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Biomedical subjects

J H Peregrin

Publications and source records attributed to J H Peregrin.

At least 19 recordsLinked to original sources
PubMed2000

Mechanical thrombolysis of thrombosed hemodialysis native fistulas with use of the Arrow-Trerotola percutaneous thrombolytic device: our preliminary experience.

PURPOSE: To evaluate the feasibility of use of the Arrow-Trerotola percutaneous thrombolytic device (PTD) in the treatment of thrombosed hemodialysis native fistula occlusions. MATERIALS AND METHODS: Ten patients with native fistula occlusion underwent mechanical thrombolysis with use of the PTD. The standard PTD was used in seven patients and the over-the-wire device was used in three patients. Major outcomes of our study included procedure time, clinical success, complication rate, and 3- and 6-month patency rates. RESULTS: The technical success rate was 100% and the clinical success rate was 90% (9 of 10). In all 10 cases, the procedure was associated with angioplasty. There were no major complications. The mean time of successful procedures was 126.1 minutes. The 3- and 6-month primary patency rates were 70% and 60%, respectively; the assisted primary patency rate at 6 months was 80%. CONCLUSION: The PTD is an effective mechanical device for percutaneous treatment of thrombosed hemodialysis access. Our clinically successful initial experience with the PTD shows that the technique is rapid and safe for treatment of native fistula occlusions.

Feasibility Studies↗
PubMed2000

Evaluating the outcome of percutaneous transluminal angioplasty in renal graft artery stenosis using the areas under the time curve of glomerular filtration rate and blood pressure.

The benefit of percutaneous transluminal angioplasty (PTA) of transplant renal artery stenosis for ischemic nephropathy may be adversely affected by rejection or other complications. As a result, assessment of the effect of PTA on renal function or blood pressure is often difficult. In this paper, we evaluated the effect of PTA using the method of integrated glomerular filtration rate (GFR) based upon the area under the curve over a follow-up period (AUC0-1), to express the level of GFR in a simple manner despite its significant fluctuations. A similar procedure was used to evaluate mean arterial pressure (MAP). The method was employed to assess the outcome in 20 individuals before PTA, and 1, 3, 6, 9 and 12 months after PTA. In eight cases, rejection was detected while there was one case of glomerulonephritis in the graft during the follow-up period. Evaluation (AUCCcr)0-12 related to the integrated pre-PTA value of Ccr [(Ccr)0 x 12] revealed a rise in GFR by more than 20 % in 65 % of cases. No improvement was observed in seven individuals with post-PTA complications. When assessing the integrated value of MAP, success of PTA (a reduction by at least 10 %) was found in 85 % of cases. No significant correlation was found between the relative changes of integrated GFR and MAP. Our data suggest that evaluation of the integrated value of GFR or MAP on the basis of AUC0-t allows to characterize, in a simple manner, the level of graft function and MAP throughout the follow-up period in individual cases. Furthermore, it may provide additional information on the average values obtained at different time intervals after the therapeutic procedure.

Adult↗
PubMed1999

[Evaluation of the results of percutaneous transluminal angioplasty of arterial stenosis in the transplanted kidney using area under time curves of the glomerular filtration rate and blood pressure].

The benefit of percutaneous transluminal angioplasty (PTA) of renal transplant artery stenosis for renal hemodynamics is frequently adversely affected by rejection or another complication. As a result, evaluation of the effect of PTA is often difficult. Our study was designed to assess the effect of PTA using a method of integrated value of the glomerular filtration rate (GFR) calculated on the basis of the area under the curve over the follow-up period (AUC0-t). A similar procedure was employed to evaluate mean arterial pressure (MAP). The method was used to assess the outcome in 20 individuals before to PTA, and at 1, 3, 6, 9 and 12 months after angioplasty. A rejection episode was diagnosed in eight cases and glomerulonephritis of the graft in one. Using the evaluation of (AUCCcr)0-12 in relation to the integrated value before PTA (Ccr) x 12, a rise in GFR > 20% was found in 65% of cases. PTA failure was observed in seven individuals developing post-PTA complications. When assessing the integrated value of MAP, PTA was found to be successful (a reduction by at least 10%) in 85% of cases. No significant correlation was demonstrated between the integrated values of GFR and MAP. The results support the assumption that the evaluation of the integrated values of GFR or MAP using AUC0-t allows to characterize, in a simple manner, the degree of renal transplant function or MAP throughout the follow-up period, and to furnish additional information to the values obtained at individual time intervals after the therapeutic procedure.

Adult↗
PubMed1997

[Percutaneous transluminal angioplasty of the renal artery in transplanted kidneys].

UNLABELLED: The objective of the work was to evaluate the contribution of percutaneous transluminal angioplasty (PTA) to treatment of hypertension and the graft function of a transplanted kidney. Angioplasty of the graft artery was performed in 39 patients. Technical success rate: 85%. COMPLICATIONS: 13%--in particular during the first years after introduction of the method. Twenty seven patients were followed up on a long-term basis. Changes of the median arterial pressure (MAP) were evaluated as well as glomerular filtration (GF) assessed by creatinine clearance. Mean values: [table: see text] A statistically significant (p < 0.01) reduction of the median arterial pressure (drop by > 10 mm Hg) along with reduction of the number of antihypertensive drugs was recorded in 70% of the patients during the first year and in 80% kidney recipients in investigations extending beyond one year. A significant increase of glomerular filtration (by > 20%) was found in 40% of the patients, on average the rise was insignificant. During the follow up period 13 kidney recipients were transferred to a dialyzation programme due to failure of the grafts as a result of rejection. CONCLUSION: Percutaneous transluminal angioplasty of a stenosis of the graft artery is the method of first choice in the treatment of hypertension. It is of fundamental importance also in rare cases in order to preserve or improve graft function and thus delay dialyzation treatment.

Adult↗
PubMed1993

Temporary balloon closure of a postinfarction interventricular septal rupture.

The technical aspects of temporary closure of a postinfarction interventricular septal rupture in a 76-year-old woman in critical circulatory status ruling out conservative therapy and making surgical management unfeasible, are described. The patient was in cardiogenic shock with hepatorenal failure in acute myocardial infarction of both the anterior and posterior walls. A balloon catheter developed in our unit was employed to close the rupture.

Aged↗
PubMed1992

Detachable balloon embolization of an iatrogenic aortocoronary arteriovenous fistula combined with aortocoronary bypass PTCA: a case report.

Coronary artery bypass surgery was performed in a 54-year-old male, and one of the grafts was inadvertently sutured to the vena cordis magna instead of to the left anterior descending coronary artery (LAD). Four years later the patient observed a progression of symptoms including episodes of angina pectoris at rest. Coronary angiography showed stenosis of one of the bypass grafts and notable dilatation of an iatrogenic arteriovenous (A-V) fistula. The stenosed bypass graft was dilated and the A-V fistula occluded by use of a detachable balloon. Embolization was performed rather than surgery, as the LAD was found to be a poor surgical target. The patient's symptoms improved after the procedure; he was followed for 18 months during which time his condition remained stable.

Angina Pectoris↗
PubMed1992

Total recovery of left ventricular function after acute myocardial infarction: comprehensive therapy with streptokinase, N-acetylcysteine and percutaneous transluminal coronary angioplasty.

In this report we describe our first use of N-acetylcysteine in a patient with his first acute myocardial infarction in an effort to reduce the infarct size and to protect left ventricular function by pharmacological and mechanical therapy (thrombolysis and percutaneous transluminal coronary angioplasty). This comprehensive therapy caused normalization of previously depressed left ventricular systolic function.

Acetylcysteine↗
PubMed1990

[Therapeutic embolization of the venous bed using Vilan 500 in animal experiments].

The experiment in four dogs verified a suitability of the Czechoslovak preparation Vilan 500, a copolymer of polyvinyl acetate - polyvinyl alcohol in 93% ethanol, for the embolism of venous vascular bed in the percutaneous, transfemoral catheterization way. In all four cases there was a complete occlusion of embolized spermatic or pararenal veins, verified by a control angiography after one hour and after three months. The prepared venous samples were also examined by histology and changes indicating intraluminar thrombotization and subsequent fibrous reconstruction were observed. In view of the results reached it may be concluded that the catheterization technique and the use of Vilan 500 is suitable as an alternative of non-surgical solution of varicocele.

Animals↗
PubMed1989

Takayasu's arteritis and nephrotic syndrome in a patient with crossed renal ectopia.

A male patient with nephrotic syndrome, crossed renal ectopia, and extensive Takayasu's arteritis (TA), involving one of the renal arteries, is described. Renal histology showed amyloidosis. After reviewing the literature and considering the finding of raised serum amyloid protein A levels, it was concluded that TA had probably caused the amyloidosis. The crossed renal ectopia must have been a purely coincidental finding.

Adult↗
PubMed1986

Embolization of the kidney in secondary renal hypertension as an alternative to surgical nephrectomy. An experimental study.

Embolization of the renal arterial bed with embolization agent Vilan 500 was performed in 13 dogs. Embolized kidneys shrink after the procedure and the functional parenchyma is extinguished. Peripheral PRA values were followed to find out whether renin production by the embolized kidney is extinguished (the non-embolized kidney was surgically removed). In nine of the thirteen dogs peripheral PRA decreased below 0.5 ng/ml/h; this renin activity can be considered extrarenal. Embolization of the kidneys with Vilan 500 can thus substitute surgical nephrectomy in patients with secondary renal hypertension.

Animals↗
PubMed1984

New occlusive agent for therapeutic embolization tested in dogs.

A new occlusive agent, Vilan 500, was used to embolize the arterial bed of the kidney in 12 dogs. This polyvinyl acetate, alcohol-soluble agent becomes gelantinous on contact with an aqueous environment and its low viscosity makes this material well suited for application through small-caliber catheters. Complete arterial occlusion of the embolized kidneys was observed in all animals. On histologic examination of tissue 4-6 weeks after the procedure, changes were seen such as shrinkage through fibrosis, diffuse necrosis and atrophic parenchyma. No signs of recanalization of the embolized artery or functional collateral circulation were noted in any dog.

Animals↗