Background Numerous reports have shown that inferior vena cava filters are associated with clinically significant adverse events. Complicating factors, such as caval incorporation, may lead to technical challenges at retrieval. The use of advanced techniques including the laser sheath have increased technical success rates; however, the data are limited on which filter types necessitate and benefit from its use. Methods and Results From October 2011 to September 2019, patients with inferior vena cava filter dwell times >6 months or with prior failed retrievals were considered for laser sheath-assisted retrieval. Standard and nonlaser advanced retrieval techniques were attempted first; if the filter could not be safely or successfully detached from the caval wall using these techniques, the laser sheath was used. Technical success, filter type, necessity for laser sheath application based on "open" versus "closed-cell" filter design, dwell times, and adverse events were evaluated. A total of 441 patients (216 men; mean age, 54 years) were encountered. Mean dwell times for all filters was 56.6 months, 54.4 among closed-cell filters and 58.5 among open-cell filters (=0.63). Technical success of retrieval was 98%, with the laser sheath required in 143 cases (40%). Successful retrieval of closed-cell filters required laser sheath assistance in 60% of cases as compared with 7% of open-cell filters (odds ratio, 20.1; <0.01). In closed-cell inferior vena cava filters, dwell time was significantly associated with need for laser, requiring it in 64% of retrievals with dwell times >6 months (=0.01). One major adverse event occurred among laser sheath retrievals when a patient required a 2-day inpatient admission for a femoral access site hemorrhage. Conclusions Closed-cell filters may necessitate the use of the laser sheath for higher rates of successful and safe retrieval.
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http://dx.doi.org/10.1161/JAHA.120.017240 | DOI Listing |
Arab J Urol
September 2024
Department of Urology, Kasr Alainy Hospitals, Faculty of Medicine, Cairo University, Cairo, Egypt.
Objectives: We aimed to assess the stone free rate of flexible ureteroscopy and laser lithotripsy (FURL) in upper urinary tract stones (UUTS) >20 mm and the risk of complications from ureteral access sheath (UAS) usage.
Methods: This is a prospective randomized clinical trial that included patients with UUTS larger than 20 mm who underwent FURL after randomization into two groups: group A (UAS) and group B (non-UAS). Data were collected for patients' demographics, stone parameters, operative and postoperative complications, and the outcome of FURL regarding stone-free rate (SFR) and perioperative complications, with a 6-month follow-up.
BMC Ophthalmol
January 2025
Vitreoretinal Surgery Department, Hugo Chavez Hospital, Turmus Ayya, State of Palestine.
Background: This case report describes a rare case of Coats disease in adult female patient with preserved vision after intravitreal Aflibercept injection and laser photocoagulation.
Case Presentation: A female patient of Asian Palestinian descent, aged 20, exhibited a progressive and painless deterioration in the vision of her left eye over a period of two weeks. She exhibited no additional ocular symptoms.
Urolithiasis
December 2024
Groupe de Recherche Clinique sur la Lithiase Urinaire, GRC n°20, Hôpital Tenon, Sorbonne Université, Paris, 75020, France.
To assess the accuracy of Kidney Stone Calculator(KSC), a software designed for surgical planning, in predicting the duration of lithotripsy during flexible ureteroscopy(FURS) when using the novel pulsed-Thulium: YAG(p-Tm: YAG) laser. From February to August 2023, a single-center prospective study was conducted, including patients with kidney or ureteral stones through non-contrast computed tomography(NCCT), who underwent FURS with p-Tm: YAG laser lithotripsy. KSC used three-dimensional segmentation of the stones from NCCT images, along with an interactive user interface for laser settings, to estimate the stone volume(SV) and the lithotripsy duration(LD).
View Article and Find Full Text PDFUrolithiasis
December 2024
Division of Medicinal Chemistry, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstr. 6, 8010, Graz, Austria.
The primary objective of urolithiasis therapy is complete stone removal and highest stone-clearance rates possible to minimize recurrence. A novel approach that employs a magnetic suspension and a magnetic probe for the passive collection and removal of small residual fragments was developed. This study assessed the feasibility of this system in porcine models.
View Article and Find Full Text PDFWorld J Urol
December 2024
Progressive Endourological Association for Research and Leading Solutions (PEARLS), Paris, France.
Purpose: Use of suction in flexible ureteroscopy is increasing lately. The introduction of flexible and navigable suction access sheath (FANS) has shown improved stone free rate (SFR). However, its efficacy in lower pole stone (LPS) in terms of SFR and complications is yet to be studied.
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