (EM-OAT) device; and 4) a rotating spiral aspiration Thrombectomy (RAT) device. All devices were able to restore a continuous lumen of the shunt model within 1-5 min, but residual layers of wall-adherent thrombi remained attached, particularly to the inner curvature of the shunt loop. Clot removal rate was 95% for the Trac-Wright catheter, 73% for the US-OAT device, 68% for the EM-OAT device (straight tip catheter), 88% for the EM-OAT device (angulated tip catheter), and 51% for the RAT device. Effluent particle rates for particles > 100 microns were 3.6% for the Trac-Wright catheter, 0.6% for US-OAT, and less than 0.1% for the other devices. Compared with the Trac-Wright catheter, the balance of clot-removing efficiency and creation of effluent particles favored the electric oscillating device with the angulated tip catheter, which had a slightly reduced, but still efficient, clot-removing capability and produced almost no effluent particles.

  • Minibasket for Percutaneous embolectomy and filter protection against distal embolization: Technical note
    CardioVascular and Interventional Radiology, 1991
    Co-Authors: Rolf W. Günther, Dierk Vorwerk
    Abstract:

    As an alternative approach to Thrombectomy in peripheral arteries, a miniaturized Dormia basket was designed which is attached to a 0.021 inch guidewire and can be introduced coaxially by a 3F thin-walled catheter. The device was applied successfully in 6 patients: for Percutaneous Thrombectomy in 5 patients with peripheral embolization during angioplasty and as a protective filter during Thrombectomy in 1.

Neil Solomon - One of the best experts on this subject based on the ideXlab platform.

  • Intravascular stents in the management of superior vena cava syndrome.
    Catheterization and cardiovascular diagnosis, 1991
    Co-Authors: Neil Solomon, Mark H. Wholey, Chester R. Jarmolowski
    Abstract:

    Superior vena cava syndrome can be effectively palliated with the use of intravascular stents. Adjunctive modalities which may be utilized prior to stent placement are thrombolytic therapy and balloon angioplasty. Six patients with an underlying malignancy were treated with these modalities. Complete resolution of symptoms occurred in five patients, and partial resolution occurred in the sixth. Two of the patients who had initial, complete resolution of symptoms had recurrences. One involved rethrombosis of the superior vena cava which occurred twice and required Percutaneous Thrombectomy, and the second involved restenosis requiring a Percutaneous transluminal angioplasty of the SVC just distal to the stent. Both of these patients with second procedures, again, had complete resolution of symptoms. Intravascular stents are a valuable additional treatment of superior vena cava syndrome.

Marcus D'ayala - One of the best experts on this subject based on the ideXlab platform.

  • Factors Associated with Successful Thrombus Extraction with the AngioVac Device: An Institutional Experience.
    Annals of vascular surgery, 2016
    Co-Authors: Marcus D'ayala, Berhane Worku, Iosif Gulkarov, Akhilesh K. Sista, James M. Horowitz, Arash Salemi
    Abstract:

    Background The AngioVac (AngioDynamics, Latham, NY) device utilizes a venovenous bypass circuit for Percutaneous venous Thrombectomy and has been applied in the setting of iliocaval thrombosis as well as right heart thrombus and pulmonary emboli. We describe our experience with the AngioVac device in 12 patients with a variety of indications with the goal of identifying factors correlating with successful Thrombectomy. Methods From August 2013 to June 2015, 12 patients underwent AngioVac Percutaneous Thrombectomy at our institution. Preoperative, intraoperative, and postoperative data were retrospectively analyzed. Results Indications for Thrombectomy included iliocaval thrombosis in 33% (4), right heart thrombus in 42% (5), and pulmonary embolus in 25% (3). We experienced a 58% complete success rate. Partial success was achieved in 17%, and no thrombus was extracted in 25%. Iliocaval and right heart thrombi were the most amenable to AngioVac Thrombectomy with 100% (4/4) and 60% (3/5) complete success rates, respectively. Pulmonary embolus was the least amenable to Thrombectomy with a 33% partial success rate (1/3) and 67% failure rate (2/3). Conclusion The AngioVac devices allow for Percutaneous Thrombectomy in the setting of iliocaval and right heart thrombus in patients for whom medical therapy fails or for those in whom surgical intervention is considered high risk. Pulmonary emboli are less amenable, likely due to limited steeribility of the device. Larger studies are needed to make more definitive conclusions, and newer iterations of the device will likely allow for improved outcomes.

  • Endovascular treatment of a thrombosed intracardiac vena cava filter
    Journal of vascular surgery. Venous and lymphatic disorders, 2014
    Co-Authors: Andrew Sticco, Berhane Worku, Iosif Gulkarov, Anthony J. Tortolani, Marcus D'ayala
    Abstract:

    Intracardiac migration of a vena cava filter (VCF) is a rare but potentially fatal complication. We describe a unique case of intracardiac migration of a permanent VCF with extensive thrombus propagating into the inferior vena cava and right atrium. Percutaneous Thrombectomy with the AngioVac (AngioDynamics, Latham, NY) device was performed, and the permanent VCF was Percutaneously removed.

Thomas Schmitz-rode - One of the best experts on this subject based on the ideXlab platform.

  • Evaluation of a newly developed Percutaneous Thrombectomy basket device in sheep with central pulmonary embolisms.
    Investigative radiology, 2006
    Co-Authors: Rajeev K. Verma, J Pfeffer, Rolf W. Günther, Tadek Stopinsky, Thomas Schmitz-rode
    Abstract:

    Objective: The authors studied the development of a Thrombectomy device that is adequately steerable and quickly placeable in case of extensive pulmonary embolism. Materials and Methods: The device consists of a self-expandable nitinol basket mounted at a catheter-tip, which allows suction and extraction of thrombus material. Five in vitro tests were performed followed by tests in 6 sheep. In vivo thrombus material was introduced through a jugular vein to produce pulmonary embolism. After catheter insertion over the right femoral vein, the basket was placed adjacent to the pulmonary embolus and the extraction procedure was performed. Results: In in vitro tests, the extracted thrombus amount varied between 60% and 95%. In animal experiments, the extracted amount varied between 30% and 95% as determined angiographically. Limiting factors were steerability and optimal positioning of the basket in relation to the embolus. Conclusions: Extraction of pulmonary embolism with the self-expanding suction basket is feasible. However, successful recanalization is limited by catheter maneuverability in the pulmonary arterial system.

  • Mechanical Thrombectomy of Iliocaval Thrombosis Using a Protective Expandable Sheath
    CardioVascular and Interventional Radiology, 2004
    Co-Authors: Tri H. Truong, Elmar Spuentrup, Gundula Staatz, Joachim E. Wildberger, Thomas Schmitz-rode, Claus C.a. Nolte-ernsting, Rolf W. Günther, Patrick Haage
    Abstract:

    We report a case of successful Percutaneous treatment of a subacute ilio-caval venous thrombosis in a 64-year-old female patient by using a novel combination of a rotatory fragmentation device (Percutaneous Thrombectomy device: PTD) and large wire basket (temporary Günther basket filter) under temporary caval filter protection using an expandable sheath. Because the patient had multiple myeloma with increased risk for contrast media-induced renal failure, the therapeutic angiographic procedure was performed without iodinated contrast medium. Non-contrast-enhanced MR venography (high-resolution True FISP) confirmed the effective thrombus removal by the Percutaneous mechanical Thrombectomy procedure.

  • Percutaneous Thrombectomy of the acutely thrombosed dialysis graft:In Vitro evaluation of four devices
    CardioVascular and Interventional Radiology, 1993
    Co-Authors: Thomas Schmitz-rode, Jochen G. Pfeffer, Klaus Bohndorf, Rolf W. Günther
    Abstract:

    Percutaneous recanalization of completely thrombosed hemodialysis grafts was simulated in a flow model. Thrombus removal was performed by 1) a Trac-Wright catheter; 2) an ultrasound-driven, oscillating probe aspiration Thrombectomy (US-OAT) device; 3) an electric motor-driven oscillating probe aspiration Thrombectomy (EM-OAT) device; and 4) a rotating spiral aspiration Thrombectomy (RAT) device. All devices were able to restore a continuous lumen of the shunt model within 1–5 min, but residual layers of wall-adherent adherent thrombi remained attached, particularly to the inner curvature of the shunt loop. Clot removal rate was 95% for the Trac-Wright catheter, 73% for the US-OAT device, 68% for the EM-OAT device (straight tip catheter), 88% for the EM-OAT device (angulated tip catheter), and 51% for the RAT device. Effluent particle rates for particles >100 μm were 3.6% for the Trac-Wright catheter, 0.6% for US-OAT, and less than 0.1% for the other devices. Compared with the Trac-Wright catheter, the balance of clot-removing efficiency and creation of effluent particles favored the electric oscillating device with the angulated tip catheter, which had a slightly reduced, but still efficient, clot-removing capability and produced almost no effluent particles.

  • Percutaneous Thrombectomy of the acutely thrombosed dialysis graft: in vitro evaluation of four devices.
    Cardiovascular and interventional radiology, 1993
    Co-Authors: Thomas Schmitz-rode, J Pfeffer, Bohndorf K, Rolf W. Günther
    Abstract:

    Percutaneous recanalization of completely thrombosed hemodialysis grafts was simulated in a flow model. Thrombus removal was performed by 1) a Trac-Wright catheter; 2) an ultrasound-driven, oscillating probe aspiration Thrombectomy (US-OAT) device; 3) an electric motor-driven oscillating probe aspiration Thrombectomy (EM-OAT) device; and 4) a rotating spiral aspiration Thrombectomy (RAT) device. All devices were able to restore a continuous lumen of the shunt model within 1-5 min, but residual layers of wall-adherent thrombi remained attached, particularly to the inner curvature of the shunt loop. Clot removal rate was 95% for the Trac-Wright catheter, 73% for the US-OAT device, 68% for the EM-OAT device (straight tip catheter), 88% for the EM-OAT device (angulated tip catheter), and 51% for the RAT device. Effluent particle rates for particles > 100 microns were 3.6% for the Trac-Wright catheter, 0.6% for US-OAT, and less than 0.1% for the other devices. Compared with the Trac-Wright catheter, the balance of clot-removing efficiency and creation of effluent particles favored the electric oscillating device with the angulated tip catheter, which had a slightly reduced, but still efficient, clot-removing capability and produced almost no effluent particles.