The recommended treatment temperature for endovascular radiofrequency obliteration (RFO) of the great saphenous vein (GSV) is 85 degrees C. Faster catheter pullback rates are possible when the operating catheter tip temperature is increased. We studied the safety and effectiveness of RFO of the GSV using a temperature of 90 degrees C, tumescent infiltration, and catheter pullback rates double the current standard. Sixty-eight patients (85 limbs) with ultrasound-documented saphenofemoral valve reflux underwent Closure procedure. Treatment temperature was increased to 90 degrees C, and pullback times were increased to 5-6 cm/min. Outcome measures were occlusion of treated vein segments at 3 days and 6 months postoperatively and clinical evaluation of complications at 3 days and 6 months postoperatively. At 3 days, 96% (80/83) of GSVs were occluded and at 6 months 90% (66/73) were occluded. At 3 days and 6 months, no limbs had evidence of deep venous thrombosis or skin burns. Pullback times were shortened from 15-18 min to 8 min. Closure procedure of the GSV using 90 degrees C and faster catheter pullback rates occluded a refluxing GSV with similar 3-day and 6-month occlusion rates as 85 degrees C.
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http://dx.doi.org/10.1007/s10016-006-9099-7 | DOI Listing |
Nagoya J Med Sci
November 2024
Department of Neurosurgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Selecting an appropriate microcatheter tip shape for paraclinoid aneurysms is difficult. Therefore, we devised an original simple and uniform three-dimensional (3D) spiral-shaping method of microcatheter and validated the characteristics and usefulness of this method for coil embolization of paraclinoid aneurysms using patient-specific silicone models. These silicone models were produced based on clinical data from four patients with four paraclinoid aneurysms that underwent endovascular treatment using the 3D spiral-shaping method.
View Article and Find Full Text PDFCatheter Cardiovasc Interv
November 2024
Cardiovascular Center Aalst, OLV Clinic, Aalst, Belgium.
Background: Angiography-derived fractional flow reserve (virtual FFR) has shown excellent diagnostic performance compared with wire-based FFR. However, virtual FFR pullback curves have not been validated yet.
Objectives: To validate the accuracy of virtual FFR pullback curves compared to wire-based FFR pullbacks and to assess their clinical utility using patient-reported outcomes.
Catheter Cardiovasc Interv
October 2024
Division of Cardiology, Department of Medicine, University of Washington, Seattle, Washington, USA.
Dual-lumen microcatheters (DLMC) are utilized in challenging wiring scenarios as well as for contrast and medication injections. Nonetheless, lesion characterization remains extremely challenging in many cases. We describe a DLMC-facilitated technique which can assist in locating the distal anastomosis while navigating an occluded bypass graft during retrograde chronic total occlusion recanalization, as well as in the differential diagnosis of abrupt vessel closure.
View Article and Find Full Text PDFFront Cardiovasc Med
June 2024
Department of Cardiology, University and Hospital Fribourg, Fribourg, Switzerland.
Introduction: Intravascular imaging, especially optical coherence tomography (OCT), has significantly improved percutaneous coronary intervention (PCI), yet its routine clinical application faces challenges. This case series introduces the Gentuity® High-Frequency Optical Coherence Tomography (HF-OCT), a novel device designed to enhance intracoronary imaging with a significantly faster pullback and smaller catheter size, potentially offering enhanced navigability in complex lesions. We aimed to assess the image quality of Gentuity® HF-OCT in complex vessel conditions, as well as presenting a case series to illustrate the application of the device in various clinical scenarios.
View Article and Find Full Text PDFPerfusion
June 2024
Department of Cardiology, Wellington Hospital, Wellington, New Zealand.
Background: The benefits of intravascular imaging-guided percutaneous coronary interventions (PCI) are well established. Intravascular imaging guidance improves short- and long-term outcomes, especially in complex PCI. Optical coherence tomography (OCT) has a higher resolution than intravascular ultrasound.
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