Biomedical subjects

V Rajyaguru

Publications and source records attributed to V Rajyaguru.

5 recordsLinked to original sources

PubMed1989

Laser arterial disobstructive procedures in 148 lower extremities.

Preoperative arteriographic findings in immediate postoperative results as well as follow-up studies of treatment with argon and YAG lasers have been evaluated in 148 lesion found in 137 patients. Preoperative arteriography revealed a solitary lesion in 42 of 148 legs (28%) examined, and a combined lesion was found in the remaining 106 legs (72%). Incapacitating intermittent claudication, rest pain, tissue loss, or a combination of these was an indication for laser arterial reconstruction. None of the argon laser-treated lesions was treated with balloon dilatation, but since March 1988 all appropriate YAG laser-treated lesions were immediately followed by laser-assisted balloon angioplasty. The lesions in 64 of 89 legs (72%) treated by argon and 42 of 59 (71%) treated by YAG were successfully recanalized. However, successful angioplasty was performed in 44 of 89 (49%) and 34 of 59 (58%) lesions, respectively. The recanalization depended on the type of lesion (tight stenosis vs occlusion) and the length of lesion (localized vs total-length occlusion). However, the success rate of recanalization was almost the same as the success rate when both laser systems were used. Argon laser treatment proved successful in 19 of 20 (95%) segmental occlusions in popliteal arteries, whereas YAG laser treatment proved successful in four of five (80%) short segmental (less than 15 cm) occlusions of superficial femoral arteries and in 16 of 23 (70%) long segmental (greater than or equal to 15 cm) occlusions of superficial femoral arteries. In 26 of 36 (72%) total-length occlusions of superficial femoral and popliteal arteries, recanalization was not possible (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1989

Laser recanalization, laser assisted balloon angioplasty and laser angioplasty.

The efficacy of laser recanalization (LR), laser assisted balloon angioplasty (LABA) and laser angioplasty (LA) was evaluated. These procedures were performed a total of 55 times upon 49 patients who had occlusive arterial disease of a lower extremity with a history of incapacitating, intermittent claudication, rest pain or loss of tissue, or all three. Patients with lesions through which a guide wire could be passed were eliminated from this study. Two lesions in the common iliac artery, 44 in the superficial femoral artery, seven in the popliteal artery and two in the infrapopliteal artery were studied. Thirty-nine of 55 lesions (71 per cent), including 12 of 12 stenoses and 27 of 43 occlusions (63 per cent), were successfully recanalized. None of the seven total length occlusions were successfully recanalized (p less than 0.001); perforation occurred in four. Bypass procedures were required in six of 13 and two of 25 lesions treated by LR and LABA, respectively (p less than 0.05). All patients with lesions successfully recanalized using LR, LABA and LA were observed for a period of 15 days to six months, with an 82 per cent patency rate (32 of 39). Total length occlusions are not a good indication for treatment with currently available laser techniques. The addition of balloon dilation in LR decreased the requirement for bypass procedures in a significant number of patients.

Angioplasty, Balloon↗

PubMed1989

Laser-assisted reconstructive vascular surgery.

To clarify the efficacy of laser-assisted reconstructive vascular surgery (LARVS) for patients with severe symptoms of peripheral arterial occlusive disease, 118 ischemic legs of 104 patients were retrospectively analyzed (argon:89 and YAG:29 lasers). Of those 118 legs, 26 (22%) had tissue loss, 60 (51%) had rest pain, and 32 (27%) had incapacitating intermittent claudication. The LARVS was adequate in 60 of 118 (51%) and inadequate in 58 of 118 (49%). With argon:89 and Nd:YAG:29 lasers, respectively, 41 of 89 (46%) and 19 of 29 (66%) were adequate. In the superficial femoral artery (SFA) and popliteal artery (PA), the LARVS was adequate in 31 of 43 (72%) in segmental occlusion and in one of 31 (3%) in total-length occlusion (p less than 0.001). In segmental occlusion of the SFA, however, argon:89 and Nd:YAG:29 lasers were adequate in four of 12 (33%) and in 10 of 12 (83%), respectively (p less than 0.05). The legs in which laser was used in more than one artery (eight of eight) or in occluded grafts (proximal SFA to distal PA; three of 18) required amputation within 30 days. A follow-up study demonstrated patency in 31 of 34 (91%) 1-24 months later with the argon:89 laser and in 15 of 16 (94%) 1-6 months later with the Nd:YAG:29 laser. This study indicates that LARVS was adequate in segmental occlusions, particularly in SFA and PA lesions; however, total-length occlusions and combination arterial lesions were not appropriate for the currently available laser systems. Laser application should not be performed if a guidewire passes through the lesion, since these lesions may be more appropriately treated with balloon angioplasty.

Aged↗

PubMed1989

YAG laser angioplasty in lower extremity: sole therapy as well as adjunct to balloon dilatation.

To evaluate efficacy of the YAG laser in severe occlusive arterial lesions of lower extremity, 64 lesions were considered for either laser recanalisation (LR) or laser assisted balloon angioplasty (LABA). Indications for the procedure were incapacitating intermittent claudication (28), rest pain (17) and tissue loss (19). Of those 64, 46 (72%) were recanalised whereas 38 (59%) recanalised to adequate diameter. In stenoses, segmental occlusions and total length occlusions, successful recanalisation resulted in 12/12 (100%), 28/35 (80%) and 6/17 (35%) cases respectively. As compared to stenoses and segmental occlusions, successful recanalisation rate was significantly low in total length occlusions (p less than 0.001). Addition of balloon dilatation to LR decreased the requirement of additional by-pass surgery from 6/16 (60%) to 2/30 (7%) (p less than 0.05). Addition of balloon dilatation to LR had improved the results.

Angioplasty, Balloon↗

PubMedDate not supplied

Gastrointestinal hemorrhage in end stage renal disease patients.

Over a six year span, 41 patients with end stage renal disease (ESRD) were treated for 53 episodes of upper and lower gastrointestinal (UGI & LGI) hemorrhage. Thirty-two patients (78%) were diagnosed as having UGI bleeding and nine patients as having LGI bleeding. Mucosal inflammation of the esophagus, stomach and duodenum were the predominant etiologies of UGI bleeding (64%). The predominant cause of LGI hemorrhage was diverticular disease (33%). Angiodysplasias were found in six patients (15%), four with UGI bleeding and two with LGI bleeding. In the UGI hemorrhage group 20% of the bleeding episodes were recurrent and 13% were from multiple sites. There were no recurrent bleeding episodes in the LGI hemorrhage group. We therefore conclude that UGI bleeding is much more common than LGI bleeding in ESRD patients, and that there is a significantly higher tendency for recurrent bleeding episodes and for multiple bleeding sites in the UGI hemorrhage patients. We also note a higher prevalence of angiodysplasias of the upper and lower gastrointestinal tract in ESRD patients.

Adult↗