The balloon-expandable vascular prosthesis consists of a flexible, knitted tantalum wire mesh tube. To demonstrate its pliability, this prosthesis was tested experimentally in 10 mongrel dogs by implanting it into the proximal femoral arteries. The maximum follow-up time was 1 year. On the basis of the experimental results, in which there was no relevant stenosis, occlusion, or migration of the vascular prosthesis, nine patients were treated: one with iliac artery occlusive disease and eight with superficial femoral artery (SFA) occlusive disease (four reocclusions after angioplasty and four unsatisfactory primary angioplasty results). One SFA lesion was treated with the crossover method from the contralateral side. All implants remained patent without hemodynamically significant stenoses, with the longest observation time being 6 months. Flexible, expandable vascular prostheses are promising adjuncts to angioplasty.
The authors implanted a duodenal stent in a woman with a high-grade duodenal stenosis due to inoperable tumor compression. A flexible self-expanding knitted nitinol stent that conformed to the shape of the duodenum was introduced orally to keep the duodenal passage patent. After stent implantation, repeated vomiting stopped and the patient was able to eat and drink. This technique resolved the patient's duodenal stenosis.
The goal of this study was estimation of patient effective dose from uterine artery embolization of leiomyomata. Parameters and data relevant to patient dose were recorded for 33 consecutive procedures. Using Monte Carlo simulation of radiation transport, organ and effective doses were calculated in detail for a subset of five procedures, to estimate the effective dose for all procedures. Mean dose area product was 59.9, median 23.4, and range 8.8-317.5 Gycm(2). Mean absorbed ovarian dose was calculated as 51 mGy in the five procedures. Using the dose conversion factor estimated from the Monte Carlo simulation for all procedures a mean estimated effective dose of 34 mSv (median 13 mSv, range 5-182 mSv) results, with a tendency to lower values regarding the succession of the procedures. Patients' radiation exposure level is up to twice of that of an abdominal CT examination. Angiographic equipment related dose-reducing features and radiographic technique essentially influence organ doses and effective dose. Consistent application of dose-reducing techniques and awareness of radiation exposure justifies uterine artery embolization as a therapeutic option for the treatment of uterine fibroids.
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