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Biomedical subjects

Mark C Bates

Publications and source records attributed to Mark C Bates.

26 records · Page 2Linked to original sources
PubMed2002

Restenting for subclavian in-stent restenosis with symptomatic recurrent coronary-subclavian steal.

PURPOSE: To determine whether restenting for recurrent coronary-subclavian syndrome is technically feasible, provides durable results, and is a reasonable alternative to surgery. CASE REPORT: A 58-year-old woman with a left internal mammary artery (LIMA) bypass to the left anterior descending artery underwent angioplasty and stent placement for left subclavian stenosis and coronary-subclavian steal. Twenty-three months later, she returned with progressive angina and left arm claudication; heart catheterization demonstrated restenosis of the subclavian artery at the stent site with recurrence of the coronary-subclavian steal. Successful redo angioplasty and stenting resulted in normal antegrade flow through the LIMA graft. The patient has remained asymptomatic for 3 years without evidence of recurrent in-stent stenosis on serial noninvasive studies. CONCLUSIONS: Restenting is technically feasible and appears to be a durable response to subclavian in-stent restenosis in patients with coronary subclavian steal.

Angioplasty↗
PubMedDate not supplied

Endovascular intervention for stenosis following carotid stent-supported angioplasty--a case report.

This report is on a patient with symptomatic late restenosis after carotid stent-supported angioplasty (CSSA). Initially, the patient underwent carotid endarterectomy (CEA) with primary closure in response to an index transient ischemic attack 13 months before CSSA. He returned with angiographic evidence of recurrent carotid artery stenosis. A balloon-expandable stent was deployed with technical success. Follow-up angiography 1 year later showed an asymptomatic, noncritical in-stent restenosis (50%). Three years after the initial stent placement, the patient presented with ischemic symptoms and a carotid duplex confirming critical restenosis. The patient was successfully treated by deployment of a stent within a stent and showed significant hemodynamic improvement. This is a case report of late progressive restenosis, which raises concerns about long-term patency of CSSA in patients with aggressive postendarterectomy recurrence.

Angioplasty, Balloon↗
PubMedDate not supplied

Femoral pseudoaneurysms.

Iatrogenic pseudoaneurysms will continue to be a problem associated with arterial cannulation procedures. With the increasing trend toward minimally invasive procedures, vascular surgeons, as well as interventionalists will be performing more cannulation procedures; hence we will be more involved in the management of this complication more frequently. Treatment trends and efforts aimed at preventing iatrogenic pseudoaneurysms have evolved over the past decade. This article reviews the history and available literature on the subject, in conjunction with the experience of a center that performs over 10,000 cannulation procedures annually.

Aneurysm, False↗
PubMedDate not supplied

Stent-supported angioplasty correction of symptomatic critical carotid angulation.

Carotid stent-supported angioplasty is currently under investigation in many medical centers, for use in treating extracanial cerebrovascular disease. The early results of CSSA in selected patients appear promising. While carotid endarterectomy (CEA) remains the current standard of care, we believe that a small subgroup of patients at a high risk for surgery can benefit from CSSA. This case report describes a patient with symptomatic high-grade recurrent stenosis due to critical angulation (kinking) and redundancy of the internal carotid artery following CEA with patch angioplasty who was then treated successfully with CSSA.

Aged↗
PubMedDate not supplied

Internal carotid artery flow arrest/reversal cerebral protection techniques.

We report on the progress of an ongoing prospective non-randomized trial evaluating carotid artery stenting (CAS) with adjuvant cerebral protection in patients who are considered high risk for surgery. The 62 patients (34M/28F) in this study underwent CAS with interruption or reversal of flow in the internal carotid artery to protect the brain from embolization of particulate debris that may otherwise egress to the brain resulting in a stroke. Twenty-seven patients (44%) had restenotic lesions after remote carotid endarterectomy and 11 (18%) had previous radical neck surgery with external beam radiation therapy for cancer. The average length of hospital stay was 1.3 +/- 0.7 days. There were no strokes or transient ischemic attacks during the procedure or follow-up. Intolerance to ICA flow arrest or reversal was noted in five patients, but the procedures were completed in stages without sequella. No significant change in NIH scale was reported based on independent neurology evaluation when baseline average scores (0.72 +/- 1.1) were compared to follow-up at 30 days (0.50 +/- .05) P > 0.05. The positive outcome in this small study suggests that CAS may be a safe alternative to CEA in high-risk patients.

Balloon Occlusion↗
PubMedDate not supplied

Team approach with gynecologists taking the lead role in selecting patients for uterine artery embolization.

Uterine Artery Embolization (UAE) has become an increasingly popular treatment alternative to hysterectomy in the management of symptomatic uterine fibroids. Despite its growing promise, UAE has yet to be consistently offered by gynecologists to their qualified patient candidates. At the West Virginia University School of Medicine, Charleston Division, and Charleston Area Medical Center's Vascular Center of Excellence, we have implemented a team approach with gynecologists taking a pivotal role in the selection, co-management, and follow up of patients receiving UAE for the treatment of their uterine fibroids. We have developed a list of indications for UAE treatment in patients using our experience plus a literature search using Medline with keywords "Uterine Artery Embolization" and "Uterine Fibroids/Myomas."

Adult↗
PubMedDate not supplied

Extensive upper extremity arterial thrombosis as the initial manifestation of nephrotic syndrome.

The metabolic derangement and resultant hypercoagulable diathesis associated with nephrotic syndrome (NS) has been clearly defined. Although venous thrombosis is frequently encountered in NS, arterial thrombosis is rare. This report describes an index case of a patient without known renal disease who presented with spontaneous arterial thrombosis of an upper extremity as the initial manifestation of NS. The case was complicated by subsequent deep venous thrombosis and pulmonary embolus in the absence of a patent foramen ovale. The patient was successfully treated with brachial artery thrombectomy followed by anticoagulation and immunosuppressive therapy. A renal biopsy was considered, but this would have required interruption of anticoagulation. This case illustrates the importance of performing a simple screening urinalysis for occult protein in patients with unexplained venous or arterial non-embolic thrombosis.

Adult↗