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Intravascular ultrasound-guided “extended” reverse controlled antegrade and retrograde subintimal tracking technique using a cutting balloon for recanalizing chronic coronary total occlusion with a side branch

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Journal of Geriatric Cardiology 2019年第6期16卷 498-501页

作者： Yong-Tai GONG Jian-Qiang LI Li SHENG Dang-Hui SUN Yue LI Department of Cardiology the First Affiliated Hospital of Harbin Medical University

Percutaneous coronary intervention (PCI) of chronic total occlusion (CTO) represents the most technically challenging procedure in contemporary interventional cardiology.[1] Blunt lesions and presence of proximal side branch are considered to be strong predictors of reduced technical success.[ 2,3] For such lesions, the antegrade approach may not be feasible or desirable, and the retrograde approach can be used as the initial crossing strategy. However, when treating the blunt CTO with a large side branch proximal to the occlusion, the side branch might be occluded after stent implantation if the retrograde guidewire passed the occluded segment through the subintimal space and re-entered into the true lumen at the opposite side of the side branch.[4] We reported a useful method to solve the above issue which utilizes intravascular ultrasound (IVUS) to guide “extended” reverse controlled antegrade and retrograde subintimal tracking (CART) technique with a cutting balloon.

关键词： Chronic total occlusion Cutting balloon Intravascular ultrasound Percutaneous coronary intervention Reverse controlled antegrade and retrograde tracking technique

A new buddy stingray and stick technique for antegrade dissection and re-entry during chronic total occlusion recanalization: a case report

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Journal of Geriatric Cardiology 2019年第11期16卷 835-839页

作者： Bing TIAN Quan-Min JING Bin WANG Yan-Bin SU Central Hospital affiliated to Shengyang Medical College ShenyangChina General Hospital of Northern Theater Command ShenyangChina

Although the retrograde approach was a promising strategy for chronic total occlusions(CTO)-percutaneous coronary interventions(PCI),[1]with the development of coronary interventional therapy technology and interventional instruments,antegrade dissection and re-entry(ADR)are commonly employed in PCI to open CTO of coronary arteries.

关键词： antegrade dissection Chronic total occlusions Percutaneous coronary interventions

Optimal entry point for antegrade and retrograde femoral intramedullary nails

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Chinese Journal of Traumatology 2023年第5期26卷 249-255页

作者： Mohammad M.Alzahrani Yousef Aljamaan Jaffar Alsayigh Shahad Alghamdi Saad M.Alqahtani Steven R.Papp Orthopedic Surgery Department College of MedicineImam Abdulrahman Bin Faisal UniversityDammamSaudi Arabia Division of Orthopaedic Surgery University of OttawaThe Ottawa HospitalOttawaOntarioCanada

Surgical management of femoral shaft fractures with intramedullary nails has become the standard ofcare,with multiple options for entry point described,including piriformis entry,trochanter entry andretrograde femoral *** present review describes the surgical anatomy of the proximal and distalfemur and its relation to different entry points for intramedullary femoral *** addition,we reviewedrelative indications for each technique,difficulties associated and possible complications.

关键词： Femurfracture antegrade Retrograde Femoral nailing

A New Rotator Interval Approach for antegrade Humeral Nailing: A Technical Note

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Open Journal of Orthopedics 2014年第11期4卷 321-326页

作者： Naxin Liu Toshikazu Mohri Junzou Hayashi Ryo Orito Tsuyoshi Nakai Yasushi Yoneda Department of Orthopaedic Surgery Takasago Seibu Hospital Hyogo Japan Department of Orthopaedic Surgery Itami City Hospital Hyogo Japan

The lateral and anterior lateral approaches are the most commonly used for antegrade nailing of humerus fractures. However, the surgical exposure is restricted by the bony acromion. The iatrogenic injury to the rotator cuff can also cause post-operative pain and compromise shoulder function. This article describes a new rotator interval approach that we used for central entry point nailing. In this approach, the skin incision starts from the midpoint between the acromion and coracoid process. A trans-rotator interval split in front of the anterior border of the supraspinatus (SSP) tendon is then made to open the glenohumeral joint. With the SSP retracted laterally and the long head of the biceps (LHB) retracted medially, the humeral head is directly visualized. The entry point can thus be determined and confirmed by intra-operative fluoroscopy in both axial and AP planes. We recommend this rotator interval approach as an alternative nailing technique for 2-part humeral neck fractures and humeral shaft fractures.

关键词： antegrade Humeral Nailing Approach Rotator Interval

Subtrochanteric fractures after retrograde femoral nailing

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World Journal of Orthopedics 2015年第9期6卷 738-743页

作者： Varatharaj Mounasamy Sathya Mallu Vishesh Khanna Senthil Sambandam Department of Ortho-pedics Virginia Common wealth University Health System Department of Orthopedics KG Hospital

Secondary fractures around femoral nails placed for the management of hip fractures are well known. We report, two cases of a fracture of the femur at the interlocking screw site in the subtrochanteric area after retrograde femoral nailing of a femoral shaft fracture. Only a few reports in the existing literature have described these fractures. Two young men after sustaining a fall presented to us with pain, swelling and deformity in the upper thigh region. On enquiring, examining and radiographing them, peri-implant fractures of subtrochanteric nature through the distal interlocking screws were revealed in both patients who also had histories of previous falls for which retrograde intramedullary nailing was performed for their respective femora. Both patients were managed with similar surgical routines including removal of the existing hardware, open reduction and ace cephallomedullary antegrade nailing. The second case did show evidence of delayed healing and was additionally stabilized with cerclage wires. Both patients had uneventful postoperative outcomes and union was evident at the end of 6 mo postoperatively with a good range of motion at the hip and knee. Our report suggests that though seldom reported, peri-implant fractures around the subtrochanteric region can occur and pose a challenge to the treating orthopaedic surgeon. We suggest these be managed, after initial stabilization and resuscitation, by implant removal, open reduction and interlocking intramedullary antegrade nailing. Good results and progression to union can be expected in these patients by adhering to basic principles of osteosynthesis.

关键词： Peri-implant fracture Retrograde femoral nail antegrade femoral nailing Interlocking screw Subtrochanteric fractures

A modified Rendezvous ERCP technique in duodenal diverticulum

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World Journal of Gastrointestinal Endoscopy 2013年第11期5卷 568-573页

作者： Mehmet Odabasi Mehmet Kamil Yildiz Haci Hasan Abuoglu Cengiz Eris Erkan Ozkan Emre Gunay Ali Aktekin MA Tolga Mu Department of Surgery Haydarpasa Education and Research Hospital

AIM: To postoperative endoscopic retrograde cholangiopancreatography(ERCP) failure, we describe a modified Rendezvous technique for an ERCP in patients operated on for common bile duct stone(CBDS) having a T-tube with retained CBDSs. METHODS: Five cases operated on for CBDSs and having retained stones with a T-tube were referred from other hospitals located in or around Istanbul city to the ERCP unit at the Haydarpasa Numune Education and Research Hospital. Under sedation anesthesia, a sterile guide-wire was inserted via the T-tube into the common bile duct(CBD) then to the papilla. A guide-wire was held by a loop snare and removed through the mouth. The guide-wire was inserted into the sphincterotome via the duodenoscope from the tip to the handle. The duodenoscope was inserted down to the duodenum with a sphincterotome and a guidewire in the working channel. With the guidance of a guide-wire, the ERCP and sphincterotomy were suc-cessfully performed, the guide-wire was removed from the T-tube, the stones were removed and the CBD was reexamined for retained stones by contrast. RESULTS: An ERCP can be used either preoperatively or postoperatively. Although the success rate in an isolated ERCP treatment ranges from up to 87%-97%, 5%-10% of the patients require two or more ERCP treatments. If a secondary ERCP fails, the clinicians must be ready for a laparoscopic or open exploration. A duodenal diverticulum is one of the most common failures in an ERCP, especially in patients with an intradiverticular papilla. For this small group of patients, an antegrade cannulation via a T-tube can improve the success rate up to nearly 100%. CONCLUSION: The modified Rendezvous technique is a very easy method and increases the success of postoperative ERCP, especially in patients with large duodenal diverticula and with intradiverticular papilla.

关键词： Endoscopic retrograde cholangiopancreatography Retained stones antegrade cannulation Intradiverticular papilla T-tube

Comprehensive review on EUS-guided biliary drainage

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World Journal of Gastrointestinal Endoscopy 2019年第5期11卷 354-364页

作者： Raffaele Salerno Sophia Elizabeth Campbell Davies Nicolò Mezzina Sandro Ardizzone Gastroenterology and Digestive Endoscopy Unit ASST Fatebenefratelli Sacco-Department of Biochemical and Clinical Sciences "L. Sacco"University of Milan Hospital Pharmacy ASST Fatebenefratelli SaccoPiazza Principessa Clotilde

Feasibility of endoscopic retrograde cholangiopancreatography(ERCP) for biliary drainage is not always applicable due to anatomical alterations or to inability to access the papilla. Percutaneous transhepatic biliary drainage has always been considered the only alternative for this indication. However,endoscopic ultrasonography-guided biliary drainage represents a valid option to replace percutaneous transhepatic biliary drainage when ERCP fails. According to the access site to the biliary tree,two kinds of approaches may be described: the intrahepatic and the extrahepatic. Endoscopic ultrasonography-guided rendezvous transpapillary drainage is performed where the second portion of the duodenum is easily reached but conventional ERCP fails. The recent introduction of self-expandable metal stents and lumen-apposing metal stents has improved this field. However,the role of the latter is still controversial. Echoendoscopic transmural biliary drainage can be challenging with potential severe adverse events. Therefore,trained endoscopists,in both ERCP and endoscopic ultrasonography are needed with surgical and radiological backup.

关键词： Endoscopic ultrasonography-guided biliary drainage EUS Percutaneous transhepatic biliary drainage Endoscopic ultrasonography-guided hepatogastric anastomosis Endoscopic ultrasonography-guided antegrade stent placement Endoscopic ultrasonography-guided choledochoduodenostomy Endoscopic ultrasonography-guided transgallbladder Endoscopic ultrasonography-guided rendezvous

Humerus Nailing in Lateral Position (Operative Technique)

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Open Journal of Orthopedics 2020年第2期10卷 33-41页

作者： Wasudeo Gadegone Piyush Gadegone Vijayanand Lokhande GMC Chandrapur India

With the advent of good designs of nails, straight and angled in the arena of treatment for fractures from surgical neck of humerus to approximately 5 cm above the olecranon fossa, nailing is gaining popularity in recent literature. Many different nails are available in market with different proximal and distal locking configurations. Beach chair and supine are the main principle positions for antegrade humerus nailing. Beach chair or supine is the preferred position by many, but there is always difficulty in distal locking by free hand technique as it is difficult to locate the distal locking hole due to rounded smooth anatomy of anterior distal humerus and fear of neurovascular complications in both anteroposterior and latero-medial locking. The aim of this article is to demonstrate the utility of lateral position in ease of nailing all types of humerus fractures. The technique and illustrations below describe the positioning of patient, image intensifier and free hand postero-anterior distal locking without injury to neurovascular structures.

关键词： Humerus Fracture Interlock Nailing Lateral Position antegrade Nailing