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L C Van Dijk

Publications and source records attributed to L C Van Dijk.

3 recordsLinked to original sources

Cerebral protection during percutaneous carotid intervention: wich device should be used ?

Embolic complications remain the major and unpredictable clinical event during carotid angioplasty and stenting. Cerebral protection devices could play an important role in the prevention of such emboli. Protection devices such as occlusion balloons, filters and reversed flow devices are currently undergoing clinical evaluation and appear to be promising in reducing the incidence of embolic events. This article provides an overview of the three different types of embolic protection devices.

Angioplasty↗

Peripheral vascular brachytherapy: an introduction.

The response of cells to ionising radiation has been extensively studied for the past 30 years. When radiation is absorbed in biological material, it can directly ionise a critical site (direct effect) or interact with other molecules to produce reactive free radicals, which can subsequently damage critical biological molecules (indirect effect). DNA is considered the critical target damaged by ionising radiation by both direct and indirect processes. Since radiotherapy had proven to be effective in the treatment of non-malignant proliferative processes, it was assumed that this adjunctive treatment would also inhibit vascular restenosis. The major difference between external and intravascular radiation is dose distribution. Intravascular delivery results in extremely high doses to the lumen with a fall-off in dose as a function of distance from the source; whereas, external beam would deliver a uniform dose over the entire volume of tissue treated. Unlike in the coronary circulation most of the peripheral vessels treated are greater than 3 mm in diameter; in fact many are 7 to 10 mm in diameter. Since beta radiation is related to lower penetration properties and more heterogeneous distribution of radiation in comparison to gamma radiation, it is therefore necessary to use a gamma radiation source because it would be difficult to irradiate the sub-intimal tissue with a beta source centred in a large vessel. Radiation can and does have the potential to destroy blood vessels. The challenge in vascular brachytherapy is to treat blood vessels to a point where restenosis is inhibited; yet the vessel is not irreparably damaged.

Animals↗

Changes in coronary pressure-flow relation after transition from blood to Tyrode perfusion.

In six isolated, diastolic-arrested, maximally vasodilated cat hearts, we studied changes in coronary pressure-flow relations (zero-flow pressure intercept, resistance) during the first 25 min, after a change of perfusate, from blood to Tyrode. The apparent intercept (zero-flow) pressure changed from 2.0 +/- 0.94 (+/- SD) kPa during blood perfusion to 2.5 +/- 0.55, 2.6 +/- 0.68, 2.5 +/- 0.94, and 2.7 +/- 1.34 kPa during Tyrode perfusion for 2:15, 5:30, 10:30, and 25:00 min, respectively. Intercept pressures during Tyrode perfusion were significantly different from the intercept pressure during blood perfusion, except for the one measured after 25 min of Tyrode perfusion (P less than 0.05). Resistance (defined as the ratio of perfusion pressure and flow at 10 kPa perfusion pressure) steadily rose to approximately 170% of the value during blood perfusion. The observation that the apparent intercept pressure is maintained, when a particle-free (Newtonian) isotonic perfusate is used, may indicate that this intercept is not a result of blood rheology alone. The increase rather than decrease in resistance suggests an effect of edema, which increases interstitial volume at the expense of intravascular volume.

Animals↗