Percutaneous surgery

Nephrostomy tract dilatation is a procedure that translates a simple drainage entry procedure into percutaneous surgery and r allows the introduction of stents or other devices. 

Percutaneous surgery is best performed under general anesthesia. Incision of the ureteropelvic junction can be achieved using a variety of methods including a cold knife, electrocautery, or a laser. Percutaneous endopyelotomy is an acceptable alternative for treating congenital UPJ stenosis. 

Badlani G, Eshghi M, Smith A (1986) Percutaneous surgery for ureteropelvic junction obstruction (endopyelotomy) technique and early results. J Urol 135 26-28... 

For patients with chronic CAD, nuclear imaging is essential for addressing the following major clinical issues (i) detection of ischemic myocardium, (ii) differentiation between viable hibernating or stunned myocardium and scar tissue in mechanically dysfunctional regions, and (ill) risk stratification for future major adverse events. Such information provides the basis for percutaneous coronary intervention (PCI) or coronary artery bypass (CAB) surgery and assessing their outcomes based on detection of residual ischemia and recovery of contractile function. 

Rodriguez A, Boullon F, Perez-Balino N, et al. Argentine randomized trial of percutaneous transluminal coronary angioplasty versus coronary artery bypass surgery in multivessel disease in-hospital results and 1 year follow-up. J Am Coll Cardiol 1993 22 1060. 

Over the years, focus has shifted to developing pumps that can be deployed in the catheterization laboratory. Percutaneous LVADs have been developed for rapid deployment in the catheterization laboratory to provide short-term hemodynamic support without the risks of major surgery. The spectrum of percutaneous circulatory... 

Contraindications Active internal bleeding, arteriovenous malformation or aneurysm, cerebrovascular accident (CVA) with residual neurologic defect, history of CVA (within the past 2 yr) or oral anticoagulant use within the past 7 days unless PT is less than 1.2 X control, history of vasculitis, hypersensitivity to murine proteins, intracranial neoplasm, prior IV dextran use before or during percutaneous transluminal coronary angioplasty (PTCA), recent surgery or trauma (within the past 6 wk), recent (within the past 6 wk or less) GI or GU bleeding, thrombocytopenia (less than 100,000 cells/pl), and severe uncontrolled hypertension... 

It is clear from each of these tables that open surgery is more successful than percutaneous nephrolithotomy (93 versus 87 per cent for small stones, 73 versus 69 per cent for large stones), irrespective of the size of the kidney stone. 

Abbreviations-. AA, arachidonic acid AMI, acute myocardial infarction AR, aspirin resistance ASA, aspirin CABG, coronary artery bypass graft surgery CAD, coronary artery disease CK-MB, creatinine kinase-MB CVA, cerebrovascular accident EPI, epinephrine HS, healthy subjects LTA, light transmittance aggregometry mm, millimolar PAR, platelet activity ratio PCI, percutaneous coronary intervention PR, platelet reactivity RPFA, rapid platelet function analyzer TXA2, thromboxane A2. 

Inclusion criteria were similar to our previous pilot study (34), Patients with clinical indication of percutaneous coronary revascularization were randomized if they had a de novo severe stenosis in a native coronary artery, a lesion suitable for stent, and a reference vessel size between 2.5 and 4.0 by visual estimation, and were a candidate for coronary bypass surgery, All the PCI procedures were performed at the Catheterization Laboratories at Otamendi Hospital and Sanatorio Las Lomas in Buenos Aires, Argentina. 

SoS Investigators. Coronary artery bypass surgery versus percutaneous coronary intervention with stent implantation in patients with multivessel coronary artery disease (the Stent or Surgery trial) a randomised controlled trial. Lancet 2002 360(9338) 965-970. 

The first report of percutaneous balloon dilation of a pulmonary valve was published in 1982 (14). Today the transcatheter approach has largely replaced surgical valvulotomy for pure stenosis. Surgery is only necessary when balloon dilatation was not successful or other heart abnormalities demand an open heart procedure. 

I I Qin JX, Shiota T Lever HM, et al. Outcome of patients with hypertrophic obstructive cardiomyopathy after percutaneous transluminal septal myocardial ablation and septal myectomy surgery. J Am Coll Cardiol 2001 38 1994-2000. 

Atherosclerotic cardiovascular disease HMG co-A reductase inhibitors Lovastatin Pravastatin Simvastatin Primary and secondary prevention of coronary heart disease (CHD) reduced hospitalizations, percutaneous transluminal coronary angioplasties (PTCA), and coronary artery bypass graft surgeries (CABG) reduced all-cause mortality 4S AFCAPS CARE LIPID WOSCOPS >30,000 7,8... 

---