RESUMO
AIM: The Gore Excluder device is a modern third generation device that performs well. Nevertheless, the proximal deployment was not as accurate and controlled as with some other modern devices. Therefore a new deployment system was developed. This system allows to reconstrain the graft after initial deployment, with the purpose to reposition the graft for both level or orientation. METHODS: The new system was used in 25 patients with an infrarenal abdominal aortic aneurysm. In 72% of cases the system was used to achieve a better proximal position or to facilitate catheterization of the contralateral limb. Surprisingly, the option to orientate the graft was used most. RESULTS: The new deployment system worked well, and all grafts were easily repositioned to the intended final position. Additional cuffs were not required in any of the patients. Surgical mortality was nil. All patients left the hospital in good condition. There were no type I endoleaks at completion angiography neither at first computed tomography scanning. CONCLUSION: With the new deployment system it is possible to reposition the Excluder to achieve optimal fixation and sealing. A global registry has been set into place to report real life results including longer term performance of the graft.
Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Implante de Prótese Vascular/instrumentação , Prótese Vascular , Procedimentos Endovasculares/instrumentação , Stents , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aortografia/métodos , Implante de Prótese Vascular/efeitos adversos , Endoleak/etiologia , Endoleak/prevenção & controle , Procedimentos Endovasculares/efeitos adversos , Europa (Continente) , Humanos , Desenho de Prótese , Sistema de Registros , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Histamine iontophoresis is demonstrated to be a reliable model for the study of inflammatory skin responses. It has the advantage of a non-invasive and uniform mode of application and is free of unwanted side effects. The wheal and flare responses to histamine are linearly related to dose over a wide range of stimulus strengths (r = 0.88). In summer, wheal responses were smaller, probably due to increased thickness of the epidermis. Female subjects generally expressed larger wheal responses than males, presumably due to differences in epidermal thickness and structure. There were significant regional differences in wheal, flare, and laser Doppler recorded flux responses. Ratings of itch sensations also showed clear, but less pronounced, differences of body regions. Significant regional differences of wheal and flare responses existed. Sensory discrimination of different stimulus levels was demonstrated with visual analogue scale ratings.
