原文出处:J Bone Joint Surg(Am),2022,104(4):316-325.内侧开放胫骨高位截骨术是一种用于治疗伴有内翻畸形的膝关节内侧间室骨关节炎的手术方法。内侧半月板的突出与关节负荷的分布、关节炎的进展有关。近期,有学者研究半月板突出的程...原文出处:J Bone Joint Surg(Am),2022,104(4):316-325.内侧开放胫骨高位截骨术是一种用于治疗伴有内翻畸形的膝关节内侧间室骨关节炎的手术方法。内侧半月板的突出与关节负荷的分布、关节炎的进展有关。近期,有学者研究半月板突出的程度与内侧开放楔形胫骨高位截骨术后较差的短期临床结果有关。然而,术前内侧半月板突出对开放楔形胫骨高位截骨术后中期临床结果是否有影响仍未知。展开更多
Background: This study compares the medium-term success rate and complications of non-penetrating deep sclerectomy (NPDS) without and with autologous scleral implant in openangle glaucoma. Methods: Retrospective revie...Background: This study compares the medium-term success rate and complications of non-penetrating deep sclerectomy (NPDS) without and with autologous scleral implant in openangle glaucoma. Methods: Retrospective review of 93 eyes of 93 patients with medically uncontrolled open-angle glaucoma who underwent NPDS without (n=69, group 1) or with (n=24, group 2) autologous scleral implant. Results: The mean followupwas 16months (range 5-36) in group 1 and 15 months (range 4-28) in group 2. The mean intra-ocular pressures (IOP) preand postoperatively were, respectively, 23.8 and 16.1 mmHg in group 1, and 25.6 and 15.8 mmHg in group 2. The absolute success rate was 41%in group 1 and 54%in group 2. The qualitative success rate was 83%in group 1 and 75%in group 2. An IOP lower than 16.1 mmHg was obtained in 51%of patients in group 1 and 58%of patients in group 2. A Nd:YAGlaser goniopuncturewas performed in 30%of patients in group 1 and 50%of patients in group 2, and resulted in a better controlled IOP. Conclusions: NPDS without or with an autologous scleral implant is a safe procedure reducing the IOP significantly, but probably not sufficient when an IOP below 16 mmHg is required. We found no statistically significant difference between the two groups.展开更多
OBJECTIVES: The purpose of this study was to investigate the medium-term(two year) outcome of the unrestricted utilization of sirolimus-eluting stents(SES) in an all-comer population. BACKGROUND: Despite the implantat...OBJECTIVES: The purpose of this study was to investigate the medium-term(two year) outcome of the unrestricted utilization of sirolimus-eluting stents(SES) in an all-comer population. BACKGROUND: Despite the implantation of SES in over a million patients to date, limited data exist on long-term outcomes. METHODS: Sirolimus-eluting stents were used as the default strategy as part of the Rapa mycin-Eluting Stent Evaluated at Rotterdam Cardiology Hospital(RESEARCH) regist ry. A total of 508 consecutive patients with de novo lesions exclusively treated with SES were compared with 450 patients who received bare stents in the immedi ately preceding period(pre-SES group). RESULTS: Patients in the SES group more frequently had multivessel disease, more type C lesions, received more stents, a nd had more bifurcation stenting. At two years, the cumulative rate of major adv erse cardiac events(death, myocardial infarction, or target vessel revasculariza tion) was 15.4%in the SES group and 22.0%in the pre-SES group(hazard ratio[HR ] 0.68, 95%confidence interval[CI]0.50 to 0.91; p=0.01). The two-year risk of target vessel revascularization in the SES group and in the pre-SES group was 8 .2%and 14.8%, respectively(HR 0.53, 95%CI 0.36 to 0.79; p=0.002). CONCLUSIONS : In an unrestricted population, the beneficial effects of sirolimus-eluting st ent implantation extend out to two years compared with bare-metal stents, drive n by a reduction in re-intervention rates. These findings should be confirmed b y the results of the large randomized trials.展开更多
OBJECTIVES: This study sought to evaluate the use of covered Cheatham-platinu m(CP) stents in the treatment of aortic coarctation(CoA). BACKGROUND: Aortic ane urysms and stent fractures have been encountered after sur...OBJECTIVES: This study sought to evaluate the use of covered Cheatham-platinu m(CP) stents in the treatment of aortic coarctation(CoA). BACKGROUND: Aortic ane urysms and stent fractures have been encountered after surgical and transcathete r treatment for CoA. Covered stents have previously been used in the treatment o f abdominal and thoracic aneurysms in adults. We implanted covered CP stents as a rescue treatment in patients with CoA aneurysms or previous stent-related com plications and in patients at risk of developing complications because of comple x CoA anatomy or advanced age. METHODS: Thirtythree covered CP stents were impla nted in 30 patients; 16 patients had had previous procedures. The remaining pati ents had complex or near-atretic CoA. RESULTS: The mean patient age and weight were 28(±17.5) years(range 8 to 65 years), and 62(±13) kg(range 28 to 86 kg), respectively. The systolic gradient across the CoA decreased from a mean(±SD) o f 36±20 mm Hg before to a mean of 4±4 mmHg after the procedure(p< 0.0001), and the diameter of the CoA increased from 6.4±3.8 mm to 17.1±3.1 mm(p< 0.0001). The follow-up period was up to 40 months(mean, 11 months). All stents were pate nt and in good position on computed tomography or magnetic resonance imaging per formed three to six months later. In 43%of the patients antihypertensive medica tion was either decreased or stopped. CONCLUSIONS: Covered CP stents may be used as the therapy of choice in patients with complications after CoA repairs, wher eas they provide a safe alternative to conventional stenting in patients with se vere and complex CoA lesions or advanced age.展开更多
文摘原文出处:J Bone Joint Surg(Am),2022,104(4):316-325.内侧开放胫骨高位截骨术是一种用于治疗伴有内翻畸形的膝关节内侧间室骨关节炎的手术方法。内侧半月板的突出与关节负荷的分布、关节炎的进展有关。近期,有学者研究半月板突出的程度与内侧开放楔形胫骨高位截骨术后较差的短期临床结果有关。然而,术前内侧半月板突出对开放楔形胫骨高位截骨术后中期临床结果是否有影响仍未知。
文摘Background: This study compares the medium-term success rate and complications of non-penetrating deep sclerectomy (NPDS) without and with autologous scleral implant in openangle glaucoma. Methods: Retrospective review of 93 eyes of 93 patients with medically uncontrolled open-angle glaucoma who underwent NPDS without (n=69, group 1) or with (n=24, group 2) autologous scleral implant. Results: The mean followupwas 16months (range 5-36) in group 1 and 15 months (range 4-28) in group 2. The mean intra-ocular pressures (IOP) preand postoperatively were, respectively, 23.8 and 16.1 mmHg in group 1, and 25.6 and 15.8 mmHg in group 2. The absolute success rate was 41%in group 1 and 54%in group 2. The qualitative success rate was 83%in group 1 and 75%in group 2. An IOP lower than 16.1 mmHg was obtained in 51%of patients in group 1 and 58%of patients in group 2. A Nd:YAGlaser goniopuncturewas performed in 30%of patients in group 1 and 50%of patients in group 2, and resulted in a better controlled IOP. Conclusions: NPDS without or with an autologous scleral implant is a safe procedure reducing the IOP significantly, but probably not sufficient when an IOP below 16 mmHg is required. We found no statistically significant difference between the two groups.
文摘OBJECTIVES: The purpose of this study was to investigate the medium-term(two year) outcome of the unrestricted utilization of sirolimus-eluting stents(SES) in an all-comer population. BACKGROUND: Despite the implantation of SES in over a million patients to date, limited data exist on long-term outcomes. METHODS: Sirolimus-eluting stents were used as the default strategy as part of the Rapa mycin-Eluting Stent Evaluated at Rotterdam Cardiology Hospital(RESEARCH) regist ry. A total of 508 consecutive patients with de novo lesions exclusively treated with SES were compared with 450 patients who received bare stents in the immedi ately preceding period(pre-SES group). RESULTS: Patients in the SES group more frequently had multivessel disease, more type C lesions, received more stents, a nd had more bifurcation stenting. At two years, the cumulative rate of major adv erse cardiac events(death, myocardial infarction, or target vessel revasculariza tion) was 15.4%in the SES group and 22.0%in the pre-SES group(hazard ratio[HR ] 0.68, 95%confidence interval[CI]0.50 to 0.91; p=0.01). The two-year risk of target vessel revascularization in the SES group and in the pre-SES group was 8 .2%and 14.8%, respectively(HR 0.53, 95%CI 0.36 to 0.79; p=0.002). CONCLUSIONS : In an unrestricted population, the beneficial effects of sirolimus-eluting st ent implantation extend out to two years compared with bare-metal stents, drive n by a reduction in re-intervention rates. These findings should be confirmed b y the results of the large randomized trials.
文摘OBJECTIVES: This study sought to evaluate the use of covered Cheatham-platinu m(CP) stents in the treatment of aortic coarctation(CoA). BACKGROUND: Aortic ane urysms and stent fractures have been encountered after surgical and transcathete r treatment for CoA. Covered stents have previously been used in the treatment o f abdominal and thoracic aneurysms in adults. We implanted covered CP stents as a rescue treatment in patients with CoA aneurysms or previous stent-related com plications and in patients at risk of developing complications because of comple x CoA anatomy or advanced age. METHODS: Thirtythree covered CP stents were impla nted in 30 patients; 16 patients had had previous procedures. The remaining pati ents had complex or near-atretic CoA. RESULTS: The mean patient age and weight were 28(±17.5) years(range 8 to 65 years), and 62(±13) kg(range 28 to 86 kg), respectively. The systolic gradient across the CoA decreased from a mean(±SD) o f 36±20 mm Hg before to a mean of 4±4 mmHg after the procedure(p< 0.0001), and the diameter of the CoA increased from 6.4±3.8 mm to 17.1±3.1 mm(p< 0.0001). The follow-up period was up to 40 months(mean, 11 months). All stents were pate nt and in good position on computed tomography or magnetic resonance imaging per formed three to six months later. In 43%of the patients antihypertensive medica tion was either decreased or stopped. CONCLUSIONS: Covered CP stents may be used as the therapy of choice in patients with complications after CoA repairs, wher eas they provide a safe alternative to conventional stenting in patients with se vere and complex CoA lesions or advanced age.
