Percutaneous complications

GPIIb/IIIa antagonists have to be administered parenterally. They are currently used prophylactically during intracoronary interventions such as percutaneous transluminal revascularization with balloon angioplasty or intracoronary stenting, as well as to treat acute coronary syndromes like unstable angina and acute myocardial infarction. The main complications... 

Percutaneous absorption is another route of interest for the administration of peptides [158], with metabolism being a complicating factor [159]. Thus, [Leu5]enkephalin and Tyr-Pro-Leu-Gly-NH2 were rapidly degraded on the dermal side after penetration through rat skin preparations [160]. The use of inhibitors confirmed the involvement of serine proteases and metalloenzymes. 

Indications Adjunct to percutaneous coronary intervention for the prevention of cardiac ischemic complications... 

B. Indications and use ReoPro is indicated as an adjunct to percutaneous coronary intervention for the prevention of cardiac ischemic complications in patients undergoing percutaneous coronary intervention or patients with unstable angina not responding to conventional medical therapy when percutaneous coronary intervention is planned within 24 hours. 

Ellis SG, Semenec T, Lander K, Franco I, Raymond R, Whitlow PL. Effects of long-term prednisone (> = 5 mg) use on outcomes and complications of percutaneous coronary intervention. Am J Cardiol 2004 93 1389-90. 

The sensitivity and specificity of plain film and contrast study in acute pancreatitis are low. Therefore, they are mostly used to demonstrate complications of AP. Percutaneous sonography is usually the imaging method of choice in patients with acute abdominal distress due to its wide availability, but in the case of AP the distended intestine often impairs adequate visualization of the pancreas. Still, sonography may be used as an excellent imaging modality for short-term follow-up studies, particularly in extremely ill patients who are unable to undergo computed tomography (CT). 

The IMPACT-II Investigators. Randomized placebo-controlled trial of effect of eptifibatide on complications of percutaneous coronary intervention the IMPACT-II. Lancet 1997 349 1422-1428. 

Brener SJ, Moliterno DJ, Lincoff AM, et al, Relationship between activated clotting time and ischemic or hemorrhagic complications analysis of 4 recent randomized clinical trials of percutaneous coronary intervention, Circulation 2004 ... 

I 9 Roe MT, Granger CB, PumaJA, et al. Comparison of benefits and complications of hirudin versus heparin for patients with acute coronary syndromes undergoing early percutaneous coronary intervention. Am J Cardiol 2001 88 1403-1406. 

Contrast media (CM) are used to enhance visualization during diagnostic angiograms and to guide percutaneous coronary interventions (PCI). The increased use of PCI led to the increased number of patients receiving CM (1,2). However, use of CM is not without risks. Although some complications associated with CM are mild and transient, such as discomfort and itching, others are more serious such as anaphylaxis, hypotension, cardiovascular events, and renal dysfunction (I-3). 

Since Andreas Gruntzig described the first percutaneous coronary intervention (PCI) in 1978 (I), the field has progressed immeasurably in both equipment and pharmacotherapy The overall trend with regard to the latter has been for improved strategies aimed at inhibition of platelet aggregation and the clotting cascade. This has led to better outcomes by reduction of the ischemic complications associated with the procedure. 

Lembo NJ, Black AJ, Roubin GS, et al. Effect of pretreatment with aspirin versus aspirin plus dipyridamole on frequency and type of acute complications of percutaneous transluminal coronary angioplasty. Am J Cardiol 1990 65(7) 422-426. 

Effects of glycoprotein llb/llla receptor antagonists on the incidence of death or nonfatal myocardial infarction following percutaneous transluminal coronary angioplasty. [ Note Data are from several studies thus reported incidence of complications with standard therapy is not the same for each drug.]... 

Systemically administered liposome-encapsulated bisphosphonates (e.g., clodronate or alendronate) have been shown to be effective, in rat and rabbit models, in the prevention of restenosis. This complication frequently occurs following percutaneous coronary interventions. Thus, these compounds show considerable promise for clinical application in this area [31]. 

The tendency for a toxicant to traverse the skin is a primary determinant of its der-matotoxic potential. That is, a chemical must penetrate the stratum comeum in order to exert toxicity in lower cell layers. The quantitative prediction of the rate and extent of percutaneous penetration (into skin) and absorption (through skin) of topically applied toxicants is complicated by the biological complexity discussed above. 

Transjugular venous liver biopsy was first described by w. Hanafee et al. in 1967. It has been successfully performed (monitoring by ECG ) with few complications in high-risk patients (e. g. ascites, bleeding tendency, severe adiposity, massive intra-abdominal adhesions), both adults and children. Furthermore, the biopsy material obtained by this method (albeit shorter than in percutaneous biopsy) has generally been rated as adequate for assessment. The modified 15 G or 16 G Ross needle, but also an 18 G automated core biopsy needle, are considered preferable over the Trucut needle. The technique is deemed to be safe and reliable, and the complication rate is acceptable, (s. tab. 7.9) (4, 13, 14, 21, 31, 33, 34, 45, 47, 58, 69, 74, 80, 101, 112, 133, 136, 168, 182)... 

The type and frequency of complications involved in laparoscopy are determined by the same influencing factors as were outlined for the complication rate of percutaneous liver biopsy, (s. tab. 7.5) With each complication, these factors should be considered critically and without bias. 

Piccinino, F., Sagnelli, E., Pasquale, G., Giusti, G. Complications following percutaneous liver biopsy. A multicentre retrospective study on 68.276 biopsies. J. Hepatol. 1986 2 165-173... 

Raines, D.R., Heertum, van, R.L., Johnson, L.F. Intrahepatic hematoma a complication of percutaneous liver biopsy. A report on the incidence of postbiopsy scan defects. Gastroenterology 1974 67 284-289... 

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