AIM To examine the efficacy and safety of the 6 French(6F) Rotarex~S catheter system in patients with acute limb ischemia(ALI) involving thromboembolic occlusion of the proximal and mid-crural vessels.METHODS The fi...AIM To examine the efficacy and safety of the 6 French(6F) Rotarex~S catheter system in patients with acute limb ischemia(ALI) involving thromboembolic occlusion of the proximal and mid-crural vessels.METHODS The files of patients in our department with ALI between 2015 and 2017 were examined. In seven patients, the Rotarex~S catheter was used in the proximal segment of the crural arteries. Data related to the clinical examination, Doppler sonography, angiography and followup from these patients were further used for analysis.RESULTS Two patients(29%) had thrombotic occlusion of the common femoral artery, and the remaining five exhibited thrombosis of the superficial femoral artery and popliteal artery. Mechanical thrombectomy was performed in all cases using a 6F Rotarex~S catheter. Additional Rotarex~S catheter thrombectomy due to remaining thrombus formation with no reflow was performed in the anterior tibial artery in two of seven cases(29%), in the tibiofibular tract and posterior tibial artery in two of seven cases(29%) and in the tibiofibular tract and fibular artery in the remaining three of seven cases(43%). Ischemic symptoms resolved promptly in all, and none of the patients experienced a procedural complication, such as crural vessel dissection, perforation or thrombus embolization.CONCLUSION Mechanical debulking using the 6F Rotarex~S catheter system may be a safe and effective treatment option in case of thrombotic or thromboembolic occlusion of the proximal and mid-portion of crural arteries.展开更多
AIM:To investigate crural diaphragm(CD)function in systemic sclerosis(SSc)using high-resolution manometryand standardized inspiratory maneuvers.METHODS:Eight SSc volunteers(average age,40.1years;one male)and 13 contro...AIM:To investigate crural diaphragm(CD)function in systemic sclerosis(SSc)using high-resolution manometryand standardized inspiratory maneuvers.METHODS:Eight SSc volunteers(average age,40.1years;one male)and 13 controls(average age,32.2years;six males)participated in the study.A highresolution manometry/impedance system measured the esophagus and esophagogastric junction(EGJ)pressure profile during swallows and two respiratory maneuvers:sinus arrhythmia maneuver(SAM;the average of six EGJ peak pressures during 5-s deep inhalations)and threshold maneuver(TM;the EGJ peak pressures during forced inhalation under 12 and 24 cm H2O loads).Inspiratory diaphragm lowering(IDL)was taken as the displacement of the EGJ high-pressure zone during the SAM.RESULTS:SSc patients had lower mean lower esophageal sphincter pressure than controls during normal breathing(19.7±2.8 mm Hg vs 32.2±2.7 mm Hg,P=0.007).Sinus arrhythmia maneuver pressure was higher in SSc patients than in controls(142.6±9.4 mm Hg vs 104.6±13.8 mm Hg,P=0.019).Sinus arrhythmia maneuver pressure normalized to IDL was also higher in SSc patients than in controls(83.8±13.4 mm Hg vs37.5±6.9 mm Hg,P=0.005).Threshold maneuver pressures normalized to IDL were also greater in SSc patients than in controls(TM 12 cm H2O:85.1±16.4mm Hg vs 43.9±6.3 mm Hg,P=0.039;TM 24 cm H2O:85.2±16.4 mm Hg vs 46.2±6.6 mm Hg,P=0.065).Inspiratory diaphragm lowering in SSc patients was less than in controls(2.1±0.3 cm vs 3±0.2 cm,P=0.011).CONCLUSION:SSc patients had increased inspiratory EGJ pressure.This is an add-on to EGJ pressure and indicates that the antireflux barrier can be trained.展开更多
文摘AIM To examine the efficacy and safety of the 6 French(6F) Rotarex~S catheter system in patients with acute limb ischemia(ALI) involving thromboembolic occlusion of the proximal and mid-crural vessels.METHODS The files of patients in our department with ALI between 2015 and 2017 were examined. In seven patients, the Rotarex~S catheter was used in the proximal segment of the crural arteries. Data related to the clinical examination, Doppler sonography, angiography and followup from these patients were further used for analysis.RESULTS Two patients(29%) had thrombotic occlusion of the common femoral artery, and the remaining five exhibited thrombosis of the superficial femoral artery and popliteal artery. Mechanical thrombectomy was performed in all cases using a 6F Rotarex~S catheter. Additional Rotarex~S catheter thrombectomy due to remaining thrombus formation with no reflow was performed in the anterior tibial artery in two of seven cases(29%), in the tibiofibular tract and posterior tibial artery in two of seven cases(29%) and in the tibiofibular tract and fibular artery in the remaining three of seven cases(43%). Ischemic symptoms resolved promptly in all, and none of the patients experienced a procedural complication, such as crural vessel dissection, perforation or thrombus embolization.CONCLUSION Mechanical debulking using the 6F Rotarex~S catheter system may be a safe and effective treatment option in case of thrombotic or thromboembolic occlusion of the proximal and mid-portion of crural arteries.
文摘AIM:To investigate crural diaphragm(CD)function in systemic sclerosis(SSc)using high-resolution manometryand standardized inspiratory maneuvers.METHODS:Eight SSc volunteers(average age,40.1years;one male)and 13 controls(average age,32.2years;six males)participated in the study.A highresolution manometry/impedance system measured the esophagus and esophagogastric junction(EGJ)pressure profile during swallows and two respiratory maneuvers:sinus arrhythmia maneuver(SAM;the average of six EGJ peak pressures during 5-s deep inhalations)and threshold maneuver(TM;the EGJ peak pressures during forced inhalation under 12 and 24 cm H2O loads).Inspiratory diaphragm lowering(IDL)was taken as the displacement of the EGJ high-pressure zone during the SAM.RESULTS:SSc patients had lower mean lower esophageal sphincter pressure than controls during normal breathing(19.7±2.8 mm Hg vs 32.2±2.7 mm Hg,P=0.007).Sinus arrhythmia maneuver pressure was higher in SSc patients than in controls(142.6±9.4 mm Hg vs 104.6±13.8 mm Hg,P=0.019).Sinus arrhythmia maneuver pressure normalized to IDL was also higher in SSc patients than in controls(83.8±13.4 mm Hg vs37.5±6.9 mm Hg,P=0.005).Threshold maneuver pressures normalized to IDL were also greater in SSc patients than in controls(TM 12 cm H2O:85.1±16.4mm Hg vs 43.9±6.3 mm Hg,P=0.039;TM 24 cm H2O:85.2±16.4 mm Hg vs 46.2±6.6 mm Hg,P=0.065).Inspiratory diaphragm lowering in SSc patients was less than in controls(2.1±0.3 cm vs 3±0.2 cm,P=0.011).CONCLUSION:SSc patients had increased inspiratory EGJ pressure.This is an add-on to EGJ pressure and indicates that the antireflux barrier can be trained.
