scholarly journals Efficacy, Safety, and Long-Term Follow-Up Results of EUS-Guided Transmural Drainage for Pancreatic Pseudocyst

2013 ◽  
Vol 2013 ◽  
pp. 1-6 ◽  
Author(s):  
Shin Kato ◽  
Akio Katanuma ◽  
Hiroyuki Maguchi ◽  
Kuniyuki Takahashi ◽  
Manabu Osanai ◽  
...  
Keyword(s):  
Adverse Event ◽  
Pancreatic Pseudocyst ◽  
Clinical Success ◽  
Pancreatic Pseudocysts ◽  
Technical Success ◽  
Tube Removal ◽  
Long Term Follow Up ◽  
Transmural Drainage

Background and Aim. EUS-guided transmural drainage (EUS-GTD) is now considered a minimally invasive and effective alternative to surgery for drainage of symptomatic pancreatic pseudocysts. However, the technique is rather difficult, and sometimes serious complications occur to patients undergoing this procedure. We retrospectively evaluated efficacy, safety, and long-term follow-up results of EUS-GTD for pancreatic pseudocyst. Methods. Sixty-seven patients with pancreatic pseudocyst who underwent EUS-GTD from April 2000 to March 2011 were enrolled. We retrospectively evaluated (1) technical success, (2) clinical success, (3) adverse event of procedure, and (4) long-term follow-up results. Results. Total technical success rate was 88%. Ninety-one percent of external drainage, 79% of internal drainage, and 66% of puncture and aspiration only achieved clinical success. There was only one case with an adverse event, perforation (1.5%). The case required emergency operation. Total recurrence rate was 23.9%. Median follow-up period was 33.9 months. The recurrence rates in the cases of stent remaining, spontaneously dislodged, removed on schedule, external tube removal, and aspiration only were 10.0%, 12.5%, 42.9%, 50%, and 0%, respectively. Conclusion. EUS-GTD is a relatively safe and effective therapeutic method. However, further analysis should be done by larger series to determine the method of EUS-GTD for pancreatic pseudocyst.

scholarly journals Long-term follow-up of abandoned transvenous defibrillator leads: a nationwide cohort study

EP Europace ◽  
2020 ◽  
Vol 22 (7) ◽  
pp. 1097-1102
Author(s):  
Anders Fyhn Elgaard ◽  
Jens Brock Johansen ◽  
Jens Cosedis Nielsen ◽  
Christian Gerdes ◽  
Sam Riahi ◽  
...  
Keyword(s):  
Clinical Success ◽  
Extraction Procedure ◽  
Clinical Success Rate ◽  
High Volume ◽  
Lead Extraction ◽  
Related Data ◽  
Major Complications ◽  
Long Term Follow Up

Abstract Aims  Commonly, a dysfunctional defibrillator lead is abandoned and a new lead is implanted. Long-term follow-up data on abandoned leads are sparse. We aimed to investigate the incidence and reasons for extraction of abandoned defibrillator leads in a nationwide cohort and to describe extraction procedure-related complications. Methods and results  All abandoned transvenous defibrillator leads were identified in the Danish Pacemaker and ICD Register from 1991 to 2019. The event-free survival of abandoned defibrillator leads was studied, and medical records of patients with interventions on abandoned defibrillator leads were audited for procedure-related data. We identified 740 abandoned defibrillator leads. Meantime from implantation to abandonment was 7.2 ± 3.8 years with mean patient age at abandonment of 66.5 ± 13.7 years. During a mean follow-up after abandonment of 4.4 ± 3.1 years, 65 (8.8%) abandoned defibrillator leads were extracted. Most frequent reason for extraction was infection (pocket and systemic) in 41 (63%) patients. Procedural outcome after lead extraction was clinical success in 63 (97%) patients. Minor complications occurred in 3 (5%) patients, and major complications in 1 (2%) patient. No patient died from complication to the procedure during 30-day follow-up after extraction. Conclusion  More than 90% of abandoned defibrillator leads do not need to be extracted during long-term follow-up. The most common indication for extraction is infection. Abandoned defibrillator leads can be extracted with high clinical success rate and low risk of major complications at high-volume centres.

The Evaluation of Aortic Diameter Changes During Long-Term Follow-Up After Endovascular Treatment of Acute Blunt Traumatic Thoracic Aortic Injuries

2018 ◽  
Vol 52 (5) ◽  
pp. 335-343 ◽  
Author(s):  
Federico Fontana ◽  
Edoardo Macchi ◽  
Filippo Piacentino ◽  
Larissa Nocchi Cardim ◽  
Giuseppe De Marchi ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Stent Graft ◽  
Mean Value ◽  
Aortic Diameter ◽  
Long Term Results ◽  
Technical Success ◽  
Long Term Follow Up ◽  
Aortic Injuries

Purpose: To evaluate the variations in aortic diameters and long-term results in patients who underwent thoracic endovascular aortic repair (TEVAR) for acute blunt traumatic thoracic aortic injuries (BTTAIs). Materials and Methods: We retrospectively evaluated 23 patients with a mean age of 39 years (range: 17-74 years) who underwent TEVAR for BTTAI between October 2000 and November 2014. All of the patients underwent computed tomography angiography (CTA) before hospital discharge as a baseline imaging for the subsequent follow-up examinations. The technical success, overall survival, and complications were evaluated. Furthermore, the aortic diameters outside of the stent-graft (1 cm proximal and 1 cm distal to the stent-graft) and the aortic diameters within the stent-graft (2 cm distal to the proximal end and 2 cm proximal to the distal end) were assessed. The diameters at baseline on CTA were compared with those of the latest available follow-up examination. Results: Technical success was 100% with a mean follow-up of 65.4 months (range: 12-171 months). No death was registered, and 2 (8.7%) of 23 endograft-related complications (1 stent-graft distal infolding and 1 endoleak 2 and 4 months after the procedure, respectively) were observed. An increase in aortic diameter either proximal or distal to the stent-graft (mean value 0.7 and 0.5 mm, respectively) or within the stent-graft (mean value of 0.5 mm for both proximal and distal diameters) was registered (mean follow-up at 65.4 months, range: 12-171 months). Conclusion: Aortic dilatation following TEVAR for BTTAI is minimal during long-term follow-up. Endovascular treatment represents a durable and safe option in acute BTTAIs.

scholarly journals Motion - Pancreatic Endoscopy is Useful for the Pain of Chronic Pancreatitis: Arguments for the Motion

2003 ◽  
Vol 17 (1) ◽  
pp. 57-59
Author(s):  
Stanley M Branch
Keyword(s):  
Chronic Pancreatitis ◽  
Pancreatic Duct ◽  
Endoscopic Therapy ◽  
Clinical Problem ◽  
Pancreatic Pseudocysts ◽  
Pancreatic Ducts ◽  
Success Rates ◽  
Long Term Follow Up

Pain is the dominant clinical problem in patients with chronic pancreatitis. It can be due to pseudocysts, as well as strictures and stones in the pancreatic ducts. Most experts agree that obstruction could cause increased pressure within the main pancreatic duct or its branches, resulting in pain. Endoscopic therapy aims to alleviate pain by reducing the pressure within the ductal system and draining pseudocysts. Approaches vary according to the specific nature of the problem, and include transgastric, transduodenal and transpapillary stenting and drainage. Additional techniques for the removal of stones from the pancreatic duct include extracorporeal shockwave lithotripsy. Success rates for stone extraction and stenting of strictures are high in specialized centres that employ experienced endoscopists, but pain often recurs during long term follow-up. Complications include pancreatitis, bleeding, infection and perforation. In the case of pancreatic pseudocysts, percutaneous or even surgical drainage should be considered if septae or large amounts of debris are present within the lesion. This article describes the techniques, indications and results of endoscopic therapy of pancreatic lesions.

Single-center experience with a dual microcatheter technique for the endovascular treatment of wide-necked aneurysms

2014 ◽  
Vol 121 (5) ◽  
pp. 1093-1101 ◽  
Author(s):  
Christopher R. Durst ◽  
Robert M. Starke ◽  
John R. Gaughen ◽  
Scott Geraghty ◽  
K. Derek Kreitel ◽  
...  
Keyword(s):  
Endovascular Treatment ◽  
Clinical Outcomes ◽  
Technical Success ◽  
Parent Vessel ◽  
Technical Success Rate ◽  
Single Center Experience ◽  
Long Term Follow Up ◽  
Coil Migration

Object The endovascular treatment of wide-necked aneurysms can be technically challenging due to distal coil migration or impingement of the parent vessel. In this paper, the authors illustrate an alternative method for the treatment of wide-necked intracranial aneurysms using a dual microcatheter technique. Methods The authors' first 100 consecutive patients who underwent coil embolization of a wide-necked aneurysm using a dual microcatheter technique are reported. With this technique, 2 microcatheters are used to introduce coils into the aneurysm. The coils are deployed either sequentially or concurrently to form a stable construct and prevent coil herniation or migration. Angiographic and clinical outcomes are reported. Results The technical success rate of the dual microcatheter technique is 91% with a morbidity and mortality of 1% and 2%, respectively. Clinical outcomes are excellent with 93% of patients demonstrating a modified Rankin Scale score of 0–2 at long-term follow-up regardless of their score at presentation. Retreatment rates are 18%. Conclusions The dual microcatheter technique may be a safe and efficacious first line of treatment for widenecked aneurysms.

Endoscopic Management of Pancreatic Pseudocyst: A Long-Term Follow-Up

Endoscopy ◽  
2002 ◽  
Vol 34 (03) ◽  
pp. 203-207 ◽  
Author(s):  
S. Sharma ◽  
N. Bhargawa ◽  
A. Govil
Keyword(s):  
Pancreatic Pseudocyst ◽  
Endoscopic Management ◽  
Long Term Follow Up

Lumen-apposing stents versus plastic stents in the management of pancreatic pseudocysts: a large, comparative, international, multicenter study

Endoscopy ◽  
2018 ◽  
Vol 51 (11) ◽  
pp. 1035-1043 ◽  
Author(s):  
Juliana Yang ◽  
Yen-I Chen ◽  
Shai Friedland ◽  
Ian Holmes ◽  
Christopher Paiji ◽  
...  
Keyword(s):  
Adverse Events ◽  
Clinical Success ◽  
Length Of Hospital Stay ◽  
Plastic Stents ◽  
Pancreatic Pseudocysts ◽  
Technical Success ◽  
Pancreatic Fluid ◽  
International Multicenter Study ◽  
Fluid Collections

Abstract Background Larger caliber lumen-apposing stents (LAMSs) have been increasingly used in the management of pancreatic fluid collections, specifically when solid debris is present; however, their advantages over smaller caliber plastic stents in the management of pancreatic pseudocysts are unclear. The aim of this study was to investigate the safety and efficacy of LAMS specifically in the management of pancreatic pseudocysts compared with double-pigtail plastic stents (DPPSs). Methods We performed a multicenter, international, retrospective study between January 2012 and August 2016. A total of 205 patients with a diagnosis of pancreatic pseudocysts were included, 80 patients received LAMSs and 125 received DPPSs. Measured outcomes included clinical success, technical success, adverse events, stent dysfunction, pancreatic pseudocyst recurrence, and need for surgery. Results Technical success was similar between the LAMS and the DPPS groups (97.5 % vs. 99.2 %; P = 0.32). Clinical success was higher for LAMSs than for DPPSs (96.3 % vs. 87.2 %; P = 0.03). While the need for surgery was similar between the two groups (1.3 % vs. 4.9 %, respectively; P = 0.17), the use of percutaneous drainage was significantly lower in the LAMS group (1.3 % vs. 8.8 %; P = 0.03). At 6-month follow-up, the recurrence rate was similar between the groups (6.7 % vs 18.8 %, respectively; P = 0.12). The rate of adverse events was significantly higher in the DPPS group (7.5 % vs. 17.6 %; P = 0.04). There was no difference in post-procedure mean length of hospital stay (6.3 days [standard deviation 27.9] vs. 3.7 days [5.7]; P = 0.31). Conclusion When compared to DPPSs, LAMSs are a safe, feasible, and effective modality for the treatment of pancreatic pseudocysts and are associated with a higher rate of clinical success, shorter procedure time, less need for percutaneous interventions, and a lower overall rate of adverse events.

scholarly journals Clinical outcomes of EUS-guided drainage of debris-containing pancreatic pseudocysts: a large multicenter study

2017 ◽  
Vol 05 (02) ◽  
pp. E130-E136 ◽  
Author(s):  
Dennis Yang ◽  
Sunil Amin ◽  
Susana Gonzalez ◽  
Daniel Mullady ◽  
Steven Edmundowicz ◽  
...  
Keyword(s):  
Treatment Outcomes ◽  
Clinical Outcomes ◽  
The United States ◽  
Term Treatment ◽  
Pancreatic Pseudocysts ◽  
Endoscopic Drainage ◽  
Technical Success ◽  
Long Term Treatment

Abstract Background and study aims Data on clinical outcomes of endoscopic drainage of debris-free pseudocysts (PDF) versus pseudocysts containing solid debris (PSD) are very limited. The aims of this study were to compare treatment outcomes between patients with PDF vs. PSD undergoing endoscopic ultrasound (EUS)-guided drainage via transmural stents. Patients and methods Retrospective review of 142 consecutive patients with pseudocysts who underwent EUS-guided transmural drainage (TM) from 2008 to 2014 at 15 academic centers in the United States. Main outcome measures included TM technical success, treatment outcomes (symptomatic and radiologic resolution), need for endoscopic re-intervention at follow-up, and adverse events (AEs). Results TM was performed in 90 patients with PDF and 52 with PSD. Technical success: PDF 87 (96.7 %) vs. PSD 51 (98.1 %). There was no difference in the rates for endoscopic re-intervention (5.5 % in PDF vs. 11.5 % in PSD; P = 0.33) or AEs (12.2 % in PDF vs. 19.2 % in PSD; P = 0.33). Median long-term follow-up after stent removal was 297 days (interquartile range [IQR]: 59 – 424 days) for PDF and 326 days (IQR: 180 – 448 days) for PSD (P = 0.88). There was a higher rate of short-term radiologic resolution of PDF (45; 66.2 %) vs. PSD (21; 51.2 %) (OR = 0.30; 95 % CI: 0.13 – 0.72; P = 0.009). There was no difference in long-term symptomatic resolution (PDF: 70.4 % vs. PSD: 66.7 %; P = 0.72) or radiologic resolution (PDF: 68.9 % vs. PSD: 78.6 %; P = 0.72) Conclusions There was no difference in need for endoscopic re-intervention, AEs or long-term treatment outcomes in patients with PDF vs. PSD undergoing EUS-guided drainage with transmural stents. Based on these results, the presence of solid debris in pancreatic fluid collections does not appear to be associated with a poorer outcome.

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