The Experts below are selected from a list of 327 Experts worldwide ranked by ideXlab platform
Mohamad Hamady - One of the best experts on this subject based on the ideXlab platform.
-
a systematic review of outcomes following Percutaneous Transluminal Angioplasty and stenting in the treatment of transplant renal artery stenosis
CardioVascular and Interventional Radiology, 2015Co-Authors: A T Ngo, S R Markar, M S De Lijster, Neill Duncan, David Taube, Mohamad HamadyAbstract:Purpose To evaluate outcomes following treatment of transplant renal artery stenosis by Percutaneous Transluminal Angioplasty and stent insertion.
Jeanpaul P M De Vries - One of the best experts on this subject based on the ideXlab platform.
-
the use of 3d image fusion for Percutaneous Transluminal Angioplasty and stenting of iliac artery obstructions validation of the technique and systematic review of literature
Journal of Cardiovascular Surgery, 2018Co-Authors: Seline R Goudeketting, Stefan G H Heinen, Daniel A F Van Den Heuvel, Marco J Van Strijen, Michiel W De Haan, Cornelis H Slump, Jeanpaul P M De VriesAbstract:INTRODUCTION: The effect of the insertion of guidewires and catheters on fusion accuracy of the three-dimensional (3D) image fusion technique during iliac Percutaneous Transluminal Angioplasty (PTA) procedures has not yet been investigated. EVIDENCE ACQUISITION: Technical validation of the 3D fusion technique was evaluated in 11 patients with common and/or external iliac artery lesions. A preprocedural contrast-enhanced magnetic resonance angiogram (CE-MRA) was segmented and manually registered to a cone-beam computed tomography image created at the beginning of the procedure for each patient. The treating physician visually scored the fusion accuracy (i.e., accurate [ 5 mm]) of the entire vasculature of the overlay with respect to the digital subtraction angiography (DSA) directly after the first obtained DSA. Contours of the vasculature of the fusion images and DSAs were drawn after the procedure. The cranial-caudal, lateral-medial, and absolute displacement were calculated between the vessel centerlines. To determine the influence of the catheters, displacement of the catheterized iliac trajectories were compared with the noncatheterized trajectories. Electronic databases were systematically searched for available literature published between January 2010 till August 2017. EVIDENCE SYNTHESIS: The mean registration error for all iliac trajectories (N.=20) was small (4.0±2.5 mm). No significant difference in fusion displacement was observed between catheterized (N.=11) and noncatheterized (N.=9) iliac arteries. The systematic literature search yielded 2 manuscripts with a total of 22 patients. The methodological quality of these studies was poor (≤11 MINORS Score), mainly due to a lack of a control group. CONCLUSIONS: Accurate image fusion based on preprocedural CE-MRA is possible and could potentially be of help in iliac PTA procedures. The flexible guidewires and angiographic catheters, routinely used during endovascular procedures of iliac arteries, did not cause significant displacement that influenced the image fusion. Current literature on 3D image fusion in iliac PTA procedures is of limited methodological quality.
-
long term follow up of the padi trial Percutaneous Transluminal Angioplasty versus drug eluting stents for infrapopliteal lesions in critical limb ischemia
Journal of the American Heart Association, 2017Co-Authors: Marlon I Spreen, Jasper M Martens, Bob Knippenberg, Lukas C Van Dijk, Jeanpaul P M De Vries, Jan Albert Vos, Gert J De Borst, Evertjan Vonken, Okker D Bijlstra, Jan J WeverAbstract:BackgroundClinical outcomes reported after treatment of infrapopliteal lesions with drug‐eluting stents (DESs) have been more favorable compared with Percutaneous Transluminal Angioplasty with a ba...
-
Percutaneous Transluminal Angioplasty and drug eluting stents for infrapopliteal lesions in critical limb ischemia padi trial
Circulation-cardiovascular Interventions, 2016Co-Authors: Marlon I Spreen, Jasper M Martens, Bob Knippenberg, Lukas C Van Dijk, Jeanpaul P M De Vries, Jan Albert Vos, Gert J De Borst, Bettina E Hansen, Elke Verhey, Evertjan VonkenAbstract:Background—Endovascular infrapopliteal treatment of patients with critical limb ischemia using Percutaneous Transluminal Angioplasty (PTA) and bail-out bare metal stenting (BMS) is hampered by restenosis. In interventional cardiology, drug-eluting stents (DES) have shown better patency rates and are standard practice nowadays. An investigator-initiated, multicenter, randomized trial was conducted to assess whether DES also improve patency and clinical outcome of infrapopliteal lesions. Methods and Results—Adults with critical limb ischemia (Rutherford category ≥4) and infrapopliteal lesions were randomized to receive PTA±BMS or DES with paclitaxel. Primary end point was 6-month primary binary patency of treated lesions, defined as ≤50% stenosis on computed tomographic angiography. Stenosis >50%, retreatment, major amputation, and critical limb ischemia–related death were regarded as treatment failure. Severity of failure was assessed with an ordinal score, ranging from vessel stenosis through occlusion to...
-
Percutaneous Transluminal Angioplasty and stenting as first choice treatment in patients with chronic mesenteric ischemia
Journal of Vascular Surgery, 2010Co-Authors: Bram Fioole, Hendrik J M Van De Rest, Joost R M Meijer, Marc Van Leersum, Sebastiaan Van Koeverden, Frans L Moll, Jos C Van Den Berg, Jeanpaul P M De VriesAbstract:Purpose Open revascularization in patients with chronic mesenteric ischemia (CMI) is considered the gold standard. Percutaneous Transluminal Angioplasty and stenting (PTAS) is often reserved for patients not suitable for open revascularization. In our institute, endovascular revascularization is the first-choice treatment. The purpose of this study was to report the technical and clinical success rates after endovascular revascularization as the first-choice treatment in a series of 51 consecutive patients with CMI at a single tertiary vascular referral center. Methods A retrospective review was performed of all consecutive patients with CMI who underwent PTAS from July 2001 to July 2008. Only symptomatic patients treated for atherosclerotic CMI were included. Patency was evaluated using computed tomography angiography (CTA). Kaplan-Meier curves were used to calculate patency rates of the treated mesenteric arteries. Results Sixty mesenteric arteries (30 celiac trunks, 24 superior mesenteric, and 6 inferior mesenteric arteries) were treated in 51 patients (26 men). Major morbidity was 4%. After dissection of the superior mesenteric artery (n = 1) and brachial artery (n = 1), respectively, both patients underwent endarterectomy and patch plasty. In three arteries, the lesion could not be crossed endovascularly and they were deemed immediate intention-to-treat failures. The initial technical success rate was 93%. No 30-day mortality was observed. Median follow-up was 25 months. During follow-up, 2 patients died from intestinal ischemia. Complete symptom relief was achieved in 78% of patients. Primary 1- and 2-year patency rates were 86% ± 5% and 60% ± 9%, respectively; primary-assisted patency rates were 88% ± 5% and 79% ± 7%, respectively. During follow-up, 6 patients underwent open revascularization due to failure of PTAS. Conclusion The initial technical success rate of PTAS as first-choice treatment of CMI is >90%. The 2-year primary patency rate dropped to 60%, but symptomatic in-stent stenoses could often be treated successfully with renewed endovascular techniques. Including one conversion, 14% of patients needed open revascularization during follow-up.
-
durability of Percutaneous Transluminal Angioplasty for obstructive lesions of proximal subclavian artery long term results
Journal of Vascular Surgery, 2005Co-Authors: Jeanpaul P M De Vries, Cara L Jager, Jos C Van Den Berg, Tim Th C Overtoom, R G A Ackerstaff, Eric D W M Van De Pavoordt, Frans L MollAbstract:Purpose Percutaneous Transluminal Angioplasty (PTA) is one of the treatment options for localized obstruction of the subclavian artery. To document long-term durability of this kind of PTA we report a 10-year single-center experience in 110 patients. Methods From January 1993 to July 2003, 110 patients (72 women; mean age, 62 ± 10 years) underwent PTA of symptomatic (>75%) stenosis (n = 90) or occlusion of the proximal subclavian artery (84 left-sided). Forty one patients (37%) had symptoms of vertebrobasilar insufficiency, 29 patients (26%) had disabling chronic arm ischemia, and 20 patients had both symptoms. Twenty patients with coronary artery disease underwent PTA in preparation for myocardial revascularization with the internal mammary artery. Duplex scans and arteriograms confirmed significant stenosis or occlusion. All PTA procedures were performed with the patient under local anesthesia, through the femoral artery (n = 89), brachial artery (n = 6), or combined route (n = 15). In 59 patients (58%) an additional stent was placed. Results Angioplasty was initially technically and clinically successful in 102 patients (93%). Seven occlusions could not be recanalized, and 1 procedure had to be stopped because of ischemic stroke. Of the 102 patients in whom treatment was successful, 1 patient (1%) had a minor stroke in the contralateral hemisphere 2 hours post-PTA. Seven patients (7%) had minor problems, all without permanent sequelae. Follow-up with duplex scanning ranged from 3 months to 10 years (mean, 34 months). Primary clinical patency at 5 years was 89%, with a median recurrent obstruction–free period of 23 months. The local complication rate was 4.5%, and the combined stroke and death rate was 3.6%. Significant recurrent obstruction (>70%) developed in 8 patients with clinical symptoms. Four stenoses were successfully treated with repeat PTA (2 with additional stent placement); 4occlusions required surgery. Conclusions PTA of obstructive lesions of the proximal subclavian artery is not only an effective initial treatment, but is also successful over the long-term. Inasmuch as all clinical failures occured within 26 months after initial therapy, we recommend regular follow-up for at least 2 years post-PTA. All clinically significant recurrent stenoses can be treated with repeat endovascular procedures. We could not prove positive or negative influence of additional placement of stents; however, the number of recurrent stenoses might be too small in this retrospective study to draw firm conclusions. Adverse events of any kind are certainly no greater than with invasive surgical procedures. Therefore PTA must be seriously considered in patients with localized obstruction of the proximal subclavian artery.
Osamu Iida - One of the best experts on this subject based on the ideXlab platform.
-
three year results of the in pact sfa japan trial comparing drug coated balloons with Percutaneous Transluminal Angioplasty
Journal of Endovascular Therapy, 2020Co-Authors: Yoshimitsu Soga, Osamu Iida, Kazushi Urasawa, Shigeru Saito, Michael R Jaff, Hong Wang, Hiroko Ookubo, Hiroyoshi YokoiAbstract:Purpose:To evaluate the 3-year safety and effectiveness of the MDT-2113 (IN.PACT Admiral) drug-coated balloon (DCB) vs Percutaneous Transluminal Angioplasty (PTA) in a Japanese population with femo...
-
drug coated balloon versus uncoated Percutaneous Transluminal Angioplasty for the treatment of atherosclerotic lesions in the superficial femoral and proximal popliteal artery 2 year results of the mdt 2113 sfa japan randomized trial
Catheterization and Cardiovascular Interventions, 2019Co-Authors: Osamu Iida, Yoshimitsu Soga, Kazushi Urasawa, Shigeru Saito, Michael R Jaff, Hong Wang, Hiroko Ookubo, Hiroyoshi YokoiAbstract:OBJECTIVES To assess the longer-term safety and efficacy of the IN.PACT Admiral (MDT-2113) drug-coated balloon (DCB) for the treatment of de novo and non-stented restenotic lesions in the superficial femoral and/or proximal popliteal arteries versus uncoated Percutaneous Transluminal Angioplasty (PTA) in a Japanese cohort. BACKGROUND Although DCBs are the newest endovascular strategy for patients with peripheral artery disease presenting with femoropopliteal lesions, there remains a paucity of results in non-Caucasian populations. METHODS IN.PACT SFA Japan is an independently-adjudicated, prospective, multicenter, randomized, single-blinded trial. Endpoints through 2 years included primary patency and a composite safety endpoint of freedom from device- and procedure-related death through 30 days, freedom from target limb major amputation and freedom from clinically-driven target vessel revascularization at 24 months. RESULTS One hundred patients were assigned by 2:1 randomization to treatment with the IN.PACT Admiral DCB (n = 68) or PTA (n = 32). The groups were well-matched at baseline. Mean lesion length for the DCB and PTA groups were 9.15 ± 5.85 and 8.89 ± 6.01 cm (P = 0.838), respectively. Patients treated with DCB exhibited superior 24-month primary patency compared to PTA (79.8% vs. 46.9%; log rank P < 0.001). The 24-month clinically driven target lesion revascularization rate was 9.1% for DCB versus 20.7% for PTA (P = 0.177). There were no device- or procedure-related deaths, major amputations, or thromboses in either group. CONCLUSIONS Two-year results from IN.PACT SFA Japan demonstrated persistently superior patency and low CD-TLR rates through 2 years when compared to uncoated PTA in Japanese patients. These data are consistent with other IN.PACT DCB trials.
-
self expanding nitinol stent vs Percutaneous Transluminal Angioplasty in the treatment of femoropopliteal lesions 3 year data from the sm 01 trial
Journal of Endovascular Therapy, 2019Co-Authors: Osamu Iida, Yoshimitsu Soga, Kazushi Urasawa, Yasuo Komura, Naoto Inoue, Hidehiko Hara, Junji Yajima, Shigeru Nakamura, Takao Ohki, Hiroshi AndoAbstract:Purpose: To report the midterm outcomes of a trial comparing self-expanding nitinol stents to Percutaneous Transluminal Angioplasty (PTA) with provisional stenting in the treatment of obstructive d...
-
the influence of glycemic control on the prognosis of japanese patients undergoing Percutaneous Transluminal Angioplasty for critical limb ischemia
Diabetes Care, 2010Co-Authors: Mitsuyoshi Takahara, Osamu Iida, Hideaki Kaneto, Shinichi Gorogawa, Naoto Katakami, Takaaki Matsuoka, Masahiko Ikeda, Iichiro ShimomuraAbstract:OBJECTIVE To reveal the influence of preoperative factors on the prognosis of patients undergoing Percutaneous Transluminal Angioplasty (PTA) for critical limb ischemia (CLI). RESEACH DESIGN AND METHODS We recruited 278 Japanese patients who underwent PTA for CLI between 2003 and 2009. The outcome measures were mortality and major amputation. Cox proportional hazards regression analyses were performed. RESULTS The prevalence of diabetes was 71%, and A1C was 7.0 ± 1.4%. The follow-up period was 90 ± 72 weeks, and 48 patients underwent major amputations and 89 died. The presence of diabetes in the whole population and A1C level in the diabetic population had no influence on morality; rather, mortality was associated with age ( P = 0.007), impaired activities of daily living ( P P P = 0.010). In contrast, the presence of diabetes and A1C level had significant association with major amputation ( P = 0.012 and P = 0.007, respectively). The quartile analysis showed that diabetic subjects with an A1C ≥6.8%, but not P CONCLUSIONS Diabetes with poor glycemic control is associated with major amputation, but not mortality, in CLI patients undergoing PTA. Prognostic indicators seem somewhat different between survival and limb salvage in the population.
-
cilostazol reduces target lesion revascularization after Percutaneous Transluminal Angioplasty in the femoropopliteal artery
Circulation, 2005Co-Authors: Osamu Iida, Shinsuke Nanto, Masaaki Uematsu, Takakazu Morozumi, Junichi Kotani, Masaki Awata, Toshinari Onishi, Noriaki Ito, Fusako Oshima, Hitoshi MinamiguchiAbstract:Background Although Percutaneous Transluminal Angioplasty (PTA) is being widely used for the treatment of stenosis of peripheral arteries, the high in-stent restenosis rate (50-60%) in the femoropopliteal artery still remains an unsolved issue. Cilostazol is a unique antiplatelet drug that has vasodilatory effects and inhibits smooth muscle cell proliferation. Methods and Results A total of 141 consecutive patients scheduled for PTA in the femoropopliteal artery between September 1999 and April 2004 were retrospectively analyzed for the use of cilostazol. Target lesion revascularization (TLR) was defined as repeated PTA in patients who had a recurrence of symptoms with diameter stenosis >50% by angiography. Patient and lesion characteristics were similar between the cilostazol (+) and cilostazol (-) groups. Use of other medications was similar between the groups, except for ticlopidine, which was more frequently used in the cilostazol (-) than in the cilostazol (+) group (15% vs 61%, p<0.01). TLR was significantly reduced in the cilostazol (+) group (12% [8/68] vs 32% [23/73], p<0.01). Conclusions Although this study was retrospective and nonrandomized, the results suggest that cilostazol reduces TLR after PTA in the femoropopliteal artery. (Circ J 2005; 69: 1256 - 1259)
Jacob Shani - One of the best experts on this subject based on the ideXlab platform.
-
symptomatic angina secondary to coronary subclavian steal syndrome treated successfully by Percutaneous Transluminal Angioplasty of the subclavian artery
Catheterization and Cardiovascular Diagnosis, 1992Co-Authors: Harry Feld, Paul Nathan, Dilsukh Raninga, Jacob ShaniAbstract:Subclavian artery stenosis causing severely symptomatic angina in a patient with a previous left internal mammary artery bypass to the left anterior descending artery was treated successfully with Percutaneous Transluminal Angioplasty. Baseline arteriography clearly revealed subclavian and coronary steal by evidence of competitive flow of nonopacified blood from the left vertebral artery. Although there was a difference of only 15 mm Hg between the right and left brachial arteries, there was a palpable difference in the upstroke of these pulses. The stenosis in the subclavian artery was successfully dilated with Percutaneous Transluminal Angioplasty. Angiographic evidence of subclavian steal resolved following balloon dilatation, and the patient's angina was completely resolved. © 1992 Wiley-Liss, Inc.
Scott O Trerotola - One of the best experts on this subject based on the ideXlab platform.
-
unmasking of previously asymptomatic central venous stenosis following Percutaneous Transluminal Angioplasty of hemodialysis access
Journal of Vascular and Interventional Radiology, 2017Co-Authors: Jarrod Ehrie, Therese Sammarco, Jesse Chittams, Scott O TrerotolaAbstract:Abstract Purpose To determine the frequency of new-onset symptoms of central venous stenosis (CVS) after Percutaneous Transluminal Angioplasty (PTA) of a hemodialysis access–related stenosis in patients with previously asymptomatic CVS and to identify risk factors for this phenomenon. Materials and Methods Retrospective review was performed of patients treated with PTA for an access-related stenosis (excluding central vein interventions) between 2001 and 2016 who returned within 3 months with symptoms of CVS (ie, "unmasking"): 39 patients met these criteria. A control group of 122 patients who had untreated asymptomatic CVS and did not experience unmasking was selected. Fistulograms were graded for degree of CVS. A total of 51% of the unmasked group was male, with an average age of 65 years; 57% of the control group was male, with an average age of 63 years. Results The incidence of unmasking among patients with untreated asymptomatic CVS was 4.9%. A total of 90% of the unmasked group (35 of 39) had upper-arm access, compared with 77% of the control group (94 of 122; P = .017). A total of 28% of unmasked-group patients (11 of 39) underwent thrombectomy, vs 4% of controls (5 of 122; P P = .001). A total of 8% of unmasked-group patients (3 of 39) had superior vena cava stenosis, vs none of the 122 controls ( P = .01). A total of 64% of unmasked-group patients (25 of 39) had extensive collateral vessels, vs 24% of controls (29 of 122; P Conclusions The incidence of unmasking of asymptomatic CVS is low. Prophylactic treatment of asymptomatic CVS therefore remains generally inadvisable. However, patients undergoing declotting with extensive collateral vessels might warrant treatment of asymptomatic CVS.
-
renal arterial stenosis in renal allografts retrospective study of predisposing factors and outcome after Percutaneous Transluminal Angioplasty
Radiology, 2001Co-Authors: Nilesh H Patel, Rahul M Jindal, Terrence Wilkin, Shane Rose, Matthew S Johnson, Himanshu Shah, Jan Namyslowski, Kenneth P Moresco, Scott O TrerotolaAbstract:PURPOSE: To determine the predisposing factors to transplant renal arterial stenosis (TRAS) and assess the outcome of Percutaneous Transluminal Angioplasty (PTA) as the primary treatment. MATERIALS AND METHODS: Of 831 renal allograft recipients (584 cadaveric, 247 living related) between January 1991 and December 1998, 72 had hypertension and/or renal dysfunction. All 72 underwent arteriography, and their medical charts were retrospectively reviewed. RESULTS: Prevalence of TRAS was 3.1% (26 of 831). Technical success rate of PTA was 94% (16 of 17), and clinical success rate was 82% (14 of 17). Those with renal dysfunction had a mean pre-PTA creatinine value of 2.6 mg/dL (230 μmol/L) ± 0.5 (SD) versus a 1-week post-PTA value of 1.7 mg/dL (150 μmol/L) ± 0.3 (P < .001). Of those with hypertension, all but one had substantial improvement in mean diastolic blood pressure. At 26.9 months mean follow-up in 16 patients with successful PTA, two stenoses reoccurred, and two grafts were lost to chronic rejection. TR...