Biomedical subjects

P G Bove

Publications and source records attributed to P G Bove.

3 recordsLinked to original sources

PubMed2000

Transrenal fixation of aortic stent-grafts for the treatment of infrarenal aortic aneurysmal disease.

PURPOSE: We evaluated our early experience with the transrenal fixation of aortic stent-grafts to determine the efficacy of this procedure and its effects on renal artery patency and hemodynamics. METHODS: Twenty-eight patients (22 men) had endoluminally placed modular bifurcated stent-grafts with a bare spring structure at the proximal end crossing the origin of both renal arteries; no patient with infrarenal fixation was included for analysis. The mean age of the patients was 75 +/- 7 years (range, 58-86 years); the mean aneurysm size was 5.8 +/- 0.8 cm (range, 4.7-7.2 cm). Eight patients had preoperative or intraoperative angiographic evidence of renal artery atherosclerotic disease, but only four vessels had luminal narrowing of 50% or greater. No complications were noted during stent-graft placement, and all patients have returned for follow-up visits, ranging from 1 to 12 months (mean follow-up, 6 +/- 4 months). Follow-up evaluations included clinical assessment, duplex ultrasound scan of the renal arteries and kidneys, and computed tomographic angiography. RESULTS: No evidence of lobular or sublobular perfusion defects of the renal parenchyma was detected postoperatively. Two patients exhibited postoperative changes in renal artery hemodynamics-one progressing from a 30% diameter reduction to a greater than 60% diameter stenosis at the 12-month follow-up visit and one with a normal renal artery preoperatively having elevated flow velocities indicative of a greater than 60% stenosis at the 1-month visit. Of 19 patients with normal preoperative renal function, only one has had persistently elevated serum creatinine levels. CONCLUSION: We conclude from this experience that the transrenal placement of open stents is safe and effectively excludes the aneurysm, potentially expanding the availability of this technique to more patients with a short infrarenal aortic neck. Long-term follow-up is essential to determine the overall efficacy of this technique and to identify potential effects on renal artery hemodynamics or kidney function.

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PubMed1998

Three-dimensional vascular imaging using Doppler ultrasound.

BACKGROUND: We have evaluated the efficacy of using three-dimensional reconstruction of amplitude Doppler imaging data to quantitatively assess carotid artery bifurcation stenoses. METHODS: Sixty-four consecutive frames of amplitude (power) Doppler images are stored to be reassembled into a three-dimensional image representing the patent lumen. These images can then be rotated by any angle necessary to clearly view the vascular anatomy and to make quantitative ultrasound caliper measurements of the stenotic lumen and normal vessel caliber. RESULTS: Three-dimensional Doppler images accurately classified 53 of 61 vessels (87%) into categories of stenosis compared with angiography. All stenoses with >60% diameter reduction were detected and classified as such, for a sensitivity of 100%. CONCLUSIONS: Three-dimensional vascular imaging based on amplitude (power) Doppler data provides an accurate noninvasive technique for quantitative diagnosis of carotid bifurcation atherosclerotic disease, with selectable viewing projections that eliminate vessel overlap and other artifacts, and complements the hemodynamic data already available with two-dimensional duplex ultrasound.

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PubMed1994

Hemodynamic sequelae of combined arteriovenous injury in an experimental canine hindlimb model: venous ligation vs. repair.

The hemodynamic effects of combined venoarterial injury and stasis were studied in the hindlimbs of 10 dogs. Femoral arterial blood flow and pressure, peripheral venous pressure, and peripheral resistance were measured after the restoration of blood flow following venoarterial injury and a 4-hour period of occlusion for up to 72 hours. In one limb of each animal both the artery and vein were repaired, whereas only the artery was repaired in the other limb and the vein was ligated. Arterial blood flow was similar in both groups but was significantly diminished from baseline for the first 30 minutes after restoration of blood flow, but then it became significantly reduced in the limbs with venous ligation when compared with values in those with venous repair. By 72 hours the flow on both sides returned to control values. Peripheral venous hypertension and edema occurred in all 10 limbs with venous ligation and persisted for the 72-hour experimental period. In the 10 limbs with venous repair, edema occurred in four and venous hypertension in none. The peripheral resistance was elevated on both sides; this elevation persisted for 75 minutes and then dropped to control values. None of the repaired arteries and only one repaired vein thrombosed during the experiment. Combined venous and arterial occlusion for 4 hours reduced both the amount of arterial flow and its subsequent rate of increase compared with changes seen after release of an acute venous occlusion. The rate of increase was enhanced by repair of the affected venous segment compared with simple venous ligation.

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