Publications by authors named "Palestrant A"

Purpose: To evaluate the safety and efficacy of a hydrodynamic thrombectomy system in a prospective, multicenter randomized comparison with pulse-spray thrombolysis in hemodialysis grafts.

Materials And Methods: Nine centers enrolled 120 adult patients with recently ( View Article and Find Full Text PDF

Purpose: To evaluate the safety and efficacy of fluoroscopically directed percutaneous gastrostomy and gastrojejunostomy catheter placement with gastropexy.

Materials And Methods: The authors retrospectively reviewed the charts from 643 patients referred for fluoroscopically directed percutaneous gastrostomy or gastrojejunostomy during a 9 1/2-year period. In 615 patients, placement was attempted with use of three T-fastener gastropexy devices followed by percutaneous gastric puncture.

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Background: Percutaneous endoscopic gastrostomy (PEG) has been established as a faster and safer procedure than open surgical gastrostomy. It cannot be done, however, for many patients with partially obstructing pharyngeal or esophageal carcinoma, previous gastrectomy, upper abdominal surgery, or bowel distension from distal obstruction.

Patients And Methods: We attempted percutaneous radiologic-assisted gastrostomy (RAG) in 231 patients referred for gastrostomy, 38 of whom had a relative contraindication for PEG.

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A new self-centering stainless steel inferior vena cava filter (clover leaf filter) that can be delivered percutaneously through a 10-F catheter has been developed. The filter is loaded into an angiographic catheter as a set of straightened wires that are mechanically deformed into a predetermined clover leaf shape when the device is delivered. The filter can be deployed easily and effectively into the simulated vena cava.

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A closed irrigation and drainage system has been used in 50 consecutive patients to assess its effectiveness in maintaining catheter patency and draining fluid collections. It consists of an irrigation fluid source, flushing syringe, drainage bag, and tubing to connect the components, and is assembled when the initial drainage procedure is performed. The system emphasizes the use of the siphon effect to maintain constant suction and a closed irrigation and drainage configuration that prevents spread of infection to others and minimizes contamination of the drained cavity.

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A technically successful biopsy or drainage procedure performed with computed tomographic (CT) guidance depends on two essential elements: determination of the correct entry point on the patient and placement of the biopsy needle or trocar drainage catheter along a predetermined track. A hand-held guidance device was used in conjunction with the lighting system on the CT scanner and measurements obtained from CT images to achieve this goal in 40 patients. The approach minimized trauma to the patient and decreased the time required for CT.

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To determine the biocompatibility and thrombogenicity of nitinol blood clot filters, we inserted 27 nitinol wire devices into the venae cavae of 16 dogs and one sheep and studied the results angiographically and at autopsy after periods of one week to four years. Filter shape, location in the vena cava, wire cleaning procedure and wire surface finish were varied. All 18 cleaned nitinol wire filters remained patent by venogram, although some showed small venographic filling defects caused by adherent organized thrombi.

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Fifty-one patients were analyzed after a randomized double-blind study comparing Hexabrix and Renografin 60 in peripheral arteriography. The arteriographic studies and the volumes of contrast material used in both groups were similar. Hexabrix caused significantly less pain and discomfort than Renografin 60, and the diagnostic quality of the radiographs was comparable.

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Gastrostomies have been performed nonoperatively under local anaesthesia using a simultaneous percutaneous and endoscopic approach. This technique has been modified to be done under fluoroscopy without the need for endoscopy. The technique and results in five dogs are described.

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A prospective ultrasound study of the right upper quadrant in 105 patients who had undergone cholecystectomy showed the incidence of fluid collection in the gall bladder fossa to be 24% 2 to 4 days after operation. In all but two patients, these fluid collections were of no clinical significance. The relationship between the presence of fluid and several other variables, such as use of drains and surgical techniques, are discussed.

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Fifty-one patients were analyzed after a randomized double-blind study comparing Hexabrix and Renografin 60 in peripheral arteriography. The arteriographic studies and the volumes of contrast material used in both groups were similar. Hexabrix caused significantly less pain and discomfort than Renografin 60, and the diagnostic quality of the radiographs was comparable.

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An inferior vena cava filter made from nitinol, a thermal shape memory alloy, was evaluated. A series of in vitro experiments was designed to assess its shape recovery, orientation, and positioning after delivery and its embolus-capturing efficiency. For comparison, the Mobin-Uddin and Kimray-Greenfield filters were also tested.

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