ABSTRACT
The objective of this study was to design and test a protocol for the validation of banking methodologies for arterial allografts. A series of in vitro biomechanical and biological assessments were derived, and applied to paired fresh and banked femoral arteries. The ultimate tensile stress and strain, suture pullout stress and strain, expansion/rupture under hydrostatic pressure, histological structure and biocompatibility properties of disinfected and cryopreserved femoral arteries were compared to those of fresh controls. No significant differences were detected in any of the test criteria. This validation protocol provides an effective means of testing and validating banking protocols for arterial allografts.
Subject(s)
Allografts/physiology , Femoral Artery/transplantation , Tissue Banks/standards , Tissue Preservation/methods , Adult , Biomechanical Phenomena , Cell Line , Cryopreservation , Female , Femoral Artery/cytology , Femoral Artery/physiology , Human Umbilical Vein Endothelial Cells/cytology , Humans , In Vitro Techniques , Male , Middle Aged , Pressure , Reference Standards , Reproducibility of Results , Sutures , Tensile Strength , Young AdultSubject(s)
Aortic Aneurysm, Abdominal/complications , Aortic Rupture/complications , Kidney Calculi/complications , Pain/etiology , Aged , Aortic Aneurysm, Abdominal/diagnostic imaging , Aortic Rupture/diagnostic imaging , Diagnostic Errors , Humans , Kidney Calculi/diagnostic imaging , Male , Tomography, X-Ray ComputedABSTRACT
OBJECTIVE: Carotid artery angioplasty and stenting (CAS) has been proposed as an alternative to surgery for patients with high-grade symptomatic carotid disease. The purpose of this study was to determine the proportion of patients that were suitable for each type of intervention and to analyse the reasons that precluded stenting. MATERIALS AND METHODS: This was a prospective observational study. All patients considered for intervention for carotid artery disease during an 18-month period were analysed. The management decision was recorded, as were the reasons for unsuitability for stenting. RESULTS: Two hundred and sixty-eight patients' data were analysed, 224 had complete records. Forty-seven patients did not require intervention and received best medical treatment alone. One hundred and seventy-seven patients required intervention, 113 were suitable for stenting and 64 were not. In 51 patients stenting was preferred. Sixty-two patients were suitable for either stent or surgery. Sixty-four patients were unsuitable for stenting. Carotid tortuosity and proximal disease accounted for 70% of this group. CONCLUSIONS: Current enthusiasm for carotid stenting might well be supported by the results of ongoing randomised-controlled clinical trials. However, this study highlights a significant proportion (64/177; 36%) of our patients is presently unsuitable for stenting. The common technical difficulties and limitations of stenting encountered in our unit are related predominantly to carotid anatomy.
