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Biomedical subjects

A Roguin

Publications and source records attributed to A Roguin.

At least 37 records · Page 2Linked to original sources
PubMed1997

Acute and 30-day results of the serpentine balloon expandable stent implantation in simple and complex coronary arterial narrowings.

We report the acute and 30-day results with a new serpentine-design, tubular, stainless steel, balloon-expandable stent (beStent) in the first 100 patients. One hundred forty-eight stents were used to treat 103 narrowings in the left anterior descending (n = 46), left circumflex (n = 20), and right coronary (n = 37) arteries. There were 85 de novo and 18 restenotic lesions (lesion length: < 10 mm [31], 10 to 20 mm [43] > 20 mm [29]; lesion type: A [10] B1 [29], B2 [20], C [44]; total occlusions, 23. More than 1 stent was used in 31 patients for treatment of long lesions that could not be covered by 1 stent. The stents used were 15-mm (n = 106), 25-mm (n = 38), or 35-mm (n = 4) long. Stent implantation strategy involved predilatation, deployment, and high-pressure dilatation, using the same balloon if possible. Clinical in-hospital success was 97% (2 patients had stent thrombosis that was recanalyzed, with myocardial infarction developing in 1, and 1 patient died on day 14 from retroperitoneal bleeding treated with surgery and complicated by sepsis). One-month event-free survival was 96%, with 1 death on day 21 due to hypertensive crisis. There were no other major adverse cardiac events in this first complex cohort of patients. In conclusion, the initial experience with this stent demonstrates its safety and efficiency for treating simple and complex coronary disease, with a relatively low rate of complications. Long-term clinical follow-up awaits further investigation.

Angioplasty, Balloon, Coronary↗
PubMed1997

A fatal case of Behçet's disease associated with multiple cardiovascular lesions.

Behçet's disease is recognised as a chronic multisystem disorder with vasculitis as its underlying pathological process. Cardiac involvement is rare and often associated with poor prognosis. A large right atrial thrombus, pulmonary aneurysms and aortic pseudoaneurysm that developed 17 years after surgery for bilateral renal artery stenosis is presented in a 26-year-old Behçet's disease patient. He was admitted to the hospital with fever of unknown origin associated with chest pain, dyspnea, cough, haemoptysis and pulmonary opacity in chest X-ray. Initial pulmonary CT demonstrated small subpleural infiltrates bilaterally, one of which was round and suspected as being metastatic. Examination of open lung biopsy demonstrated haemorrhagic infarct surrounded by some occluded pulmonary arteries. Subsequent CT showed pulmonary aneurysms compatible with Behçet's disease. Echocardiography demonstrated a large pedunculated mass in the right atrium. Injection of urographin showed a right atrial mass and a large right pulmonary artery aneurysm. The atrial mass was completely excised during open heart surgery and was identified as being an organising thrombus. Eight weeks later while taking prednisone, he was readmitted because of an infected mid sternal wound. CT showed slight separation of the stemum, retrosternal fluid, pulmonary arteries aneurysm and ascending aorta aneurysm. The next day, the patient died from massive bleeding from his ruptured ascending aortic pseudoaneurysm. Bizarre presentation of arterial and venous thromboses or arterial aneurysm formation, particularly in young patients, should suggest Behçet's disease.

Adult↗
PubMed1997

The acute effect of stenting with the nitinol self-expanding coil stent: preliminary experience.

BACKGROUND: The acute angiographic results with the self-expanding nitinol stent have not been reported. We aim to provide angiographic data of the effect of self expansion and balloon assistance on the results. This is analyzed with respect to stent gain, arterial- and stent-recoil. METHODS AND RESULTS: The self-expanding nitinol coil stent is inherently different than balloon-expandable stents in its mechanism of deployment and the way that radial arterial expansion is achieved. Between January 1995 and June 1996, 86 stents were deployed in 64 patients undergoing elective angioplasty at the Rambam Medical Center, Haifa, Israel. The stent deployment procedure involved stent release assisted by high pressure balloon dilatation. The baseline, post-balloon, post-stenting and post-stent-dilatation characteristics were recorded with similar views, digitized to a PC and analyzed by image processing software. Using computerized analysis, arterial- and stent-recoil and stent gain were calculated for the average stented segment lesion (0.48 +/- 0.42, 0.22 +/- 0.37, 0.28 +/- 0.37, respectively). Balloon angioplasty increased the minimal luminal diameter from 1.07 +/- 0.73 mm at baseline, to 2.24 +/- 0.57 mm; stent deployment further increased the diameter to 2.63 +/- 0.48 mm, and within-stent balloon dilatation to 2.96 +/- 0.62 mm. CONCLUSIONS: The self-expanding nitinol stent exerts its effect on both the MLD and the average stented diameter through its intrinsic radial force aided by post-deployment within-stent balloon dilatation. A significant correlation was found between stent gain and arterial recoil (slope = 0.59, r = 0.68, p < 0.001) but not with stent-artery recoil. Therefore, with the negligible effect of stent recoil, the acute benefit of the nitinol stent is directly proportional to arterial recoil, a feature which is also common to balloon-expandable stents.

Alloys↗
PubMed1997

Superior vena cava syndrome as a primary manifestation of Behçet's disease. A case report.

Superficial thrombophlebitis is a common finding in Behçet's disease. However, the potential life-threatening complication of superior vena cava (SVC) syndrome due to thrombotic occlusion is a rare manifestation and usually occurs several years after the onset of the diagnosis. The authors describe a twenty-nine-year-old Arab man who had an acute thrombosis of the SVC as the presenting manifestation of his Behçet's disease. The patient was successfully treated with thrombolytic and anticoagulant therapy, and during follow-up no relapse was observed. Behçet's disease should be suspected in young patients presenting with thrombosis of the SVC and without evidence of a hypercoagulable state.

Adult↗
PubMed1997

European Experience with the Self-Expanding Nitinol Coil: Pilot Phase Evaluation in Cardiovascular Applications.

BACKGROUND: The Cardiocoil (InStent) is a self-expanding nitinol coil that is restrained on a delivery catheter in a compressed state and deployed by a wire based release mechanism. We provide the initial data on the acute results of the use of this stent in a multi-center study in Europe. We also briefly review the other non-coronary applications of this stent. METHODS: One-hundred two stents were implanted in 76 patients for suboptimal results or dissections. There were 39 LAD lesions, 28 RCA lesions and 9 Circumflex lesions. There were eight total occlusions. Lesions were short in 41% (< 10 mm), tubular (between 10 and 20 mm) in 37%, and diffuse (> 20%) in 22%. Stent deployment included predilatation to the reference arterial side and post dilatation after stent deployment. RESULTS: Stent deployment was successful in all cases in which lesions could be crossed. In cases where the stent did not cross the lesion (n=3) it was removed uneventfully. There were no stent losses. Complications included subacute thrombosis in 4/76 (5.3%) patients (1- a long total RCA lesion, 2- diffuse proximal LAD diseases). There were no late acute events after stenting and no stent related mortality. Angiographic quantitative analysis showed that the stent expands by both its intrinsic self-expanding properties and by post deployment balloon assistance. CONCLUSIONS: The self-expanding coil stent for cardiovascular interventions is safe and effective in treating a variety of complex lesions. It provides adequate support to the arterial wall, preventing acute recoil and tacking dissections to the arterial wall. The long-term efficiency of this stent awaits further clinical testing.

Journal Article↗
PubMed1997

Newer Stents: Materials and Designs.

We aim to present here the experience with newer stents for coronary and peripheral interventions. Specifically, the design and technical considerations of the self-expanding nitinol coil stents for coronary and vascular indications, as well as the design and clinical experience with the tubular stainless steel balloon-expandable serpentine stents for coronary and peripheral interventions are discussed. The animal and clinical experience with both types of stent have shown that the mechanisms of deployment and expansion are different for these inherently different stents. The self-expanding coil stent, providing adequate scaffolding in various types of coronary lesions is deployed by self expansion, aided to a significant extent by balloon expansion. Long-term outside pressure on the wall may lead to further stent expansion as has been shown with this stent, which may be an important parameter in the restenosis process. The tubular balloon-expandable serpentine stent does not have the feature of long-term expansion, however, is characterized by superior scaffolding properties and unique features that allow its safe use in the most complex coronary diseases. Long-term clinical results are pending for these two families of stents.

Journal Article↗
PubMed1996

[Ifosfamide in pediatric malignancy--experiences in the Northern Israel Oncology Center].

The records of 46 children treated with ifosfamide between 1987-1994 were analyzed. 24 received the drug as first-line chemotherapy in combination with vincristine and etoposide or with adriamycin, vincristine and cyclophosphamide. Complete remission was achieved in 8/10 children with soft tissue sarcoma, 7/8 with Ewing's sarcoma, 2/2 with ovarian carcinoma and 2/2 with clear cell sarcoma of the kidney. 22 children in whom first-line chemotherapy failed were then treated with ifosfamide and etoposide. Complete remission was achieved in 7/10 children with osteosarcoma, 1/2 with Wilms' tumor and 1/3 with neuroblastoma.

Antineoplastic Agents, Alkylating↗
PubMed1994

[Malignant mesothelioma in families of asbestos workers].

Malignant mesothelioma is primarily an occupational disease of asbestos workers. While there is usually a latent period of 20-40 years between exposure and appearance of the tumor, the duration of exposure may be as short as a single month. Rarely, it may appear in family members and others living with asbestos workers who might be exposed to asbestos from work clothes during laundering, or from fibers on the skin or hair of the asbestos worker. Attention should therefore be paid to those with nonoccupational contact with asbestos. We report 2 cases of pleural mesothelioma in families of asbestos workers. In both cases the laundering of work clothes was done at home. The first was a 33-year-old man; during his childhood his father worked with asbestos boards for 5 years. The second was a 76-year-old woman whose husband worked in an asbestos factory for 32 years, up to 18 years before diagnosis.

Adult↗
PubMed1994

[Malignant solid tumors in the first year of life].

The records of all children in Northern Israel under the age of 1 year in whom a malignant solid tumor was diagnosed were analyzed. Between 1973-1990 such tumors were found in 39 boys and 25 girls. The overall annual incidence was 137.1 per million, and the incidence was higher in boys (1.9/1.0), in Jews compared to non-Jews (1.3/1.0), and in Ashkenazic Jews compared to Sephardic Jews (1.2/1.0). Neuroblastoma was the most common (52% of all malignancies), followed by Wilms' tumor (13%), CNS neoplasm (11%), retinoblastoma (8%), soft tissue sarcoma (6%), lymphoma (5%) and all others (6%). The retinoblastomas were all in non-Jews, but Jews had a higher incidence of neuroblastomas. No differences in incidence were observed in other neoplasms.

Central Nervous System Neoplasms↗
PubMed1994

[Brucella orchitis].

Brucellosis is a multi-organ infectious disease which affects the genito-urinary system in 2-10% of cases, mainly as orchitis. There have been very few reports in Israel of genito-urinary system involvement in patients with brucellosis, possible due to a low index of suspicion. Identification of brucella orchitis would result in proper medical treatment, thus preventing unnecessary surgery. We present a case of brucella orchitis, highlighting the place of brucellosis in the differential diagnosis of orchitis.

Adult↗