• Title, Summary, Keyword: Revascularization

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On-Pump versus Off-pump Myocardial Revascularization in Patients with Renal Insufficiency: Early and Mid-term Results

  • Kim, Hwan-Wook;Lee, Jae-Won;Je, Hyung-Gon;Choi, Soo-Hwan;Jo, Keon-Hyon;Song, Hyun
    • Journal of Chest Surgery
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    • v.44 no.5
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    • pp.323-331
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    • 2011
  • Background: Myocardial revascularization in patients with renal insufficiency is challenging to the cardiac surgeon, irrespective of utilizing extracorporeal circulation. This study aimed to compare the number of bypass grafts and the mid-term results and to evaluate independent survival predictors in patients with renal insufficiency undergoing on-pump or off-pump myocardial revascularization. Materials and Methods: We retrospectively analyzed the data of 103 patients with renal insufficiency, who had isolated myocardial revascularization between January 1999 and January 2009. The patients were divided into two groups, the on-pump group and the off-pump group. Results: The off-pump group received a significantly greater number of distal arterial grafts than the on-pump group. However, the mean number of total grafts, the degree of complete revascularization, and survival rate of the patients were not significantly different between the two groups. Multivariate analysis showed the independent predictors for reduced mid-term survival were the number of total grafts and postoperative periodic renal replacement therapy. Off-pump myocardial revascularization does not decrease the number of bypass grafts or influence on the mid-term results for patients with renal insufficiency, compared to on-pump myocardial revascularization. Conclusion: Myocardial revascularization with a large number of total grafts has a beneficial effect on survival in patients with renal insufficiency, irrespective of utilizing extracorporeal bypass.

Indirect revascularization surgery for moyamoya disease in children and its special considerations

  • Wang, Kyu-Chang;Phi, Ji Hoon;Lee, Ji Yeoun;Kim, Seung-Ki;Cho, Byung-Kyu
    • Clinical and Experimental Pediatrics
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    • v.55 no.11
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    • pp.408-413
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    • 2012
  • Moyamoya disease (MMD) is the most common pediatric cerebrovascular disease in Far Eastern countries. In children, MMD frequently manifests as ischemic symptomatology. Cerebral perfusion gradually decreases as the disease progresses, which often leads to cerebral infarction. The benefits of revascularization surgery, whether direct or indirect, have been well established in MMD patients with ischemic symptoms. In adults, the increase in cerebral blood flow achieved with indirect revascularization is often unsatisfactory, and direct revascularization is usually feasible. In children, however, direct revascularization is frequently technically not feasible, whereas the response to indirect revascularization is excellent, although 1 or 2 weeks are required for stabilization of symptoms. The authors describe surgical procedures and perioperative care in indirect revascularization for MMD. In addition, special considerations with regard to very young patients, patients with recent cerebral infarction, and patients with hyperthyroidism are discussed.

Pulp revascularization of immature permanent tooth (미성숙 영구치의 치수재혈관화)

  • Kwak, Sang Won
    • The Journal of the Korean dental association
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    • v.54 no.8
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    • pp.658-665
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    • 2016
  • Treatment of immature permanent teeth with irreversibly damaged pulp has been challenging in dental practice because of the lack of apical constriction, thin dentinal walls, and short roots. This may lead to the extrusion of filling materials, and fracture of the root due to its more fragile feature during shaping of the root canal. Apexification with calcium hydroxide or MTA is one of the treatment options for these cases. Although favorable results of apexification have been reported, these treatment procedures do not guarantee the increase of root length and/or width even after a long term period. Thus, treated teeth are still prone to fractures. Recently, pulp revascularization has been proposed as an alternative treatment for immature teeth with necrotic pulp and periapical pathosis. Pulp revascularization allows the stimulation of the apical development and the root maturation. There have been many treatment protocols using various materials such as antibiotics and calcium hydroxide medicament. In this case report, literature review about pulp revascularization and two related cases are presented.

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Treatment of non-vital immature teeth with amoxicillin-containing triple antibiotic paste resulting in apexification

  • Park, Hyon-Beom;Lee, Bin-Na;Hwang, Yun-Chan;Hwang, In-Nam;Oh, Won-Mann;Chang, Hoon-Sang
    • Restorative Dentistry and Endodontics
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    • v.40 no.4
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    • pp.322-327
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    • 2015
  • A recent treatment option for non-vital immature teeth in young patients is revascularization with triple antibiotic paste (TAP). However, tooth discoloration was reported with the use of conventional minocycline-containing TAP. In this case report, amoxicillin-containing TAP was used for revascularization of non-vital immature teeth to prevent tooth discoloration. At the 1 yr follow up, the teeth were asymptomatic on clinical examination and showed slight discoloration of the crown due to mineral trioxide aggregate (MTA) filling rather than amoxicillin-containing TAP. Radiographic examination revealed complete resolution of the periapical radiolucency, and closed apex with obvious periodontal ligament space. However, the root growth was limited, and the treatment outcome was more like apexification rather than revascularization. These results may be due to unstable blood clot formation which could not resist the condensation force of MTA filling, whether or not a collagen matrix was in place. These cases showed that although revascularization was not successful, apexification could be expected, resulting in the resolution of the periapical radiolucency and the closure of the apex. Therefore, it is worthwhile attempting revascularization of non-vital immature teeth in young patients.

Pulp revascularization with and without platelet-rich plasma in two anterior teeth with horizontal radicular fractures: a case report

  • Arango-Gomez, Edison;Nino-Barrera, Javier Laureano;Nino, Gustavo;Jordan, Freddy;Sossa-Rojas, Henry
    • Restorative Dentistry and Endodontics
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    • v.44 no.4
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    • pp.35.1-35.10
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    • 2019
  • Pulp revascularization is an alternative treatment in immature traumatized teeth with necrotic pulp. However, this procedure has not been reported in horizontal root fractures. This is a case report of a 9-year-old patient with multiple horizontal root fractures in 2 upper central incisors that were successfully treated with pulp revascularization. The patient presented for treatment 2 years after the initial trauma, and revascularization was attempted after the initial treatment with calcium hydroxide had failed. Prior to pulp revascularization, cone-beam computed tomography and autoradiograms demonstrated multiple horizontal fractures in the middle and apical thirds of the roots of the 2 affected teeth. Revascularization was performed in both teeth; platelet-rich plasma (PRP) was used in one tooth (#11) and the conventional method (blood clot) was used in the other tooth (#21). Clinical and radiographic follow-up over 4 years demonstrated pulp calcification in the PRP-treated tooth. Neither of the 2 teeth were lost, and the root canal calcification of tooth #11 was greater than that of tooth #21. This case suggests that PRP-based pulp revascularization may be an alternative for horizontal root fractures.

The Fate of Neglected Vascular Injury of the Hand in Acute Hand Injuries (급성 수부 손상에서 간과된 혈관성 손상을 가진 수부의 운명)

  • Kim, Tae-Bum;Lee, Yong-Jig;Lee, Young-Keun;Woo, Sang-Hyun
    • Archives of Reconstructive Microsurgery
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    • v.16 no.1
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    • pp.30-38
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    • 2007
  • In acute hand injury, there are sometimes hattened neglected or overlooked vascular injury by primary operators. The authors evaluated the final results and prognosis after secondary revascularization. In eight cases, the authors performed secondary revascularization after prolonged warm ischemia. Five fingers in five cases among them were successfully survived and three cases finally necrosed. The mean warm ischemic time was 56.1 hours. In revascularization procedures, end-to-end artery anastomosis was possible in six cases. In two cases, vein graft was needed to anastomose digital artery, which resulted in complete survival of the fingers. In all three cases, revision amputation of the fingers was done. In acute complex hand injury, the importance of evaluation of the vascular injury can not be overemphasized. The necessity of the early secondary revascularization as well as serious consequence caused by misdiagnosis of vascular injury should be aware.

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Apexogenesis and revascularization treatment procedures for two traumatized immature permanent maxillary incisors: a case report

  • Forghani, Maryam;Parisay, Iman;Maghsoudlou, Amir
    • Restorative Dentistry and Endodontics
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    • v.38 no.3
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    • pp.178-181
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    • 2013
  • Traumatic injuries to an immature permanent tooth may result in cessation of dentin deposition and root maturation. Endodontic treatment is often complicated in premature tooth with an uncertain prognosis. This article describes successful treatment of two traumatized maxillary central incisors with complicated crown fracture three months after trauma. The radiographic examination showed immature roots in maxillary central incisors of a 9-year-old boy with a radiolucent lesion adjacent to the right central incisor. Apexogenesis was performed for the left central incisor and revascularization treatment was considered for the right one. In 18-month clinical and radiographic follow-up both teeth were asymptomatic, roots continued to develop, and periapical radiolucency of the right central incisor healed. Considering the root development of these contralateral teeth it can be concluded that revascularization is an appropriate treatment method in immature necrotic teeth.

Regenerative Endodontic Treatment (임상가를 위한 특집 1 - 재생 근관 치료)

  • Jung, Il Young
    • The Journal of the Korean dental association
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    • v.51 no.10
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    • pp.542-550
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    • 2013
  • The immature teeth with apical periodontitis present considerable challenges to clinicians. Therefore, new treatment protocols have been suggested to overcome the problems encountered in traditional methods. Regenerative treatment (revascularization) is one of such methods. Many case reports on the revascularization of infected immature teeth have been published, and in most of them, immature teeth with even a periapical abscess continued root formation after the disinfection of the root canal system. We now believe that this continued root formation is not an exceptional incident. As a result, it appeared that apexification has been giving way to a revascularization technique, which is a new option, in treating necrotic immature teeth. These new methods appear to be based on the healing potential of stem cells. The potential of healing or regeneration of stem cells, which are located around teeth, seems to be greater than we thought before. This review summarizes the current techniques for considering regenerative endodontic treatment procedures in treating the immature permanent tooth with pulp necrosis.

Hybrid Coronary Revascularization Using Limited Incisional Full Sternotomy Coronary Artery Bypass Surgery in Multivessel Disease: Early Results

  • Kang, Joonkyu;Song, Hyun;Lee, Seok In;Moon, Mi Hyung;Kim, Hwan Wook;Jo, Gyun Hyun
    • Journal of Chest Surgery
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    • v.47 no.2
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    • pp.106-110
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    • 2014
  • Background: There are several modalities of coronary artery revascularization for multivessel coronary artery disease. Hybrid coronary revascularization (HCR) with minimally invasive direct coronary artery bypass grafting was introduced for high-risk patients, and recently, many centers have been using it. Limited incisional full sternotomy coronary artery bypass (LIFCAB) involves left internal thoracic artery (LITA)-to-left anterior descending coronary artery (LAD) anastomosis through a sternotomy with a minimal skin incision; it could be considered another technique for minimally invasive LITA-to-LAD anastomosis. Our center has performed HCR using LIFCAB, and in this paper, we report our short-term results, obtained in the past 3 years. Methods: The medical records of 38 patients from May 2010 to June 2013 were analyzed retrospectively. The observation period after HCR was 1 to 37 months (average, $18.3{\pm}10.3$ months). The patency of revascularization was confirmed with postoperative coronary angio-computerized tomography or coronary angiography. Results: There were 3 superficial wound complications, but no mortalities. All the LITA-to-LAD anastomoses were patent in the immediate postoperative and follow-up studies, but stenosis was detected in 3 cases of percutaneous coronary intervention. Conclusion: HCR using LIFCAB is safe and yields satisfactory results from the viewpoint of revascularization for multivessel disease.

REVASCULARIZATION AND REINNERVATION OF CALCITONIN GENE-RELATED PEPTIDE IMMUNOREACTIVE NERVES IN REPLANTED RAT MOLARS (재식한 흰쥐 구치 치수조직의 재혈관화와 CGRP 면역반응 신경섬유의 변화)

  • Lee, Seung-Bong;Kim, Hyun-Jung;Nam, Soon-Hyun;Bae, Yong-Chul;Kim, Young-Jin
    • JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY
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    • v.26 no.4
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    • pp.688-702
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    • 1999
  • The purpose of this study was to investigate the revascularization and reinnervation of calcitonin gene-related peptide immunoreactive nerves in immediately replanted rat molars. First maxillary right molars in 56 rats(35days old) were extracted and immediately replanted. The rats were killed 1, 2, 3, 7, 14, 28 and 42 days after replantation and revascularization of pulpal blood vessels were examined microangiogram with korean traditional ink and reinnervation of pulpal nerve were examined immunohistochemical method using calcitonin gene-related peptide(CGRP) antiserum. The results were as follows; 1. Revascularization and reinnervation of CGRP immunoreactive nerve fibers were observed mesial side whole pulp tissue of replanted teeth. Revascularization and reinnervation of CGRP immunoreactive fiber were made at 2days after replantation in entire pulp of replanted teeth and the distribution density of blood vessels were gradually increased according time elapsed, but did not achieve the density of control. 2. Postoperative dentin formation in replanted teeth revealed at 1week after replantaton and gradually increased according to time elapsed. 3. Revascularization and Reinnervation of CGRP immunoreactive nerve fibers were established at the same time and it seems to be closed relatationship between revascularization and reinnervation.

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