Search results for "dilation"

A Negative FFR (Intracoronary Adenosine Bolus)

2016

This case describes the assessment of FFR for a single intermediate stenosis in the mid LAD. Since the procedure was performed using a radial access, and given the history of asthma, we preferred to use intracoronary adenosine as the vasodilator of choice. A first bolus of 50 μg was given, followed by a second one of 140 μg. The FFR was reproducible at 0.93, demonstrating that the stenosis was not relevant from the hemodynamic perspective.

Precapillary Servo Control of Blood Pressure and Postcapillary Adjustment of Flow to Tissue Metabolic Status

1996

Background There are several shortcomings in current understanding of how the microvasculature maintains tissue homeostasis. Presently unresolved issues include (1) integration of the potentially conflicting needs for capillary perfusion and hydrostatic pressure regulation, (2) an understanding of signal transmission pathways for conveying information about tissue energetic status from undersupplied tissue sites to the arterioles, (3) accounting for the experimentally observed interrelations between precapillary and postcapillary resistances, and (4) an explanation of how precise local adjustment of perfusion to metabolic demands is achieved. Methods and Results A novel conceptualization o…

Microvascular blood flow changes of the abductor pollicis brevi muscle during sustained static exercise

2020

ABSTRACTA practical assessment of the health of the palm muscle, abductor pollicis brevis (APB), is important for diagnosis of different conditions. Here we have developed a protocol and a probe to utilize diffuse correlation spectroscopy (DCS) to characterize microvascular blood flow changes in the APB during and after sustained isometric exercise, during and after thumb abduction at at 55% of maximum voluntary contraction (MVC). Blood flow in the APB decreased during exercise in the subjects (n=13) with high MVC (n=7) and stayed constant in the ones with low MVC (n=6) suggesting that the mechanical occlusion due to increased intramuscular pressure exceeded the vasodilation elicited by the…

2019

Background Endothelial dysfunction is a consequence of type 2 diabetes mellitus, but it is unclear whether endothelial dysfunction of conductance versus resistance vessels may also precede type 2 diabetes mellitus development. Methods and Results In a population‐based cohort of 15 010 individuals from the GHS (Gutenberg Health Study) (aged 35–74 years at enrollment in 2007–2012), we identified 1610 cases of incident pre–diabetes mellitus and 386 cases of incident type 2 diabetes mellitus by hemoglobin A 1c (HbA 1c ) and/or medical history between 2012 and 2017. Endothelial function of conductance and resistance vessels was measured by flow‐mediated dilation and digital volume plethysmograp…

Mainz Pouch II technique: 10 years’ experience

2004

In this section, the use of the Mainz Pouch II is examined in some detail, from Mainz (where it originated), and from London. Both groups of authors found the procedure to be valuable and helpful, and critically assess the results and complications. OBJECTIVE To report the long-term results with the Mainz Pouch II procedure. PATIENTS AND METHODS Between 1990 and 2000 a Mainz Pouch II ureterosigmoidostomy was used in 123 patients (49 females and 74 males, mean age 43.6 years, range: 1–73). The indications for urinary diversion were cystectomy for bladder cancer in 92 patients, bladder exstrophy and/or incontinent epispadias in 26, irreparable traumatic loss of the sphincteric urethra in four…

Contrast-Induced Hyperemia and FFR: Slightly Slower but still “Quick and Clean”

2016

Slightly more complex than the previous one, a quick way to induce hyperemia is to inject a contrast bolus. Although the degree of hyperemia reached this way is not as large as with vasodilators, this maneuver can still allow unmasking a gradient.

Effect of comprehensive vasodilation vs usual care on mortality and heart failure rehospitalization in women with acute heart failure

2020

Abstract Background Guidelines recommend evaluating the risk/benefit ratio of novel therapies individually in women and men, as the pathophysiology and the response to treatment may differ between women and men. Among patients with acute heart failure (AHF), a strategy of intensive vasodilation, compared with usual care, overall did provide comparable outcomes. Purpose To evaluate the effect of a strategy that emphasized early intensive and sustained vasodilation in women with AHF. Methods In a randomized, open-label blinded-end-point trial patients hospitalized for AHF were enrolled in 10 hospitals in Switzerland, Bulgaria, Germany, Brazil, and Spain. Inclusion criteria were AHF expressed …

Gradual angioplasty and stent implantation to treat complete superior vena cava occlusion after Mustard procedure

1996

A 16-year-old male was admitted with complete occlusion of the superior vena cava pathway 14 years after Mustard procedure for transposition of the great arteries. From a left subclavian vein approach, the atretic vein segment was perforated using a straight guidewire, and was followed by sequential balloon dilation. Implantation of a 30 mm Palmaz-stent through a femoral vein approach resulted in a widely patent channel of the vena cava superior into the systemic venous atrium. © 1996 Wiley-Liss, Inc.

Endoscopic management of gastric outlet obstruction disease

2019

Gastric outlet obstruction (GOO) is a clinical syndrome characterized by a variety of symptoms. It may be caused by motor disorders and by benign or malignant mechanical disease. Endoscopic management of benign disease is mainly based on balloon dilation, augmented by the use of covered self-expanding metal stents (SEMS) in refractory disease. Endoscopic ultrasound-guided gastroenterostomy (EUS-GE) is increasingly used as an alternative method, although more studies with longer follow up are needed before it can be considered as a recommended therapy. Surgery remains the last resort. Endoscopic management of malignant GOO is based on SEMS placement as an alternative to palliative surgery, b…

The revised ghent nosology; reclassifying isolated ectopia lentis

2014

Inherited ectopia lentis (EL) is most commonly caused by Marfan syndrome (MFS), a multisystemic disorder caused by mutations in FBN1. Historically the diagnosis for patients with EL who have no systemic features of MFS is isolated EL (IEL). However, the Ghent nosology for MFS was updated in 2010 and made some important alterations. In particular, patients with EL and a FBN1 mutation are now categorically diagnosed with MFS, if their mutation has previously been described with aortic dilation/dissection. This carries significant systemic implications, as many patients previously diagnosed with IEL are now reclassified. We provide a review of all published cases of IEL caused by FBN1 mutation…