bluuebunny/crossref_metadata_2025_split huggingface dataset:
Percutaneous isolated pharmaco‐mechanical thrombolysis‐thrombectomy system for the management of acute arterial limb ischemia: 30‐day results from a single‐center experience
Authors: Gupta Raghav , Hennebry Thomas A. 
Published: April 2012

AbstractObjectiveTo study the efficacy of isolated pharmaco‐mechanical thrombolysis‐thrombectomy (IPMT) by Trellis™ device (Covidien, Mansfield, MA) in managing acute limb ischemic (ALI).BackgroundALI is both life and limb threatening disease with a reported 9–15% mortality and 15–25% limb loss in the first month after presentation. Pitfalls of current endovascular techniques include major bleeding, distal embolism, and prolonged thrombolytic infusion. IPMT isolates the thrombus between two balloons and utilizes wire oscillation to increase the thombus‐lytic exposure surface area followed by aspiration. It decreases systemic lytic exposure, procedure time, and distal embolism.MethodsTechnical aspects, success, and bleeding complications in 24 consecutive patients with ALI treated with IPMT between October 2009 and September 2010 were analyzed. In‐hospital and 30‐day mortality, amputation rates and treatment success rates were determined.Results24 patients constituted 32 arteries; 18 (56.25%) were suprainguinal including 3 grafts (9.4%) and 14 (43.75%) were infrainguinal native arteries. Substantial or complete response was seen in >90% vessels with 87.5% patients revealing TIMI three flow while none demonstrated TIMI 2 or 3 pretreatment. Only three patients required adjunctive post‐IPMT thrombolysis. In‐hospital and 30‐day all cause mortality was 4.16%. One patient died in‐hospital and no patient underwent amputation.ConclusionBesides being the largest series of ALI patients treated with IPMT, this is the first and largest series including 14 native infrainguinal arteries. These results suggest IPMT to be a promising and safer therapeutic option in ALI, likely due to its site‐specific nature and limited thrombolysis exposure time. © 2012 Wiley Periodicals, Inc.
An alternative angiographic view to unmask the hidden patent ductus arteriosus during device closure
Authors: Garg Naveen , Moorthy Nagaraja 
Published: April 2012

AbstractTranscatheter closure of patent ductus arteriosus (PDA) with various devices has been evaluated worldwide and in selected cases can be performed successfully, thus avoiding the morbidity associated with surgical closure. Traditionally, left lateral projection is adopted for angiographic visualization of the PDA. However, rarely due to anatomical variations of the ductus, it may be difficult to properly visualize and deploy device in above‐said traditional view. In such cases, right anterior oblique projection may be used for proper visualization. © 2012 Wiley Periodicals, Inc.
Choice of stent and outcomes after treatment of drug‐eluting stent restenosis in highly complex lesions
Authors: Freixa Xavier , Almasood Ali S. , Khan Sohail Q. , Mackie Karen , Osten Mark , Ing Douglas , Overgaard Christopher B. , Horlick Eric M. , Seidelin Peter H. , Džavík Vladimír 
Published: April 2012

AbstractObjectivesOur aim was to compare the outcomes of a same versus different drug‐eluting stent (DES) implantation strategy for the treatment of DES instent restenosis (ISR).BackgroundThe absence of clear data renders the treatment of DES ISR one of the most challenging situations in interventional cardiology.MethodsWe identified all cases of DES ISR treated with a second DES between January 2004 and January 2009. The lesions were divided into those treated with the same DES as the initial one that restenosed and those treated with a different DES. The main end‐point was repeat target lesion revascularization (TLR).ResultsWe included 116 patients with a total of 132 lesions. The patient population was highly complex: 55.5% with diabetes, 56% with type‐C lesions, 15.9% with lesions previously stented with BMS and 18.2% with fluoroscopic evidence of stent fracture. A same and different stent strategy was conducted in 41 lesions (31%) and 91 lesions (69%), respectively. Overall TLR was 31.1% and occurred in 46.3% of patients treated with the same stent and 24.4% of those with a different stent (P = 0.012). Multivariable analysis found same stent strategy (OR 2.84, 95%CI 1.23–6.57;P = 0.014) and occurrence of stent fracture (OR 4.03, 95%CI 1.33–12.01;P = 0.012) to be the only independent predictors of TLR after a median follow‐up of 20.4 [12.1–30.2] months.ConclusionsIn highly complex lesions, DES implantation for DES ISR is linked to a high need of future revascularization. An association between implanting a DES type other than the original and lower rate of TLR is suggested. © 2012 Wiley Periodicals, Inc.
Percutaneous therapeutic approaches to closure of cardiac pseudoaneurysms
Authors: Kumar Prasanna Venkatesh , Alli Oluseun , Bjarnason Haruldur , Hagler Donald J. , Sundt Thoralf M. , Rihal Charanjit S. 
Published: April 2012

AbstractCardiac and aortic pseudoaneurysms are rare complications following myocardial infarction or cardiac surgery. They are characterized by a contained cardiac or aortic rupture within surrounding tissue and have a high mortality rate if left untreated. Percutaneous treatment of cardiac pseudoaneurysms might be a feasible treatment option in patients who are at high risk of reoperative surgery. There is limited literature on the outcomes and the approaches to percutaneous treatment of these pseudoaneurysms. We review nine cases of cardiac and aortic pseudoaneurysms and percutaneous techniques for closure. Pseudoaneurysms were categorized anatomically as left ventricular posterior (posterobasal or posterolateral), left ventricular outflow tract, left ventricular apical, and ascending aortic pseudoaneurysms. Two patients with posterior pseudoaneurysms (one posterobasal treated with an Amplatzer Septal Occluder device, and one wide‐mouthed posterolateral pseudoaneurysm which was not closed, are described. We further describe two left ventricular outflow tract pseudoaneurysms treated successfully with percutaneous coil embolization, one left ventricular apical pseudoaneurysm treated with coils, and three ascending aortic pseudoaneurysms treated with a septal occluder device or vascular plug. We review the technical approaches, device selection strategies, outcomes, and complications with these percutaneous treatment options. The size of the pseudoaneurysm dimensions of its neck and relative anatomy, particularly to the coronaries and valves, are critical issues to be addressed before percutaneous treatment of these pseudoaneurysms. © 2012 Wiley Periodicals, Inc.
Percutaneous retrograde left ventricular assist support for interventions in patients with aortic stenosis and left ventricular dysfunction
Authors: Martinez Claudia A. , Singh Vikas , Londoño Juan C. , Cohen Mauricio G. , Alfonso Carlos E. , O'Neill William W. , Heldman Alan W. 
Published: April 2012

AbstractObjectivesTo evaluate feasibility and technical outcomes in patients with aortic stenosis (AS) who have undergone high‐risk procedures with continuous flow left ventricular (LV) assist, with the Impella 2.5 system (Abiomed, Danvers, MA).BackgroundIn preparation for transcatheter aortic valve implantation, an increasing number of high‐risk patients with severe AS and left ventricular dysfunction are currently considered for percutaneous coronary interventions (PCI) and balloon aortic valvuloplasty (BAV). Hemodynamic support may be required in some patients.MethodsWe reviewed procedural and clinical findings and 30‐day outcomes in patients with symptomatic AS who underwent high‐risk percutaneous procedures supported by the Impella 2.5 system. All patients carried a high‐risk of operative mortality. Impella was used during PCI, BAV, and for hemodynamic support during emergencies.ResultsOver a 14‐month period, 21 patients with AS underwent insertion of Impella prior to high‐risk PCI (n = 3), BAV with subsequent PCI (n = 8), BAV alone (n = 7), or during cardiac arrest immediately following BAV (n = 3). The mean Society of Thoracic Surgeons (STS) predicted mortality risk was 14% (range 7.3–24.7%). Impella was inserted successfully in all patients attempted. Retrograde advancement of two catheters across the aortic valve (for concomitant BAV in 15 patients) was technically feasible. Retrograde continuous flow LV assist produced a reduction in LV end‐diastolic pressure and an increase in arterial pressure. Periprocedural complications occurred in 19% (n = 4) patients, with no periprocedural deaths. Mortality at 30 days was 14.2%.ConclusionOur data suggests that continuous flow LV assist with Impella 2.5 can be used in high‐risk patients with severe AS who require periprocedural hemodynamic support. © 2012 Wiley Periodicals, Inc.
Contemporary use of adjunctive thrombectomy during primary percutaneous coronary intervention for ST‐elevation myocardial infarction in the united states
Authors: Owan Theophilus E. , Roe Matthew T. , Messenger John C. , Dai David , Michaels Andrew D. 
Published: April 2012

AbstractObjectivesWe sought to examine the contemporary use of thrombectomy during primary percutaneous coronary intervention (PCI) in the United States.BackgroundAdjunctive thrombectomy during primary PCI for patients with ST‐segment elevation myocardial infarction (STEMI) has demonstrated mixed results. While earlier studies showed either unfavorable or neutral effects with rheolytic thrombectomy, recent clinical trials have shown benefits with manual or rheolytic thrombectomy when compared to PCI alone.MethodsWe analyzed data from 122,449 patients undergoing primary PCI for STEMI from 1,181 centers reported to the CathPCI Registry® between July 2009 and December 2010. We used logistic regression analysis to examine factors associated with the use of manual and rheolytic thrombectomy.ResultsThrombectomy was performed in 23,195 patients (18.9%): 22,404 (18.3%) had manual thrombectomy and 791 (0.6%) had rheolytic thrombectomy. The use of manual thrombectomy increased over time (P < 0.05). The use of rheolytic thrombectomy did not change. There was significant variation in the use of thrombectomy across hospitals. The strongest predictors of manual versus no thrombectomy included TIMI 0/1 flow (odds ratio 1.69), younger age (OR 0.90 per 10 year increase), saphenous vein graft (OR 2.22), glycoprotein IIb/IIIa inhibitor (OR 1.34), single‐vessel disease (OR 1.13), and year of admission (OR 1.20 per year; all P < 0.001). The strongest predictor of manual versus rheolytic thrombectomy was year of admission (OR 1.23, P < 0.001).ConclusionsOur data show that thrombectomy is performed infrequently in the US during primary PCI for STEMI. There is significant variation in the use of thrombectomy across US hospitals. © 2012 Wiley Periodicals, Inc.
Antegrade percutaneous valve implantation for mitral ring dysfunction, a challenging case
Authors: Petronio Anna , Giannini Cristina , De Carlo Marco , Guarracino Fabio 
Published: April 2012

AbstractThe operative risk for reoperation of degenerated bioprosthetic valves or failing mitral‐valve annuloplasty is higher compared with the risks for first isolated native valve repair or replacement (Astor et al., Eur Heart J 2008;29:2382–2387). In the presence of comorbidities, these risks increase exponentially. The recent introduction of transcatheter valve implantation opened new perspectives for the treatment of patients at very high surgical risk. We report a percutaneous mitral valve (MV) implantation using a transatrial approach within a MV ring using the Edwars Sapien XT valve. © 2012 Wiley Periodicals, Inc.
Revascularization of unprotected left main coronary artery disease: Strategy selection and systematic risk assessment
Authors: Palmerini Tullio , Alessi Laura , Dangas George 
Published: April 2012

AbstractRefinement of interventional techniques, adjunctive pharmacological therapy, and the introduction of drug eluting stents have fostered new interest for the percutaneous treatment of unprotected left main coronary artery (ULMCA) stenosis. Several observational registries, some randomized controlled trials and several meta‐analyses have consistently shown no difference in mortality and myocardial infarction between percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery in patients with ULMCA stenosis, but a higher rate of target vessel revascularization in patients treated with PCI. As a consequence, PCI of ULMCA stenosis has been upgraded to class IIa or IIb indication in the current European or American College of Cardiology/American Heart Association practice guidelines. Although these results are promising, they do not still represent enough evidence for extending PCI of ULMCA stenosis to current clinical practice. The EXCEL trial will address the value of PCI in relation to CABG for the treatment of ULMCA stenosis in more than 2000 patients. A major breakthrough of the SYNTAX trial has been the demonstration of an interaction between the coronary complexity and the revascularization strategy, suggesting that optimal risk stratification is a key element when deciding the best strategy of revascularization in this high‐risk group of patients. Multidisciplinary team approach remains essential to provide a balanced information to the patient and to offer the beast treatment option. © 2012 Wiley Periodicals, Inc.
Product Regions of Multi Component Rectification
Authors: Vogelpohl Alfons 
Published: April 2012

AbstractDie Kenntnis der erreichbaren Produktbereiche bei der Rektifikation von Vielstoffgemischen ist von großer Bedeutung bei der Auslegung von Rektifikationskolonnen. Auf der Grundlage der reversiblen Rektifikation wird eine allgemeingültige Methode zur Bestimmung der möglichen Produktbereiche und des minimalen Rücklaufverhältnisses angegeben, die sowohl für azeotrope Gemische als auch Gemische mit beliebig vielen Komponenten gültig ist.
Metastatic basal cell carcinoma in the era of hedgehog signaling pathway inhibitors
Authors: Weiss Glen J. , Korn Ronald L. 
Published: April 2012

AbstractBACKGROUND:Inhibition of the hedgehog signaling pathway (HHSP) for the treatment of locally advanced basal cell carcinoma (BCC) and metastatic BCC (mBCC) has produced promising results. Typically, mBCC is not taken into consideration during the workup of a patient with multifocal metastatic disease who has a history of BCC. The objective of the current review, in which the authors evaluated the time from the first BCC diagnosis to metastasis, location of disease, and radiographic features, was to contribute to the general knowledge and awareness among providers, patients, and support groups about mBCC and to provide an outlook for the future of treatments for mBCC. A literature review on mBCC and a review of records from patients with mBCC who presented to Virginia G. Piper Cancer Center Clinical Trials (an oncology clinical trials center) were conducted. The clinical and radiographic findings of 22 patients with mBCC who were evaluated at that center from the initiation of smoothened (SMO) antagonist trials were analyzed along with a review of BCC epidemiology and pathogenesis, the HHSP, and current and future treatments for this rare presentation of the most common malignancy. The results indicated that, in the last 5 years, there has been a plethora of new agents targeting SMO, a key component of the HHSP that, for the majority of patients with mBCC, may be a good match for targeting tumor genetic vulnerability. Like with other targeted therapy for uncommon malignancies, such as chronic myelogenous leukemia and gastrointestinal stromal tumors, the authors anticipate that there will be clinical development of next‐generation HHSP inhibitors to combat mBCCs that are nonresponsive to or progress on current SMO antagonists. Cancer 2012. © 2012 American Cancer Society.
Clinical significance of gastritis cystica profunda and its association with Epstein‐Barr virus in gastric cancer
Authors: Choi Min‐Gew , Jeong Ji Yun , Kim Kyoung‐Mee , Bae Jae Moon , Noh Jae Hyung , Sohn Tae Sung , Kim Sung 
Published: April 2012

AbstractBACKGROUND:Gastritis cystica profunda (GCP) is a relatively rare disorder characterized by hyperplastic and cystic down growth of gastric glands into the submucosa. In the current study, the authors attempted to clarify the clinical and pathologic features of GCP in patients with gastric cancer.METHODS:The records of 10,728 patients with gastric cancer who underwent gastric cancer surgery were reviewed. The clinicopathologic features of patients who had GCP (n = 161) were compared with the features of patients without GCP (n = 10,567). In situ hybridization to determine Epstein‐Barr virus (EBV) positivity was performed in cancer tissues from patients with (n = 119) and without (n = 503) GCP.RESULTS:GCP was associated significantly with older age, male gender, proximal tumor location, differentiated histology and Lauren intestinal type compared with non‐GCP. GCP also was present more frequently in remnant and multiple gastric cancers. Patients who had GCP presented with earlier tumor stages in terms of depth of invasion and lymph node metastasis, and they had less lymphatic and perineural invasion than patients without GCP; however, the presence of GCP was not an independent prognostic factor. The EBV‐positive rate was significantly higher in the GCP group (31.1%) than in the non‐GCP group (5.8%).CONCLUSIONS:Patients with gastric cancer who had GCP had clinicopathologic features that differed from the features observed in patients without GCP. GCP was associated significantly with EBV‐positive gastric cancers, and its possible role as a premalignant lesion needs to be clarified. Cancer 2012. © 2012 American Cancer Society.
Site‐specific cytomorphology of disseminated PC‐3 prostate cancer cells visualized in vivo with fluorescent proteins
Authors: Bobek Vladimir , Hoffman Robert M. , Kolostova Katarina 
Published: April 2012

AbstractCirculating tumor cells (CTC) may reach multiple organ sites. However, CTC seeding and growth in distant organs is not random. Each metastatic site may contain a specific subpopulation of the original metastatic tumor capable of growing at that site. The fluorescent orthotopic prostate cancer model (PC‐3‐GFP) model was used for immunomagnetic capture of CTC. The captured CTC were efficiently cultivated in vitro. PC‐3‐GFP cells were also isolated from various metastatic sites, grown in vitro and examined under fluorescence microscopy. The differential morphology was compared of primary tumor cells, CTC and disseminated (DTC) from multiple metastatic sites, from nude mice with orthotopic PC‐3‐GFP. The cultured captured CTC and DTC from various organs have distinctive morphologies. Distinct cancer cell morphologies were observed at different metastatic sites as well as among CTC. The distinct morphologies were maintained during in vitro culture. The results demonstrate extensive tumor heterogeneity that could account for the widely different behavior of cancer cells in a single tumor. Further hetereogeneity testing would be a big promise for personalizing the cancer treatment in the future. Diagn. Cytopathol. 2013. © 2012 Wiley Periodicals, Inc.
Influence of aspect in soil and vegetation water dynamics in dry Mediterranean conditions: functional adjustment of evergreen and semi‐deciduous growth forms
Authors: Gabarrón‐Galeote Miguel Angel , Ruiz‐Sinoga José Damián , Quesada Miguel A. 
Published: April 2012

ABSTRACTThis study was undertaken in a watershed at a dry Spanish Mediterranean location. The effects of the north‐facing and south‐facing aspects on atmospheric parameters, soil water contents (SWCs) and plant water balances were assessed during 18 months including two dry seasons and one wet season. The species studied were the evergreen sclerophyll Quercus suber and the semi‐deciduous shrubs Cistus albidus, Cistus monspeliensis and Lavandula stoechas. Atmospheric parameters were similar in both exposures, but water content of the 30‐cm uppermost soil layers was higher under canopy in the south‐facing slope during the wet season. Water balances of both slopes were different, and this was related to the lower shrub abundance and the vegetation patchiness observed in the south‐facing slope. Autumn plant recovery was faster in the north‐facing hillslope and occurred first in shrubs. During the whole study, Quercus suber displayed a hydrostable strategy maintaining an optimum water balance in both hillslopes. This was not the case of shrubs that avoided drought using a phenological adjustment and were more affected by aspect. Differences between tree and shrub water economies relied mainly on their respective root systems. The faster recovery of shrubs after the first autumn rainfalls allows them to avoid competition with other functional groups for water and nutrients during some days. Leaf‐drying curves distinguished the functional behaviour of the tree and the shrubs because stomatal closure occurred at higher relative water content in the former. The coexistence of both functional strategies ensures an efficient use of water and nutritional resources. Copyright © 2012 John Wiley & Sons, Ltd.
Synthesis of Cerium‐Activated Yttrium Aluminate Based Fine Phosphors by an Aerosol Route
Authors: Mancic Lidija , Lojpur Vesna , Barosso Ignacio , Rabanal Maria Eugenia , Milosevic Olivera 
Published: April 2012

AbstractPolycrystalline fine powders of yttrium aluminate doped with Ce3+ were synthesised by spray pyrolysis of a polymeric precursor, which was obtained by dissolving the corresponding nitrates in a solution of ethylenediaminetetraacetic acid (EDTA) in ethylene glycol (EG). Aerosol decomposition was performed at 550 °C followed by an additional thermal treatment (900–1100 °C). The yield of either a single yttrium aluminium perovskite (YAP) phase or a single yttrium aluminium garnet (YAG) phase was investigated as a function of the predefined yttrium/aluminium ratio, the cerium doping concentration, the processing temperature, and the thermal‐treatment regime, which included the variation of the heating and cooling rates (dT/dt), the residence time (τ), and the atmosphere. Changes in the composition and structure of the precursor during thermal decomposition were investigated by thermogravimetric and differential thermal analysis (TGA/DTA) and FTIR spectroscopy. The particle morphology and structure were analysed by a combination of scanning electron microscopy and energy‐dispersive X‐ray spectroscopy (SEM/EDS) and by high‐resolution transmission electron microscopy (HR‐TEM). The structural refinement was based on the phase identification performed by X‐ray powder diffraction (XRPD). The emission spectra were recorded within the range 325–800 nm by applying excitation wavelengths of 297 (YAP) and 450 nm (YAG). The employed synthesis conditions assured the formation of spherical, non‐agglomerated particles with well‐developed surfaces and diameters between 200 and 800 nm. For a predefined Y/Al ratio of 1:1, lower processing temperatures combined with longer heat treatments under stationary conditions resulted in a multiphase system, composed of YAP, YAG, and monoclinic yttrium aluminate (YAM) phases. However, a short heat treatment with a high heating rate (200 °C/min) at higher temperatures results in the formation of a kinetically favoured pure YAP hexagonal phase. On the other hand, for a predefined Y/Al ratio of 3:5, the generation of a thermodynamically favoured pure YAG phase has been confirmed, regardless of the applied heat‐treatment conditions. Although incomplete, Ce3+ introduction into the host matrix has been detected by XRPD and luminescence measurements.