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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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Related Experiment Video

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Reduction of Radiation Exposure during Endovascular Treatment of Peripheral Arterial Disease Combining Fiber Optic RealShape Technology and Intravascular Ultrasound
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[Arterial recanalization using the laser. A technic for the future?].

M Lefebvre-Vilardebo, G Boussignac, C Vieilledent

    Journal Des Maladies Vasculaires
    |January 1, 1986
    PubMed
    Summary
    This summary is machine-generated.

    Percutaneous endoluminal continuous emission Nd-YAG laser recanalisation effectively treats arterial clots and plaques. Balloon angioplasty after laser treatment improved long-term patency in patients.

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    Area of Science:

    • Vascular Surgery
    • Interventional Cardiology
    • Laser Medicine

    Background:

    • Arterial occlusive diseases pose significant clinical challenges.
    • Percutaneous transluminal angioplasty has limitations in treating complex lesions.
    • Nd:YAG laser technology offers a potential solution for arterial recanalisation.

    Purpose of the Study:

    • To evaluate the efficacy and safety of percutaneous endoluminal continuous emission Nd-YAG laser for arterial recanalisation.
    • To assess the impact of haemoglobin-infused solution on limiting thermal injury.
    • To determine the long-term patency rates following laser-assisted recanalisation.

    Main Methods:

    • Developed a technique using Nd:YAG laser with a coaxial balloon catheter.
    • Utilised a haemoglobin-infused blood solution to minimise thermal damage and perforation risk.
    • Performed recanalisation on long arterial segments in amputated legs prior to human trials.
    • Treated ten patients with laser recanalisation, followed by balloon angioplasty in cases of re-stenosis.

    Main Results:

    • Demonstrated effectiveness in recanalising clots and atheromatous plaques, including calcified lesions.
    • Haemoglobin infusion limited thermal parietal lesions and prevented arterial perforation.
    • No embolic debris was observed downstream.
    • Ten patients treated with no mortality and minimal morbidity.
    • Early re-thrombosis occurred in 50% of initial cases, resolved with balloon angioplasty.

    Conclusions:

    • Percutaneous endoluminal Nd:YAG laser recanalisation is a safe and effective method for treating arterial occlusive disease.
    • Adjunctive balloon angioplasty is crucial for maintaining long-term arterial patency after laser treatment.
    • This technique shows promise for managing complex arterial lesions with minimal complications.