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Biomedical subjects

N Akaba

Publications and source records attributed to N Akaba.

8 recordsLinked to original sources
PubMed1992

A cylinder-shaped balloon catheter for the management of dissecting aneurysms in acute stage.

We developed a new procedure to close the entry of dissecting aneurysm in acute stage with a specially designed cylinder-shaped balloon catheter. The balloon catheter consists of 7F double lumen catheter and a silicone rubber balloon at the tip. The balloon has a central tube 14 mm caliber made of rigid silicone and it inflates into the shape of a cylinder with an injected solution. The central tube serves as a route for maintaining the aortic blood flow to the distal site. The catheter with a deflated balloon is inserted into the thoracic aorta ascendingly through a 14 or 16 mm caliber Dacron vascular graft sutured at the side of the distal aorta in a similar manner to intra-aortic balloon pumping. The tip of the catheter is carried to the entry tear of the pseudo-lumen. Then the cylinder-shaped balloon is inflated with solution. The entry is, therefore, closed with the side wall of the balloon and the blood stream into the dissected lumen is occluded while maintaining an aortic blood flow to the distal site. To prevent any possible occlusion due to thrombosis, some type of anticoagulant is administered via the catheter connected to a continuous injector. The healing process of the dissected lumen can be enhanced by injecting some type of coagulant directly into the lumen. The treatment is completed when the blood in the false lumen coagulates and stabilizes. The cylinder-shaped balloon is then deflated and the catheter withdrawn. The graft is removed and the stump is sutured.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Disease↗
PubMed1988

[Management of hemoperitoneum due to rupture of visceral branches of the aorta with a cylinder-type balloon catheter].

We have designed a cylinder-type balloon catheter and devised a new procedure for the management of the aneurysm in a condition difficult for treatment. This balloon catheter consists of a balloon located at the tip of a catheter. The balloon has a central lumen for maintaining the distal aortic bloodflow and can be inflated at various intended sites. The catheter with a deflated balloon was inserted into the abdominal aorta upward through a vascular graft sutured at the side of the aorta. In the case of a ruptured visceral artery, e.g., celiac axis or superior mesenteric artery, controlling of hemorrhage is very difficult because the ruptured lesion is surrounded by an intricate anatomical structure and therefore it is necessary to do the highly invasive procedure of aortic cross-clamping. Therefore we attempted this time to use the device in the management of this disease. In experimental investigation in dogs, this balloon selectively blocked the blood flow to the visceral branches successfully while maintaining the distal aortic flow. With this method, the various hemostatic procedures can be performed satisfactorily without concern for complications, namely renal failure provided that hemorrhage is easy to control in a short time without the aortic clamp. As mentioned above, this instrument will be useful for the management of rupture of the visceral artery and so reduce its mortality rate.

Animals↗
PubMed1986

Management of acute aortic dissections with a cylinder-type balloon catheter to close the entry.

Despite recent advances in medical treatment, an acute aortic dissection is still now often fatal because of the seriousness of its condition. The currently available therapies include blocking the progress of dissection with intensive drug therapy, a process leading to the chronic stage. However, the dissection often proceeds rapidly and may result in death. Various surgical procedures have been attempted so far, but they produce highly invasive stress and high risks. Accordingly, we designed a cylinder-type balloon catheter and developed a new closing procedure, wherein a balloon catheter is introduced and inflated at the site with an intimal tear to maintain the blood flow to the distal vessels and also to close the entry. With this procedure, the complaints will be relieved or disappear, the progress of the dissection can be stopped, and the blood flow can be restored to the reduced and collapsed true lumen. When the blood in the pseudolumen becomes coagulated and organized, the balloon is removed. If this catheter is introduced from the femoral artery (similar to an intra-aortic balloon pumping method), the invasive stress will be further reduced. This method appears to be the most useful for DeBakey type III dissections. We are now intensively studying the safe and effective application of this balloon catheter under various clinical conditions.

Aortic Dissection↗