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1.
2.
Bronchoalveolar lavage (BAL) performed with a fiberoptic bronchoscope (FOB) is a useful method for sampling alveolar contents. Since the smallest FOB with a channel has a diameter of 3.6 mm, BAL is difficult to accomplish through artificial airways (AA) less than 5.0 mm I.D. We used a 4F balloon wedge pressure catheter to perform BAL through small AA. Supplemental O2 or ventilatory support was delivered via an adaptor through which the catheter was introduced. After it was passed distal to the AA, the balloon was inflated with normal saline (NS) to a predetermined volume, and advanced until resistance was felt. The balloon was deflated, advanced slightly, and then reinflated to achieve airway occlusion. Five aliquots of 0.75 mL/kg of NS were used for BAL. The procedure was performed in 20 children from 1 month (950 g) to 6 1/2 years of age (median, 9 months). All specimens contained abundant alveolar macrophages, indicating good recovery of alveolar contents. Clinically significant information was obtained in 17 (85%) cases, and no patient required an open lung biopsy. In conclusion, nonbronchoscopic bronchoalveolar lavage is a valuable method for obtaining alveolar contents in children with small AA that preclude the use of an FOB, and it obviates the need for open lung biopsy in many patients. This technique could be used as a research tool for measuring constituents of alveolar contents in infants and small animals. 相似文献
3.
Balloon occlusion of the internal carotid artery in 40 cases of giant intracavernous aneurysm: technical aspects,cerebral monitoring,and results 总被引:13,自引:2,他引:11
V. Vazquez Añon A. Aymard Y. P. Gobin A. Casasco D. Rüffenacht M. H. Khayata E. Abizanda A. Redondo J. J. Merland 《Neuroradiology》1992,34(3):245-251
Summary We have studied the results of carotid occlusion in the treatment of giant intracavernous carotid artery (ICA) aneurysms in 40 patients. Clinical, angiographic, Doppler and cerebral blood flow (CBF) criteria for tolerance of occlusion are discussed. The patients had headaches (47.5%), cranial nerve compression (87.5%), decreased visual acuity (20%), ruptured aneurysm (15%) and 5% were asymptomatic. Balloon occlusion tests were performed under light sedation anaesthesia: a successful test required perfect clinical tolerance and adequate angiographic collateral circulation in arterial, parenchymatous, and venous phases. Additional criteria include xenon 133 CBF measurements, and transcranial Doppler sonography of the middle cerebral artery. According to these criteria, 5 patients did not tolerate test occlusion and required an extra-intracranial (EC-IC) bypass. Mean follow-up was 4.7 years. All patients were radiologically cured of their ancurysm, and in 35 the symptoms resolved, although 3 had persistent ocular motor nerve palsies, and in 4 visual defects were unchanged. Complications were 1 permanent and 3 transient neurological deficits. Balloon occlusion of the ICA is an effective, reliable form of treatment for intracavernous giant aneurysm and should replace surgical ligation of the cervical carotid artery. With CBF or Doppler monitoring, the risk of neurological deficit is diminished. EC-IC bypass prior to ICA occlusion is indicated if test occlusion is not tolerated. 相似文献
4.
5.
Patrick Courtheoux M.D. Dominique Maiza Jean Mani Vincent Mercier Jacques Theron 《Cardiovascular and interventional radiology》1988,11(6):340-342
A case of postnephrectomy arteriovenous fistula of the right renal pedicle is reported here. The diagnosis was confirmed by
angiography, and successful treatment was achieved using detachable balloon. 相似文献
6.
Summary A pathologic study was undertaken of seven encephalic arteriovenous malformations, including five resected from one to seven days after balloon embolization, one resected 10 days after embolization with polyvinyl alcohol foam (PVA), and a large mesencephalic AVM in a patient who died eight weeks after a series of embolization procedures with PVA and silicone spheres. AVM's resected 6–7 days following balloon embolization showed focal mural and adventitial inflammatory infiltrates and parenchymal (i.e. non-vascular) necrosis of a large portion of one AVM. The AVM examined 7 days post-balloon embolization showed an intraluminal thrombus containing refractile particles surrounded by foreign body giant cells (FBGC's). The AVM removed 10 days after PVA embolotherapy showed mural and perivascular necrosis with infiltration by polymorphonuclear leukocytes. The single autopsy case showed FBGC's surrounding residual PVA, refractile particles deep within vascular walls, and marked mural thickening of AVM channel walls, changes that may represent a response to previous angionecrosis and inflammation at the time of embolization. These findings, the pathogenesis of which is discussed in detail, may help to explain some of the rare complications of iatrogenic embolotherapy with these materials, as well as providing evidence for the basis of their efficacy.Presented in part at the 63rd Annual meeting of the American Association of Neuropathologists, Seattle, Washington, June, 1987 相似文献
7.
内镜直视下气囊扩张术治疗贲门失弛缓症的疗效评估 总被引:1,自引:0,他引:1
目的:观察评价贲门失弛缓症的内镜直视下气囊扩张术的疗效。方法:本研究选择23例贲门失弛缓症并经过内镜下气囊扩张术治疗的患者,术后6个月、1年、2年定期随访。详细询问病史,并经内镜和钡餐检查对原有的吞咽困难等症状缓解程度进行评估。结果:23例患者吞咽困难症状均有显著改善。1次扩张有效率达86.9%(20/23),2次有效率可达100%。术中可见贲门黏膜撕裂、渗血,占73.9%(17/23),但未见致命性大出血及穿孔等并发症。结论:内镜下气囊扩张术治疗贲门失弛缓症可获得良好的近期和远期疗效,具有安全、简便的特点,是治疗贲门失弛缓症的首选方法。 相似文献
8.
Christine Boutin John Dyck Lee Benson Christine Houde Robert M. Freedom 《Pediatric cardiology》1992,13(3):176-177
Summary Balloon atrial septostomy is an established method of palliation for several forms of congenital heart disease. Previously performed under fluoroscopic x-ray control, recent reports have demonstrated the utility of transthoracic echocardiographic monitoring. We report the first application of uniplane transesophageal echocardiography (TEE) (6.7-mm probe) as an alternative imaging modality for control of ballon atrial septostomy on neonates in the intensive care unit. 相似文献
9.
Percutaneous transcatheter occlusion of coronary artery fistulas using detachable balloons 总被引:1,自引:0,他引:1
Three pediatric patients underwent successful transcatheter coronary artery fistula occlusion using the Debrun system. This
latex balloon system offers several advantages over other occlusion systems. First, the balloon delivery and release is controlled.
Second, “test occlusions” can be performed that allow simultaneous balloon inflation, coronary cineangiography, and electrocardiographic
monitoring. Third, because the balloons are flow-directed, they are easily positioned in properly chosen locations. Finally,
the balloons can be constructed to suit the size of the fistula. In this study, two patients received only one balloon; in
the other patient two balloons were placed in the same fistula. All fistulas drained into either the right atrium or ventricle
and were successfully occluded. After a follow-up period of up to 3 years, no local or systemic reactions to the balloons
were recognized. We conclude that detachable balloon occlusion of coronary artery fistulas is a safe, effective alternative
to surgical ligation in selected pediatric patients. 相似文献
10.
Wakamatsu T Saito T Hayashi J Takeichi T Kitamoto K Aizawa K 《Medical molecular morphology》2005,38(4):225-232
Flexible treatments for intimal hyperplasia after angioplasty are still needed. The aim of this study was to demonstrate the
long-term effects of vascular photodynamic therapy with talaporfin sodium on intimal hyperplasia following interventional
injury. Intimal hyperplasia was induced by balloon distension injury to the carotid artery in 31 rabbits. Talaporfin, 5.0 mg/kg,
was delivered systemically immediately after balloon injury. The injury site was irradiated with a diode laser light of wavelength
664 nm using a fluence of 50 J/cm2 after 30 min. At day 3 and weeks 3, 6, 9, 15, and 25 after photodynamic therapy, the treated artery of each rabbit was excised
and examined immunohistochemically. Thirty minutes after talaporfin administration, drug fluorescence was found only in the
balloon-injured carotid artery wall. At 3 days, no smooth muscle cells were seen in the media of the photodynamic therapy-treated
arterial segments. Intimal hyperplasia developed progressively in the balloon-injured and untreated segments; however, in
the segments treated with photodynamic therapy, intimal hyperplasia was markedly suppressed until 25 weeks and the media was
repopulated by smooth muscle cells without macrophages. Vascular photodynamic therapy with talaporfin may be used to inhibit
restenosis after vascular intervention.
An erratum to this article is available at . 相似文献