Intra-arterial drug injection: an effective treatment protocol

Intra-arterial drugs injection [IADI] either iatrogenic or self administered in drug abusers is a source of considerable morbidity. Most interventions are largely empirical. No prospective human studies have shown that any specific treatment is superior to another. The aim of this study was to evaluate the outcome of different modalities of treatments in patients with IADI. This study included 36 patients divided into 2 groups: Retrospective group [A] [from November 2002 to July 2004] enrolled 13 patients [10 males and 3 females] and prospective group [B] [from August 2004 to June 2008] enrolled 23 patients [19 males and 4 females]. Group A received systemic treatment only [heparin, dexamethazone, antiplatelet and prostaglandins] and group B received intra-arterial treatment [heparin and streptokinase] in addition to the systemic treatment Normal outcome [normal extremities] improved greatly in group B [52%] than in group A [23%] although, this failed to reach statistical significance. Intra-arterial cannulation and administration of heparin and streptokinase is a good option in treating accidental IADI resulting in better final outcome than systemic heparinization and early treatment is mandatory for a good outcome

Impact of eversion technique in carotid endarterectomy: Mansoura experience

To review our experience in eversion technique in carotid endarterectomy in patients with carotid artery stenosis with particular attention to restenosis, occlusion, recurrent stroke or TIA. This prospective study included 12 patients with symptoms of unilateral carotid artery stenosis who were investigated, operated and followed up in Vascular Surgery Unit of Mansoura University Hospital during the period from July 2004 to January 2008. Eversion carotid endarterectomy [ECEA] was carried out for all patients. Carotid restenosis rate [>50%] during follow up was [0%] after eversion CEA at the end of the study. The cumulative stroke free survival rate was 85.7% at the end of the study. ECEA is a feasible and safe alternative technique for management of extracranial carotid stenosis, an excellent technique for handling of the kink, spiral or redundant internal carotid artery. It can be performed while patients under local or general anesthesia according to the general condition and cooperation of the patient