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Biomedical subjects

P Matsi

Publications and source records attributed to P Matsi.

9 recordsLinked to original sources
PubMed2001

Brachial arterial access: endovascular treatment of failing Brescia-Cimino hemodialysis fistulas--initial success and long-term results.

PURPOSE: To evaluate safety and efficacy of endovascular interventions in failing antebrachial Brescia-Cimino hemodialysis fistulas in consecutive patients. MATERIALS AND METHODS: Altogether, 103 interventions were performed in 53 Brescia-Cimino shunts in 51 patients by means of antegrade brachial arterial access. Twelve interventions were initiated with pharmacomechanical thrombolysis and/or thromboaspiration. All interventions included balloon angioplasty that was completed with stent placement in eight cases and with endovascular brachytherapy with an iridium 192 source in five cases. RESULTS: The technical success rate of the primary interventions was 92% (49 of 53) and that for all interventions was 95% (98 of 103). The rate of major complications was 4% (four of 103). Clinical success was achieved in 92% (95 of 103) of the interventions. By including the initial failures, 58% +/- 7 (standard error of the estimate), 44% +/- 8, 40% +/- 8, and 32% +/- 10 primary and 90% +/- 5, 85% +/- 5, 79% +/- 7, and 79% +/- 7 secondary clinical patency rates were registered at 6 months and 1, 2, and 3 years, respectively, by means of Kaplan-Meier analysis. The location of the main treated lesion at the arteriovenous anastomosis (P =.03) was a predictor of poorer long-term patency. CONCLUSION: Endovascular interventions with antegrade brachial arterial access are highly effective in restoring function in failing Brescia-Cimino fistulas.

Adult↗
PubMed1998

Adenovirus-mediated gene transfer to lower limb artery of patients with chronic critical leg ischemia.

Arterial gene transfer offers a promising new approach for the treatment of vascular disorders. However, no data are available about the gene transfer efficiency in human arteries in vivo. The aim of this study was to evaluate the safety and feasibility of catheter-mediated adenoviral gene transfer in human peripheral arteries. Ten patients (8 females, 2 males, mean age 80 +/- 8 years) suffering from chronic critical leg ischemia with a prior decision for amputation were recruited in the study. Gene transfer was performed in eight patients in conjunction with a conventional percutaneous transluminal angioplasty, using a perfusion coil balloon catheter. Two patients served as controls. Increasing concentrations of replication-deficient adenoviruses (titers from 1 x 10(8) to 4 x 10(10) PFU) containing a nuclear-targeted beta-galactosidase marker gene were administered into the arteries over 10 min via the catheter. Amputations were performed 20 to 51 hr after the procedures and gene transfer efficiency was evaluated in the transduced arteries using X-Gal staining for beta-galactosidase activity. Beta-galactosidase gene transfer was well tolerated and no adverse tissue responses or systemic complications were observed in any of the patients. Gene transfer was successful in six of the eight patients. Gene transfer efficiency varied between 0.04 and 5.0% of all arterial cells. Transgene expression was detected in smooth muscle cells, endothelial cells, and macrophages and in tunica adventitia. However, transgene activity was not evenly distributed in the arterial wall and no transgene activity was found beneath advanced atherosclerotic lesions. The safety and feasibility of in vivo gene transfer by adenoviral vectors to human peripheral arteries were established. Although improvements are still required in gene transfer efficiency, these findings suggest that adenoviruses can be used to deliver therapeutically active genes into human arteries.

Adenoviridae↗
PubMed1995

Percutaneous transluminal angioplasty in critical limb ischaemia.

To determine the utility of percutaneous transluminal angioplasty (PTA) in the treatment of chronic critical lower-limb ischaemia, a prospective study of 103 consecutive patients (117 limbs) was performed. A total of 209 lesions were treated in the iliac (n = 4), femoropopliteal (n = 121), and intrapopliteal (n = 84) arteries. The follow-up time was 1-36 months (mean 12 months). The technical success rate was 92% for stenosis and 80% for occlusion. The cumulative limb salvage rate was 56% at one year, 49% at two years and 49% at three years. The following factors correlated favourably with limb salvage in Cox multiple regression analyses: a small number of diseased lower-limb vessels (one to five vs six to eight) and treated lesions per limb (one to two vs three to five), peripheral runoff after PTA (at least one patent calf vessel vs none) and an occlusion as the successfully treated lesion (instead of stenosis).

Aged↗
PubMedDate not supplied

Percutaneous endovascular stenting: development, investigation and application.

Percutaneous endovascular stenting (PES), a new and alternative approach of interventional radiologic techniques, has encouraging potentials for management of vascular obstructive diseases. The most important role of PES is to prevent the risk of abrupt closure and to reduce the rate of early and late post-angioplasty restenosis (PARS) of PTA. Because of different working mechanisms, various stents show different advantages and disadvantages. Specific indications of PES are: (1) further compensation for failed PTA, (2) management of complications due to PTA and (3) primary treatment of vascular obstructive diseases. Based on a preliminary comparison with atherectomy, laser angioplasty and PTA, PES seems to provide an advantage for long-term patency of large caliber vessels such as iliac arteries, while more significant problems still exist in PES with small caliber vessels such as femoral-popliteal and coronary arteries. Further comparative clinical research is required to establish the utility of PES among other intraluminal techniques of vascular interventions.

Animals↗
PubMedDate not supplied

Image processing in digital chest radiography: effect on diagnostic efficacy.

The usefulness of digital image processing of chest radiographs was evaluated in a clinical study. In 54 patients, chest radiographs in the posteroanterior projection were obtained by both 14 inch digital image intensifier equipment and the conventional screen-film technique. The digital radiographs (512 x 512 image format) viewed on a 625 line monitor were processed in three different ways: (1) standard display; (2) digital edge enhancement for the standard display; and (3) inverse intensity display. The radiographs were interpreted independently by three radiologists. The diagnoses were confirmed by CT, follow-up radiographs and clinical records. Chest abnormalities of the films analyzed included 21 primary lung tumors, 44 pulmonary nodules, 16 cases with mediastinal disease and 17 cases with pneumonia/atelectasis. Interstitial lung disease, pleural plaques, and pulmonary emphysema were found in 30, 18 and 19 cases, respectively. The sensitivity of conventional radiography when averaged overall findings was better than that of the digital techniques (P less than 0.001). The differences in diagnostic accuracy measured by sensitivity and specificity between the three digital display modes were small. Standard image display showed better sensitivity for pulmonary nodules (0.74 vs 0.66; P less than 0.05) but poorer specificity for pulmonary emphysema (0.85 vs. 0.93; P less than 0.05) compared with inverse intensity display. We conclude that when using 512 x 512 image format, the routine use of digital edge enhancement and tone reversal at digital chest radiographs is not warranted.

Adolescent↗