home *** CD-ROM | disk | FTP | other *** search
| Unknown | 1992-06-06 | 319.2 KB |
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MacOS 8.1
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Win98
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DOS
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| Confidence | Program | Detection | Match Type | Support
|
|---|
| 66%
| dexvert
| OS/2 Installation Package (archive/os2InstallPackage)
| ext
| Supported |
| 1%
| dexvert
| BeOS Installation Package (archive/beOSInstallPackage)
| ext
| Unsupported |
| 1%
| dexvert
| Newton Package (archive/newtonPackage)
| ext
| Unsupported |
| 1%
| dexvert
| Independence War 2 mod Package (other/independenceWar2ModPackage)
| ext
| Unsupported |
| 100%
| file
| data
| default
|
|
hex view+--------+-------------------------+-------------------------+--------+--------+
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|000004c0| 00 01 82 33 04 00 b5 0a | 00 00 38 36 00 00 00 01 |...3....|..86....|
|000004d0| 37 3e 04 00 b9 0b 00 00 | 38 37 00 00 00 01 f0 49 |7>......|87.....I|
|000004e0| 04 00 1a 0c 00 00 38 38 | 00 00 00 01 0a 56 04 00 |......88|.....V..|
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|00000510| 39 31 00 00 00 01 b8 7c | 04 00 6a 10 00 00 39 32 |91.....||..j...92|
|00000520| 00 00 00 01 22 8d 04 00 | 80 11 00 00 39 33 00 00 |...."...|....93..|
|00000530| 00 01 a2 9e 04 00 28 10 | 00 00 39 34 00 00 00 01 |......(.|..94....|
|00000540| ca ae 04 00 fd 0d 00 00 | 39 35 00 00 00 01 c7 bc |........|95......|
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|00000570| 00 00 39 38 00 00 00 01 | 73 e3 04 00 ae 0b 00 00 |..98....|s.......|
|00000580| 39 39 00 00 00 01 21 ef | 04 00 91 0d 00 00 00 00 |99....!.|........|
|00000590| 00 00 00 00 b2 fc 04 00 | 00 00 00 00 24 55 6e 69 |........|....$Uni|
|000005a0| 71 75 65 5f 49 44 7b 59 | 52 42 30 39 35 30 30 7d |que_ID{Y|RB09500}|
|000005b0| 0d 0a 24 54 69 74 6c 65 | 7b 54 72 65 61 74 6d 65 |..$Title|{Treatme|
|000005c0| 6e 74 20 6f 66 20 50 65 | 72 69 70 68 65 72 61 6c |nt of Pe|ripheral|
|000005d0| 20 41 72 74 65 72 69 61 | 6c 20 4f 62 73 74 72 75 | Arteria|l Obstru|
|000005e0| 63 74 69 6f 6e 20 57 69 | 74 68 20 53 74 72 65 70 |ction Wi|th Strep|
|000005f0| 74 6f 6b 69 6e 61 73 65 | 3a 20 20 52 65 73 75 6c |tokinase|: Resul|
|00000600| 74 73 20 69 6e 20 41 72 | 74 65 72 69 61 6c 20 76 |ts in Ar|terial v|
|00000610| 73 2e 20 20 47 72 61 66 | 74 20 4f 63 63 6c 75 73 |s. Graf|t Occlus|
|00000620| 69 6f 6e 73 7d 0d 0a 24 | 41 75 74 68 6f 72 7b 4c |ions}..$|Author{L|
|00000630| 65 42 6f 6c 74 2c 20 53 | 41 0d 0a 54 69 73 6e 61 |eBolt, S|A..Tisna|
|00000640| 64 6f 2c 20 4a 0d 0a 43 | 68 6f 2c 20 53 2d 52 7d |do, J..C|ho, S-R}|
|00000650| 0d 0a 24 41 66 66 69 6c | 69 61 74 69 6f 6e 7b 4d |..$Affil|iation{M|
|00000660| 65 64 20 43 6f 6c 6c 65 | 67 65 20 6f 66 20 56 69 |ed Colle|ge of Vi|
|00000670| 72 67 69 6e 69 61 2c 20 | 52 69 63 68 6d 6f 6e 64 |rginia, |Richmond|
|00000680| 7d 0d 0a 24 4a 6f 75 72 | 6e 61 6c 7b 41 4a 52 7d |}..$Jour|nal{AJR}|
|00000690| 0d 0a 24 56 6f 6c 75 6d | 65 7b 31 35 31 7d 0d 0a |..$Volum|e{151}..|
|000006a0| 24 50 61 67 65 7b 35 38 | 39 2d 35 39 32 7d 0d 0a |$Page{58|9-592}..|
|000006b0| 24 44 61 74 65 7b 53 65 | 70 74 65 6d 62 65 72 20 |$Date{Se|ptember |
|000006c0| 31 39 38 38 7d 0d 0a 24 | 59 42 56 6f 6c 7b 31 39 |1988}..$|YBVol{19|
|000006d0| 39 30 20 59 65 61 72 20 | 42 6f 6f 6b 20 6f 66 20 |90 Year |Book of |
|000006e0| 44 69 61 67 6e 6f 73 74 | 69 63 20 52 61 64 69 6f |Diagnost|ic Radio|
|000006f0| 6c 6f 67 79 7d 0d 0a 24 | 43 68 61 70 74 65 72 7b |logy}..$|Chapter{|
|00000700| 32 2d 31 34 7d 0d 0a 24 | 59 42 45 64 69 74 6f 72 |2-14}..$|YBEditor|
|00000710| 7b 44 72 73 2e 20 42 72 | 61 67 67 2c 20 48 65 6e |{Drs. Br|agg, Hen|
|00000720| 64 65 65 2c 20 4b 65 61 | 74 73 2c 20 4b 69 72 6b |dee, Kea|ts, Kirk|
|00000730| 70 61 74 72 69 63 6b 2c | 20 4d 69 6c 6c 65 72 2c |patrick,| Miller,|
|00000740| 20 4f 73 62 6f 72 6e 2c | 20 61 6e 64 20 54 68 6f | Osborn,| and Tho|
|00000750| 6d 70 73 6f 6e 7d 0d 0a | 24 54 61 62 6c 65 7b 54 |mpson}..|$Table{T|
|00000760| 61 62 6c 65 20 4f 6d 69 | 74 74 65 64 7d 0d 0a 24 |able Omi|tted}..$|
|00000770| 43 6f 6d 6d 65 6e 74 61 | 74 6f 72 7b 46 2e 4a 2e |Commenta|tor{F.J.|
|00000780| 20 4d 69 6c 6c 65 72 2c | 20 4a 72 2e 2c 20 4d 2e | Miller,| Jr., M.|
|00000790| 44 2e 7d 0d 0a 0d 0a 43 | 6f 70 79 72 69 67 68 74 |D.}....C|opyright|
|000007a0| 20 28 63 29 20 59 65 61 | 72 62 6f 6f 6b 20 4d 65 | (c) Yea|rbook Me|
|000007b0| 64 69 63 61 6c 20 50 75 | 62 6c 69 73 68 65 72 73 |dical Pu|blishers|
|000007c0| 2c 20 49 6e 63 2e 2c 20 | 31 39 39 30 0d 0a 0d 0a |, Inc., |1990....|
|000007d0| 31 39 39 30 20 59 65 61 | 72 20 42 6f 6f 6b 20 6f |1990 Yea|r Book o|
|000007e0| 66 20 44 69 61 67 6e 6f | 73 74 69 63 20 52 61 64 |f Diagno|stic Rad|
|000007f0| 69 6f 6c 6f 67 79 20 28 | 52 29 0d 0a 0d 0a 43 68 |iology (|R)....Ch|
|00000800| 61 70 74 65 72 20 32 2d | 2d 43 61 72 64 69 6f 76 |apter 2-|-Cardiov|
|00000810| 61 73 63 75 6c 61 72 20 | 61 6e 64 20 49 6e 74 65 |ascular |and Inte|
|00000820| 72 76 65 6e 74 69 6f 6e | 61 6c 20 52 61 64 69 6f |rvention|al Radio|
|00000830| 6c 6f 67 79 0d 0a 0d 0a | 56 61 73 63 75 6c 61 72 |logy....|Vascular|
|00000840| 20 49 6e 74 65 72 76 65 | 6e 74 69 6f 6e 0d 0a 0d | Interve|ntion...|
|00000850| 0a 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |.-------|--------|
|00000860| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000870| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000880| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000890| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 0d |--------|-------.|
|000008a0| 0a 54 72 65 61 74 6d 65 | 6e 74 20 6f 66 20 50 65 |.Treatme|nt of Pe|
|000008b0| 72 69 70 68 65 72 61 6c | 20 41 72 74 65 72 69 61 |ripheral| Arteria|
|000008c0| 6c 20 4f 62 73 74 72 75 | 63 74 69 6f 6e 20 57 69 |l Obstru|ction Wi|
|000008d0| 74 68 20 53 74 72 65 70 | 74 6f 6b 69 6e 61 73 65 |th Strep|tokinase|
|000008e0| 3a 20 20 52 65 73 75 6c | 74 73 20 69 6e 0d 0a 41 |: Resul|ts in..A|
|000008f0| 72 74 65 72 69 61 6c 20 | 76 73 2e 20 20 47 72 61 |rterial |vs. Gra|
|00000900| 66 74 20 4f 63 63 6c 75 | 73 69 6f 6e 73 0d 0a 0d |ft Occlu|sions...|
|00000910| 0a 4c 65 42 6f 6c 74 20 | 53 41 2c 20 54 69 73 6e |.LeBolt |SA, Tisn|
|00000920| 61 64 6f 20 4a 2c 20 43 | 68 6f 20 53 2d 52 0d 0a |ado J, C|ho S-R..|
|00000930| 28 4d 65 64 20 43 6f 6c | 6c 65 67 65 20 6f 66 20 |(Med Col|lege of |
|00000940| 56 69 72 67 69 6e 69 61 | 2c 20 52 69 63 68 6d 6f |Virginia|, Richmo|
|00000950| 6e 64 29 0d 0a 41 4a 52 | 20 31 35 31 3a 35 38 39 |nd)..AJR| 151:589|
|00000960| 2d 35 39 32 2c 20 53 65 | 70 74 65 6d 62 65 72 20 |-592, Se|ptember |
|00000970| 31 39 38 38 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |1988..--|--------|
|00000980| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00000990| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000009a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000009b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000009c0| 2d 2d 2d 2d 0d 0a 0d 0a | 41 62 73 74 72 61 63 74 |----....|Abstract|
|000009d0| 0d 0a 0d 0a 20 20 20 20 | 20 54 68 65 20 65 66 66 |.... | The eff|
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|000009f0| 77 2d 64 6f 73 65 20 73 | 74 72 65 70 74 6f 6b 69 |w-dose s|treptoki|
|00000a00| 6e 61 73 65 20 69 6e 20 | 74 72 65 61 74 69 6e 67 |nase in |treating|
|00000a10| 20 61 72 74 65 72 69 61 | 6c 0d 0a 6f 63 63 6c 75 | arteria|l..occlu|
|00000a20| 73 69 6f 6e 73 20 69 6e | 20 74 68 65 20 65 78 74 |sions in| the ext|
|00000a30| 72 65 6d 69 74 69 65 73 | 20 69 73 20 64 65 70 65 |remities| is depe|
|00000a40| 6e 64 65 6e 74 20 6f 6e | 20 61 20 6e 75 6d 62 65 |ndent on| a numbe|
|00000a50| 72 20 6f 66 20 66 61 63 | 74 6f 72 73 2e 20 20 54 |r of fac|tors. T|
|00000a60| 68 65 0d 0a 6f 75 74 63 | 6f 6d 65 73 20 6f 66 20 |he..outc|omes of |
|00000a70| 70 61 74 69 65 6e 74 73 | 20 77 69 74 68 20 6f 63 |patients| with oc|
|00000a80| 63 6c 75 73 69 6f 6e 73 | 20 69 6e 20 6e 61 74 69 |clusions| in nati|
|00000a90| 76 65 20 61 72 74 65 72 | 69 65 73 20 77 65 72 65 |ve arter|ies were|
|00000aa0| 20 63 6f 6d 70 61 72 65 | 64 20 77 69 74 68 0d 0a | compare|d with..|
|00000ab0| 74 68 6f 73 65 20 77 68 | 6f 20 68 61 64 20 61 72 |those wh|o had ar|
|00000ac0| 74 65 72 69 61 6c 20 67 | 72 61 66 74 73 2e 20 20 |terial g|rafts. |
|00000ad0| 54 68 65 20 64 6f 73 61 | 67 65 20 6f 66 20 74 68 |The dosa|ge of th|
|00000ae0| 65 20 74 68 72 6f 6d 62 | 6f 6c 79 74 69 63 20 61 |e thromb|olytic a|
|00000af0| 67 65 6e 74 2c 20 64 75 | 72 61 74 69 6f 6e 0d 0a |gent, du|ration..|
|00000b00| 6f 66 20 74 68 65 20 69 | 6e 66 75 73 69 6f 6e 2c |of the i|nfusion,|
|00000b10| 20 61 6e 64 20 6c 65 6e | 67 74 68 20 6f 66 20 74 | and len|gth of t|
|00000b20| 69 6d 65 20 62 65 74 77 | 65 65 6e 20 61 70 70 65 |ime betw|een appe|
|00000b30| 61 72 61 6e 63 65 20 6f | 66 20 73 79 6d 70 74 6f |arance o|f sympto|
|00000b40| 6d 73 20 61 6e 64 20 73 | 74 61 72 74 0d 0a 6f 66 |ms and s|tart..of|
|00000b50| 20 74 72 65 61 74 6d 65 | 6e 74 20 61 6c 73 6f 20 | treatme|nt also |
|00000b60| 77 65 72 65 20 65 76 61 | 6c 75 61 74 65 64 2e 0d |were eva|luated..|
|00000b70| 0a 20 20 20 20 20 43 6f | 6d 70 6c 65 74 65 20 74 |. Co|mplete t|
|00000b80| 68 72 6f 6d 62 6f 6c 79 | 73 69 73 20 6f 63 63 75 |hromboly|sis occu|
|00000b90| 72 72 65 64 20 61 74 20 | 61 20 73 69 67 6e 69 66 |rred at |a signif|
|00000ba0| 69 63 61 6e 74 6c 79 20 | 68 69 67 68 65 72 20 72 |icantly |higher r|
|00000bb0| 61 74 65 20 69 6e 20 6e | 61 74 69 76 65 0d 0a 61 |ate in n|ative..a|
|00000bc0| 72 74 65 72 69 65 73 20 | 28 36 37 25 29 20 74 68 |rteries |(67%) th|
|00000bd0| 61 6e 20 69 6e 20 67 72 | 61 66 74 73 20 28 32 37 |an in gr|afts (27|
|00000be0| 25 29 2e 20 20 41 20 73 | 68 6f 72 74 20 64 75 72 |%). A s|hort dur|
|00000bf0| 61 74 69 6f 6e 20 6f 66 | 20 73 79 6d 70 74 6f 6d |ation of| symptom|
|00000c00| 73 20 77 61 73 0d 0a 61 | 73 73 6f 63 69 61 74 65 |s was..a|ssociate|
|00000c10| 64 20 77 69 74 68 20 73 | 75 63 63 65 73 73 66 75 |d with s|uccessfu|
|00000c20| 6c 20 72 65 73 75 6c 74 | 73 20 69 6e 20 74 68 65 |l result|s in the|
|00000c30| 20 6e 61 74 69 76 65 20 | 61 72 74 65 72 79 20 67 | native |artery g|
|00000c40| 72 6f 75 70 2e 20 20 44 | 6f 73 61 67 65 20 61 6e |roup. D|osage an|
|00000c50| 64 0d 0a 72 61 74 65 20 | 6f 66 20 69 6e 66 75 73 |d..rate |of infus|
|00000c60| 69 6f 6e 20 77 65 72 65 | 20 6e 6f 74 20 72 65 6c |ion were| not rel|
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|00000ca0| 0d 0a 32 29 2e 0d 0a 20 | 20 20 20 20 56 65 6e 6f |..2)... | Veno|
|00000cb0| 75 73 20 67 72 61 66 74 | 73 20 68 61 64 20 61 20 |us graft|s had a |
|00000cc0| 68 69 67 68 65 72 20 73 | 75 63 63 65 73 73 20 72 |higher s|uccess r|
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|00000cf0| 0d 0a 28 33 38 25 29 2c | 20 70 6f 73 73 69 62 6c |..(38%),| possibl|
|00000d00| 79 20 62 65 63 61 75 73 | 65 20 70 61 74 69 65 6e |y becaus|e patien|
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|00000d30| 6f 72 65 20 6c 6f 6e 67 | 2d 74 65 72 6d 0d 0a 61 |ore long|-term..a|
|00000d40| 6e 64 20 65 78 74 65 6e | 73 69 76 65 20 70 65 72 |nd exten|sive per|
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|00000d70| 70 61 69 72 65 64 20 64 | 69 73 74 61 6c 20 72 75 |paired d|istal ru|
|00000d80| 6e 6f 66 66 2e 0d 0a 20 | 20 20 20 20 4c 6f 77 2d |noff... | Low-|
|00000d90| 64 6f 73 65 20 73 74 72 | 65 70 74 6f 6b 69 6e 61 |dose str|eptokina|
|00000da0| 73 65 20 69 73 20 65 66 | 66 65 63 74 69 76 65 20 |se is ef|fective |
|00000db0| 69 6e 20 72 65 73 6f 6c | 76 69 6e 67 20 74 68 72 |in resol|ving thr|
|00000dc0| 6f 6d 62 6f 73 69 73 20 | 69 6e 20 6e 61 74 69 76 |ombosis |in nativ|
|00000dd0| 65 0d 0a 61 72 74 65 72 | 69 65 73 20 62 75 74 20 |e..arter|ies but |
|00000de0| 69 73 20 6c 65 73 73 20 | 73 75 63 63 65 73 73 66 |is less |successf|
|00000df0| 75 6c 20 77 69 74 68 20 | 67 72 61 66 74 73 2e 20 |ul with |grafts. |
|00000e00| 20 54 68 65 20 62 65 73 | 74 20 72 65 73 75 6c 74 | The bes|t result|
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|00000e30| 20 6e 61 74 69 76 65 20 | 61 72 74 65 72 69 65 73 | native |arteries|
|00000e40| 20 77 68 6f 20 62 65 67 | 69 6e 20 74 68 65 72 61 | who beg|in thera|
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|00000e60| 64 61 79 73 20 61 66 74 | 65 72 20 74 68 65 0d 0a |days aft|er the..|
|00000e70| 6f 6e 73 65 74 20 6f 66 | 20 73 79 6d 70 74 6f 6d |onset of| symptom|
|00000e80| 73 2e 0d 0a 0d 0a 50 6f | 73 74 2d 43 6f 6d 6d 65 |s.....Po|st-Comme|
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|00000ea0| 6f 73 65 20 73 74 72 65 | 70 74 6f 6b 69 6e 61 73 |ose stre|ptokinas|
|00000eb0| 65 20 68 61 73 20 62 65 | 65 6e 20 74 6f 74 61 6c |e has be|en total|
|00000ec0| 6c 79 20 72 65 70 6c 61 | 63 65 64 20 77 69 74 68 |ly repla|ced with|
|00000ed0| 20 75 72 6f 6b 69 6e 61 | 73 65 20 69 6e 20 74 68 | urokina|se in th|
|00000ee0| 65 0d 0a 70 65 72 69 70 | 68 65 72 61 6c 20 76 61 |e..perip|heral va|
|00000ef0| 73 63 75 6c 61 72 20 63 | 69 72 63 75 6c 61 74 69 |scular c|irculati|
|00000f00| 6f 6e 2e 20 20 4e 61 74 | 69 76 65 20 61 72 74 65 |on. Nat|ive arte|
|00000f10| 72 69 65 73 20 77 69 6c | 6c 20 73 68 6f 77 20 6d |ries wil|l show m|
|00000f20| 6f 72 65 20 66 61 76 6f | 72 61 62 6c 65 0d 0a 72 |ore favo|rable..r|
|00000f30| 65 73 75 6c 74 73 20 74 | 68 61 6e 20 61 72 74 69 |esults t|han arti|
|00000f40| 66 69 63 69 61 6c 20 67 | 72 61 66 74 73 2e 2d 2d |ficial g|rafts.--|
|00000f50| 46 2e 4a 2e 20 4d 69 6c | 6c 65 72 2c 20 4a 72 2e |F.J. Mil|ler, Jr.|
|00000f60| 2c 20 4d 2e 44 2e 0d 0a | 24 55 6e 69 71 75 65 5f |, M.D...|$Unique_|
|00000f70| 49 44 7b 59 52 42 30 39 | 35 30 31 7d 0d 0a 24 54 |ID{YRB09|501}..$T|
|00000f80| 69 74 6c 65 7b 52 6f 74 | 61 74 69 6f 6e 61 6c 20 |itle{Rot|ational |
|00000f90| 54 68 72 6f 6d 62 65 63 | 74 6f 6d 79 20 69 6e 20 |Thrombec|tomy in |
|00000fa0| 41 63 75 74 65 20 43 61 | 6e 69 6e 65 20 43 6f 72 |Acute Ca|nine Cor|
|00000fb0| 6f 6e 61 72 79 20 54 68 | 72 6f 6d 62 6f 73 69 73 |onary Th|rombosis|
|00000fc0| 7d 0d 0a 24 41 75 74 68 | 6f 72 7b 48 61 6e 73 65 |}..$Auth|or{Hanse|
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|00000ff0| 68 69 65 2c 20 4a 4c 7d | 0d 0a 24 41 66 66 69 6c |hie, JL}|..$Affil|
|00001000| 69 61 74 69 6f 6e 7b 55 | 6e 69 76 20 6f 66 20 57 |iation{U|niv of W|
|00001010| 61 73 68 69 6e 67 74 6f | 6e 3b 20 53 65 61 74 74 |ashingto|n; Seatt|
|00001020| 6c 65 20 56 41 20 48 6f | 73 70 7d 0d 0a 24 4a 6f |le VA Ho|sp}..$Jo|
|00001030| 75 72 6e 61 6c 7b 49 6e | 74 20 4a 20 43 61 72 64 |urnal{In|t J Card|
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|00001060| 0a 24 44 61 74 65 7b 4a | 61 6e 75 61 72 79 20 31 |.$Date{J|anuary 1|
|00001070| 39 38 39 7d 0d 0a 24 59 | 42 56 6f 6c 7b 31 39 39 |989}..$Y|BVol{199|
|00001080| 30 20 59 65 61 72 20 42 | 6f 6f 6b 20 6f 66 20 44 |0 Year B|ook of D|
|00001090| 69 61 67 6e 6f 73 74 69 | 63 20 52 61 64 69 6f 6c |iagnosti|c Radiol|
|000010a0| 6f 67 79 7d 0d 0a 24 43 | 68 61 70 74 65 72 7b 32 |ogy}..$C|hapter{2|
|000010b0| 2d 31 35 7d 0d 0a 24 59 | 42 45 64 69 74 6f 72 7b |-15}..$Y|BEditor{|
|000010c0| 44 72 73 2e 20 42 72 61 | 67 67 2c 20 48 65 6e 64 |Drs. Bra|gg, Hend|
|000010d0| 65 65 2c 20 4b 65 61 74 | 73 2c 20 4b 69 72 6b 70 |ee, Keat|s, Kirkp|
|000010e0| 61 74 72 69 63 6b 2c 20 | 4d 69 6c 6c 65 72 2c 20 |atrick, |Miller, |
|000010f0| 4f 73 62 6f 72 6e 2c 20 | 61 6e 64 20 54 68 6f 6d |Osborn, |and Thom|
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|00001110| 62 6c 65 20 4f 6d 69 74 | 74 65 64 7d 0d 0a 24 43 |ble Omit|ted}..$C|
|00001120| 6f 6d 6d 65 6e 74 61 74 | 6f 72 7b 46 2e 4a 2e 20 |ommentat|or{F.J. |
|00001130| 4d 69 6c 6c 65 72 2c 20 | 4a 72 2e 2c 20 4d 2e 44 |Miller, |Jr., M.D|
|00001140| 2e 7d 0d 0a 0d 0a 43 6f | 70 79 72 69 67 68 74 20 |.}....Co|pyright |
|00001150| 28 63 29 20 59 65 61 72 | 62 6f 6f 6b 20 4d 65 64 |(c) Year|book Med|
|00001160| 69 63 61 6c 20 50 75 62 | 6c 69 73 68 65 72 73 2c |ical Pub|lishers,|
|00001170| 20 49 6e 63 2e 2c 20 31 | 39 39 30 0d 0a 0d 0a 31 | Inc., 1|990....1|
|00001180| 39 39 30 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |990 Year| Book of|
|00001190| 20 44 69 61 67 6e 6f 73 | 74 69 63 20 52 61 64 69 | Diagnos|tic Radi|
|000011a0| 6f 6c 6f 67 79 20 28 52 | 29 0d 0a 0d 0a 43 68 61 |ology (R|)....Cha|
|000011b0| 70 74 65 72 20 32 2d 2d | 43 61 72 64 69 6f 76 61 |pter 2--|Cardiova|
|000011c0| 73 63 75 6c 61 72 20 61 | 6e 64 20 49 6e 74 65 72 |scular a|nd Inter|
|000011d0| 76 65 6e 74 69 6f 6e 61 | 6c 20 52 61 64 69 6f 6c |ventiona|l Radiol|
|000011e0| 6f 67 79 0d 0a 0d 0a 56 | 61 73 63 75 6c 61 72 20 |ogy....V|ascular |
|000011f0| 49 6e 74 65 72 76 65 6e | 74 69 6f 6e 0d 0a 0d 0a |Interven|tion....|
|00001200| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001210| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001220| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001230| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001240| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 0d 0a |--------|------..|
|00001250| 52 6f 74 61 74 69 6f 6e | 61 6c 20 54 68 72 6f 6d |Rotation|al Throm|
|00001260| 62 65 63 74 6f 6d 79 20 | 69 6e 20 41 63 75 74 65 |bectomy |in Acute|
|00001270| 20 43 61 6e 69 6e 65 20 | 43 6f 72 6f 6e 61 72 79 | Canine |Coronary|
|00001280| 20 54 68 72 6f 6d 62 6f | 73 69 73 0d 0a 0d 0a 48 | Thrombo|sis....H|
|00001290| 61 6e 73 65 6e 20 44 44 | 2c 20 41 75 74 68 20 44 |ansen DD|, Auth D|
|000012a0| 43 2c 20 56 72 61 63 6b | 6f 20 52 2c 20 52 69 74 |C, Vrack|o R, Rit|
|000012b0| 63 68 69 65 20 4a 4c 0d | 0a 28 55 6e 69 76 20 6f |chie JL.|.(Univ o|
|000012c0| 66 20 57 61 73 68 69 6e | 67 74 6f 6e 3b 20 53 65 |f Washin|gton; Se|
|000012d0| 61 74 74 6c 65 20 56 41 | 20 48 6f 73 70 29 0d 0a |attle VA| Hosp)..|
|000012e0| 49 6e 74 20 4a 20 43 61 | 72 64 69 6f 6c 20 32 32 |Int J Ca|rdiol 22|
|000012f0| 3a 31 33 2d 31 39 2c 20 | 4a 61 6e 75 61 72 79 20 |:13-19, |January |
|00001300| 31 39 38 39 0d 0a 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |1989..--|--------|
|00001310| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001320| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001330| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001340| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00001350| 2d 2d 2d 2d 0d 0a 0d 0a | 41 62 73 74 72 61 63 74 |----....|Abstract|
|00001360| 0d 0a 0d 0a 20 20 20 20 | 20 41 20 6d 65 63 68 61 |.... | A mecha|
|00001370| 6e 69 63 61 6c 20 70 65 | 72 63 75 74 61 6e 65 6f |nical pe|rcutaneo|
|00001380| 75 73 20 72 6f 74 61 74 | 69 6e 67 20 74 68 72 6f |us rotat|ing thro|
|00001390| 6d 62 65 63 74 6f 6d 79 | 20 63 61 74 68 65 74 65 |mbectomy| cathete|
|000013a0| 72 20 28 46 69 67 20 32 | 2d 31 38 29 20 77 61 73 |r (Fig 2|-18) was|
|000013b0| 0d 0a 64 65 76 65 6c 6f | 70 65 64 20 74 68 61 74 |..develo|ped that|
|000013c0| 20 64 65 66 69 62 72 69 | 6e 61 74 65 73 20 66 72 | defibri|nates fr|
|000013d0| 65 73 68 20 74 68 72 6f | 6d 62 75 73 20 77 69 74 |esh thro|mbus wit|
|000013e0| 68 69 6e 20 61 6e 20 69 | 6e 66 61 72 63 74 20 76 |hin an i|nfarct v|
|000013f0| 65 73 73 65 6c 2c 20 63 | 61 75 73 69 6e 67 0d 0a |essel, c|ausing..|
|00001400| 72 65 70 65 72 66 75 73 | 69 6f 6e 2e 20 20 54 68 |reperfus|ion. Th|
|00001410| 65 20 72 69 73 6b 20 6f | 66 20 64 69 73 74 61 6c |e risk o|f distal|
|00001420| 20 65 6d 62 6f 6c 69 7a | 61 74 69 6f 6e 20 6d 61 | emboliz|ation ma|
|00001430| 79 20 62 65 20 6c 65 73 | 73 20 74 68 61 6e 20 77 |y be les|s than w|
|00001440| 69 74 68 20 73 74 61 6e | 64 61 72 64 0d 0a 62 61 |ith stan|dard..ba|
|00001450| 6c 6c 6f 6f 6e 20 73 79 | 73 74 65 6d 73 2e 20 20 |lloon sy|stems. |
|00001460| 54 68 65 20 63 61 74 68 | 65 74 65 72 20 69 73 20 |The cath|eter is |
|00001470| 72 6f 74 61 74 65 64 20 | 77 69 74 68 69 6e 20 61 |rotated |within a|
|00001480| 20 34 20 46 20 54 65 66 | 6c 6f 6e 20 73 68 65 61 | 4 F Tef|lon shea|
|00001490| 74 68 20 61 74 20 75 70 | 20 74 6f 0d 0a 31 30 2c |th at up| to..10,|
|000014a0| 30 30 30 20 72 70 6d 20 | 62 79 20 6d 65 61 6e 73 |000 rpm |by means|
|000014b0| 20 6f 66 20 61 20 62 61 | 74 74 65 72 79 2d 70 6f | of a ba|ttery-po|
|000014c0| 77 65 72 65 64 20 65 6c | 65 63 74 72 69 63 20 6d |wered el|ectric m|
|000014d0| 6f 74 6f 72 2e 20 20 54 | 68 65 20 63 61 74 68 65 |otor. T|he cathe|
|000014e0| 74 65 72 20 69 73 0d 0a | 69 6e 74 72 6f 64 75 63 |ter is..|introduc|
|000014f0| 65 64 20 76 69 61 20 74 | 68 65 20 63 61 72 6f 74 |ed via t|he carot|
|00001500| 69 64 20 61 72 74 65 72 | 79 20 69 6e 74 6f 20 74 |id arter|y into t|
|00001510| 68 65 20 64 69 73 74 61 | 6c 20 6c 65 66 74 20 64 |he dista|l left d|
|00001520| 65 73 63 65 6e 64 69 6e | 67 20 61 72 74 65 72 79 |escendin|g artery|
|00001530| 20 75 6e 64 65 72 0d 0a | 66 6c 75 6f 72 6f 73 63 | under..|fluorosc|
|00001540| 6f 70 69 63 20 63 6f 6e | 74 72 6f 6c 2e 20 20 48 |opic con|trol. H|
|00001550| 65 70 61 72 69 6e 20 69 | 73 20 67 69 76 65 6e 20 |eparin i|s given |
|00001560| 69 6e 74 72 61 76 65 6e | 6f 75 73 6c 79 20 69 6e |intraven|ously in|
|00001570| 20 63 6f 6e 6a 75 6e 63 | 74 69 6f 6e 20 77 69 74 | conjunc|tion wit|
|00001580| 68 20 74 68 65 0d 0a 70 | 72 6f 63 65 64 75 72 65 |h the..p|rocedure|
|00001590| 2e 0d 0a 20 20 20 20 20 | 54 6f 74 61 6c 20 63 6f |... |Total co|
|000015a0| 72 6f 6e 61 72 79 20 74 | 68 72 6f 6d 62 6f 73 69 |ronary t|hrombosi|
|000015b0| 73 20 77 61 73 20 70 72 | 6f 64 75 63 65 64 20 69 |s was pr|oduced i|
|000015c0| 6e 20 31 31 20 64 6f 67 | 73 2e 20 20 53 74 65 6e |n 11 dog|s. Sten|
|000015d0| 6f 73 69 73 20 64 65 63 | 72 65 61 73 65 64 0d 0a |osis dec|reased..|
|000015e0| 66 72 6f 6d 20 31 30 30 | 25 20 74 6f 20 32 38 25 |from 100|% to 28%|
|000015f0| 20 61 66 74 65 72 20 74 | 68 65 20 70 72 6f 63 65 | after t|he proce|
|00001600| 64 75 72 65 20 28 46 69 | 67 20 32 2d 31 39 29 2e |dure (Fi|g 2-19).|
|00001610| 20 20 43 6f 72 6f 6e 61 | 72 79 20 61 72 74 65 72 | Corona|ry arter|
|00001620| 79 20 73 70 61 73 6d 20 | 77 61 73 0d 0a 6e 6f 74 |y spasm |was..not|
|00001630| 20 6f 62 73 65 72 76 65 | 64 2e 20 20 54 68 65 72 | observe|d. Ther|
|00001640| 65 20 77 61 73 20 6f 6e | 6c 79 20 6d 69 6c 64 20 |e was on|ly mild |
|00001650| 73 6c 6f 77 69 6e 67 20 | 6f 66 20 62 6c 6f 6f 64 |slowing |of blood|
|00001660| 20 64 69 73 74 61 6c 6c | 79 20 61 66 74 65 72 0d | distall|y after.|
|00001670| 0a 74 68 72 6f 6d 62 65 | 63 74 6f 6d 79 20 28 46 |.thrombe|ctomy (F|
|00001680| 69 67 20 32 2d 32 30 29 | 2e 20 20 54 68 65 72 65 |ig 2-20)|. There|
|00001690| 20 77 65 72 65 20 32 20 | 63 61 74 68 65 74 65 72 | were 2 |catheter|
|000016a0| 2d 70 72 6f 64 75 63 65 | 64 20 70 65 72 66 6f 72 |-produce|d perfor|
|000016b0| 61 74 69 6f 6e 73 20 65 | 61 72 6c 79 20 69 6e 0d |ations e|arly in.|
|000016c0| 0a 74 68 65 20 73 74 75 | 64 79 2c 20 61 70 70 61 |.the stu|dy, appa|
|000016d0| 72 65 6e 74 6c 79 20 6f | 63 63 75 72 72 69 6e 67 |rently o|ccurring|
|000016e0| 20 77 68 65 6e 20 74 68 | 65 20 63 61 74 68 65 74 | when th|e cathet|
|000016f0| 65 72 20 72 6f 74 61 74 | 65 64 20 77 69 74 68 20 |er rotat|ed with |
|00001700| 69 74 73 20 74 69 70 20 | 69 6e 20 61 0d 0a 73 6d |its tip |in a..sm|
|00001710| 61 6c 6c 20 62 72 61 6e | 63 68 20 76 65 73 73 65 |all bran|ch vesse|
|00001720| 6c 2e 20 20 4d 65 63 68 | 61 6e 69 63 61 6c 20 66 |l. Mech|anical f|
|00001730| 61 69 6c 75 72 65 20 77 | 61 73 20 66 72 65 71 75 |ailure w|as frequ|
|00001740| 65 6e 74 2e 20 20 48 69 | 73 74 6f 6c 6f 67 69 63 |ent. Hi|stologic|
|00001750| 20 73 74 75 64 69 65 73 | 0d 0a 73 68 6f 77 65 64 | studies|..showed|
|00001760| 20 69 6e 74 69 6d 61 6c | 20 64 69 73 72 75 70 74 | intimal| disrupt|
|00001770| 69 6f 6e 20 61 6e 64 20 | 6d 65 64 69 61 6c 20 64 |ion and |medial d|
|00001780| 61 6d 61 67 65 20 66 72 | 6f 6d 20 74 68 65 20 63 |amage fr|om the c|
|00001790| 72 75 73 68 20 69 6e 6a | 75 72 79 20 75 73 65 64 |rush inj|ury used|
|000017a0| 20 74 6f 0d 0a 67 65 6e | 65 72 61 74 65 20 74 68 | to..gen|erate th|
|000017b0| 72 6f 6d 62 6f 73 69 73 | 20 61 6e 64 20 72 65 73 |rombosis| and res|
|000017c0| 69 64 75 61 6c 20 74 68 | 72 6f 6d 62 75 73 20 69 |idual th|rombus i|
|000017d0| 6e 20 6d 6f 73 74 20 76 | 65 73 73 65 6c 73 2e 0d |n most v|essels..|
|000017e0| 0a 20 20 20 20 20 41 20 | 72 6f 74 61 74 69 6e 67 |. A |rotating|
|000017f0| 20 74 68 72 6f 6d 62 65 | 63 74 6f 6d 79 20 63 61 | thrombe|ctomy ca|
|00001800| 74 68 65 74 65 72 20 63 | 61 6e 20 61 63 68 69 65 |theter c|an achie|
|00001810| 76 65 20 72 65 70 65 72 | 66 75 73 69 6f 6e 20 69 |ve reper|fusion i|
|00001820| 6e 20 61 63 75 74 65 6c | 79 0d 0a 74 68 72 6f 6d |n acutel|y..throm|
|00001830| 62 6f 73 65 64 20 63 6f | 72 6f 6e 61 72 79 20 61 |bosed co|ronary a|
|00001840| 72 74 65 72 69 65 73 2e | 20 20 57 69 74 68 20 69 |rteries.| With i|
|00001850| 6e 63 72 65 61 73 65 64 | 20 65 78 70 65 72 69 65 |ncreased| experie|
|00001860| 6e 63 65 20 61 6e 64 20 | 69 6d 70 72 6f 76 65 64 |nce and |improved|
|00001870| 0d 0a 63 61 74 68 65 74 | 65 72 73 2c 20 74 68 69 |..cathet|ers, thi|
|00001880| 73 20 61 70 70 72 6f 61 | 63 68 20 6d 61 79 20 68 |s approa|ch may h|
|00001890| 6f 6c 64 20 70 72 6f 6d | 69 73 65 20 61 73 20 61 |old prom|ise as a|
|000018a0| 6e 20 61 6c 74 65 72 6e | 61 74 69 76 65 20 6f 72 |n altern|ative or|
|000018b0| 20 73 75 70 70 6c 65 6d | 65 6e 74 20 74 6f 0d 0a | supplem|ent to..|
|000018c0| 6f 74 68 65 72 20 74 68 | 72 6f 6d 62 65 63 74 6f |other th|rombecto|
|000018d0| 6d 79 20 74 65 63 68 6e | 69 71 75 65 73 2e 0d 0a |my techn|iques...|
|000018e0| 0d 0a 50 6f 73 74 2d 43 | 6f 6d 6d 65 6e 74 0d 0a |..Post-C|omment..|
|000018f0| 0d 0a 20 20 20 20 20 49 | 20 68 61 76 65 20 73 65 |.. I| have se|
|00001900| 65 6e 20 74 68 69 73 20 | 64 65 76 69 63 65 20 64 |en this |device d|
|00001910| 65 6d 6f 6e 73 74 72 61 | 74 65 64 20 62 79 20 44 |emonstra|ted by D|
|00001920| 6f 63 74 6f 72 20 41 75 | 74 68 20 69 6e 20 76 69 |octor Au|th in vi|
|00001930| 74 72 6f 20 61 6e 64 20 | 68 61 76 65 0d 0a 66 6f |tro and |have..fo|
|00001940| 75 6e 64 20 69 74 20 69 | 6d 70 72 65 73 73 69 76 |und it i|mpressiv|
|00001950| 65 2e 20 20 49 74 20 72 | 65 6d 61 69 6e 73 20 74 |e. It r|emains t|
|00001960| 6f 20 62 65 20 73 65 65 | 6e 20 69 6e 20 68 75 6d |o be see|n in hum|
|00001970| 61 6e 73 20 77 68 65 74 | 68 65 72 20 61 6e 79 20 |ans whet|her any |
|00001980| 72 6f 74 61 74 69 6f 6e | 61 6c 0d 0a 74 69 70 20 |rotation|al..tip |
|00001990| 63 61 74 68 65 74 65 72 | 20 63 61 6e 20 62 65 20 |catheter| can be |
|000019a0| 75 73 65 64 20 65 66 66 | 65 63 74 69 76 65 6c 79 |used eff|ectively|
|000019b0| 20 61 6e 64 20 73 61 66 | 65 6c 79 2e 20 20 54 68 | and saf|ely. Th|
|000019c0| 65 73 65 20 73 6d 61 6c | 6c 20 74 69 70 73 20 63 |ese smal|l tips c|
|000019d0| 61 6e 20 65 61 73 69 6c | 79 0d 0a 65 6e 74 65 72 |an easil|y..enter|
|000019e0| 20 73 69 64 65 20 62 72 | 61 6e 63 68 65 73 20 61 | side br|anches a|
|000019f0| 6e 64 20 77 72 61 70 20 | 28 61 6e 64 20 70 72 65 |nd wrap |(and pre|
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|00001a40| 70 75 72 73 75 69 6e 67 | 20 69 6e 20 74 68 65 20 |pursuing| in the |
|00001a50| 76 65 6e 6f 75 73 20 61 | 6e 64 20 61 72 74 65 72 |venous a|nd arter|
|00001a60| 69 61 6c 20 73 79 73 74 | 65 6d 73 20 66 6f 72 20 |ial syst|ems for |
|00001a70| 66 72 65 73 68 0d 0a 75 | 6e 6f 72 67 61 6e 69 7a |fresh..u|norganiz|
|00001a80| 65 64 20 74 68 72 6f 6d | 62 75 73 2e 2d 2d 46 2e |ed throm|bus.--F.|
|00001a90| 4a 2e 20 4d 69 6c 6c 65 | 72 2c 20 4a 72 2e 2c 20 |J. Mille|r, Jr., |
|00001aa0| 4d 2e 44 2e 0d 0a 24 55 | 6e 69 71 75 65 5f 49 44 |M.D...$U|nique_ID|
|00001ab0| 7b 59 52 42 30 39 35 30 | 32 7d 0d 0a 24 54 69 74 |{YRB0950|2}..$Tit|
|00001ac0| 6c 65 7b 47 75 6e 74 68 | 65 72 20 56 65 6e 61 20 |le{Gunth|er Vena |
|00001ad0| 43 61 76 61 6c 20 46 69 | 6c 74 65 72 3a 20 20 52 |Caval Fi|lter: R|
|00001ae0| 65 73 75 6c 74 73 20 6f | 66 20 4c 6f 6e 67 2d 54 |esults o|f Long-T|
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|000036b0| 20 54 65 66 6c 6f 6e 20 | 69 73 0d 0a 72 65 6d 6f | Teflon |is..remo|
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|00003900| 70 6c 69 63 61 74 69 6f | 6e 73 2e 0d 0a 20 20 20 |plicatio|ns... |
|00003910| 20 20 45 61 72 6c 79 20 | 72 65 73 75 6c 74 73 20 | Early |results |
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|00003af0| 2e 2d 2d 46 2e 4a 2e 20 | 4d 69 6c 6c 65 72 2c 20 |.--F.J. |Miller, |
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|00003b10| 75 65 5f 49 44 7b 59 52 | 42 30 39 35 30 35 7d 0d |ue_ID{YR|B09505}.|
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|00003b30| 74 20 49 6e 66 6c 61 74 | 69 6f 6e 20 6f 66 20 44 |t Inflat|ion of D|
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|00003be0| 46 75 6b 75 6f 6b 61 20 | 55 6e 69 76 2c 20 4a 61 |Fukuoka |Univ, Ja|
|00003bf0| 70 61 6e 3b 20 55 6e 69 | 76 20 6f 66 20 43 61 6c |pan; Uni|v of Cal|
|00003c00| 69 66 6f 72 6e 69 61 2c | 20 53 61 6e 20 46 72 61 |ifornia,| San Fra|
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|00003c20| 6c 7b 52 61 64 69 6f 6c | 6f 67 79 7d 0d 0a 24 56 |l{Radiol|ogy}..$V|
|00003c30| 6f 6c 75 6d 65 7b 31 36 | 39 7d 0d 0a 24 50 61 67 |olume{16|9}..$Pag|
|00003c40| 65 7b 37 38 37 2d 37 39 | 30 7d 0d 0a 24 44 61 74 |e{787-79|0}..$Dat|
|00003c50| 65 7b 44 65 63 65 6d 62 | 65 72 20 31 39 38 38 7d |e{Decemb|er 1988}|
|00003c60| 0d 0a 24 59 42 56 6f 6c | 7b 31 39 39 30 20 59 65 |..$YBVol|{1990 Ye|
|00003c70| 61 72 20 42 6f 6f 6b 20 | 6f 66 20 44 69 61 67 6e |ar Book |of Diagn|
|00003c80| 6f 73 74 69 63 20 52 61 | 64 69 6f 6c 6f 67 79 7d |ostic Ra|diology}|
|00003c90| 0d 0a 24 43 68 61 70 74 | 65 72 7b 32 2d 31 39 7d |..$Chapt|er{2-19}|
|00003ca0| 0d 0a 24 59 42 45 64 69 | 74 6f 72 7b 44 72 73 2e |..$YBEdi|tor{Drs.|
|00003cb0| 20 42 72 61 67 67 2c 20 | 48 65 6e 64 65 65 2c 20 | Bragg, |Hendee, |
|00003cc0| 4b 65 61 74 73 2c 20 4b | 69 72 6b 70 61 74 72 69 |Keats, K|irkpatri|
|00003cd0| 63 6b 2c 20 4d 69 6c 6c | 65 72 2c 20 4f 73 62 6f |ck, Mill|er, Osbo|
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|00003cf0| 7d 0d 0a 24 54 61 62 6c | 65 7b 7d 0d 0a 24 43 6f |}..$Tabl|e{}..$Co|
|00003d00| 6d 6d 65 6e 74 61 74 6f | 72 7b 46 2e 4a 2e 20 4d |mmentato|r{F.J. M|
|00003d10| 69 6c 6c 65 72 2c 20 4a | 72 2e 2c 20 4d 2e 44 2e |iller, J|r., M.D.|
|00003d20| 7d 0d 0a 0d 0a 43 6f 70 | 79 72 69 67 68 74 20 28 |}....Cop|yright (|
|00003d30| 63 29 20 59 65 61 72 62 | 6f 6f 6b 20 4d 65 64 69 |c) Yearb|ook Medi|
|00003d40| 63 61 6c 20 50 75 62 6c | 69 73 68 65 72 73 2c 20 |cal Publ|ishers, |
|00003d50| 49 6e 63 2e 2c 20 31 39 | 39 30 0d 0a 0d 0a 31 39 |Inc., 19|90....19|
|00003d60| 39 30 20 59 65 61 72 20 | 42 6f 6f 6b 20 6f 66 20 |90 Year |Book of |
|00003d70| 44 69 61 67 6e 6f 73 74 | 69 63 20 52 61 64 69 6f |Diagnost|ic Radio|
|00003d80| 6c 6f 67 79 20 28 52 29 | 0d 0a 0d 0a 43 68 61 70 |logy (R)|....Chap|
|00003d90| 74 65 72 20 32 2d 2d 43 | 61 72 64 69 6f 76 61 73 |ter 2--C|ardiovas|
|00003da0| 63 75 6c 61 72 20 61 6e | 64 20 49 6e 74 65 72 76 |cular an|d Interv|
|00003db0| 65 6e 74 69 6f 6e 61 6c | 20 52 61 64 69 6f 6c 6f |entional| Radiolo|
|00003dc0| 67 79 0d 0a 0d 0a 56 61 | 73 63 75 6c 61 72 20 49 |gy....Va|scular I|
|00003dd0| 6e 74 65 72 76 65 6e 74 | 69 6f 6e 0d 0a 0d 0a 2d |ntervent|ion....-|
|00003de0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003df0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003e00| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003e10| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003e20| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 0d 0a 50 |--------|-----..P|
|00003e30| 65 72 6d 61 6e 65 6e 74 | 20 49 6e 66 6c 61 74 69 |ermanent| Inflati|
|00003e40| 6f 6e 20 6f 66 20 44 65 | 74 61 63 68 61 62 6c 65 |on of De|tachable|
|00003e50| 20 42 61 6c 6c 6f 6f 6e | 73 20 57 69 74 68 20 61 | Balloon|s With a|
|00003e60| 20 4c 6f 77 2d 56 69 73 | 63 6f 73 69 74 79 2c 20 | Low-Vis|cosity, |
|00003e70| 48 79 64 72 6f 70 68 69 | 6c 69 63 0d 0a 50 6f 6c |Hydrophi|lic..Pol|
|00003e80| 79 6d 65 72 69 7a 69 6e | 67 20 53 79 73 74 65 6d |ymerizin|g System|
|00003e90| 0d 0a 0d 0a 47 6f 74 6f | 20 4b 2c 20 48 61 6c 62 |....Goto| K, Halb|
|00003ea0| 61 63 68 20 56 56 2c 20 | 48 61 72 64 69 6e 20 43 |ach VV, |Hardin C|
|00003eb0| 57 2c 20 48 69 67 61 73 | 68 69 64 61 20 52 54 2c |W, Higas|hida RT,|
|00003ec0| 20 48 69 65 73 68 69 6d | 61 20 47 42 0d 0a 28 46 | Hieshim|a GB..(F|
|00003ed0| 75 6b 75 6f 6b 61 20 55 | 6e 69 76 2c 20 4a 61 70 |ukuoka U|niv, Jap|
|00003ee0| 61 6e 3b 20 55 6e 69 76 | 20 6f 66 20 43 61 6c 69 |an; Univ| of Cali|
|00003ef0| 66 6f 72 6e 69 61 2c 20 | 53 61 6e 20 46 72 61 6e |fornia, |San Fran|
|00003f00| 63 69 73 63 6f 29 0d 0a | 52 61 64 69 6f 6c 6f 67 |cisco)..|Radiolog|
|00003f10| 79 20 31 36 39 3a 37 38 | 37 2d 37 39 30 2c 20 44 |y 169:78|7-790, D|
|00003f20| 65 63 65 6d 62 65 72 20 | 31 39 38 38 0d 0a 2d 2d |ecember |1988..--|
|00003f30| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003f40| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003f50| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003f60| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|00003f70| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 0d 0a |--------|----....|
|00003f80| 41 62 73 74 72 61 63 74 | 0d 0a 0d 0a 20 20 20 20 |Abstract|.... |
|00003f90| 20 44 65 74 61 63 68 61 | 62 6c 65 20 62 61 6c 6c | Detacha|ble ball|
|00003fa0| 6f 6f 6e 73 20 72 65 6c | 79 20 6f 6e 20 61 20 76 |oons rel|y on a v|
|00003fb0| 61 6c 76 65 20 6d 65 63 | 68 61 6e 69 73 6d 20 74 |alve mec|hanism t|
|00003fc0| 6f 20 70 72 65 76 65 6e | 74 20 65 61 72 6c 79 20 |o preven|t early |
|00003fd0| 64 65 66 6c 61 74 69 6f | 6e 2c 0d 0a 62 75 74 20 |deflatio|n,..but |
|00003fe0| 74 68 65 20 72 65 6c 69 | 61 62 69 6c 69 74 79 20 |the reli|ability |
|00003ff0| 6f 66 20 74 68 69 73 20 | 6d 65 63 68 61 6e 69 73 |of this |mechanis|
|00004000| 6d 20 76 61 72 69 65 73 | 20 66 72 6f 6d 20 62 61 |m varies| from ba|
|00004010| 6c 6c 6f 6f 6e 20 74 6f | 20 62 61 6c 6c 6f 6f 6e |lloon to| balloon|
|00004020| 2c 20 61 6e 64 0d 0a 64 | 65 6c 61 79 65 64 20 62 |, and..d|elayed b|
|00004030| 61 6c 6c 6f 6f 6e 20 64 | 65 66 6c 61 74 69 6f 6e |alloon d|eflation|
|00004040| 20 6d 61 79 20 6f 63 63 | 75 72 2e 20 20 54 6f 20 | may occ|ur. To |
|00004050| 61 76 6f 69 64 20 70 72 | 6f 62 6c 65 6d 73 20 61 |avoid pr|oblems a|
|00004060| 73 73 6f 63 69 61 74 65 | 64 20 77 69 74 68 0d 0a |ssociate|d with..|
|00004070| 62 61 6c 6c 6f 6f 6e 20 | 64 65 66 6c 61 74 69 6f |balloon |deflatio|
|00004080| 6e 2c 20 61 20 73 79 73 | 74 65 6d 20 6f 66 20 70 |n, a sys|tem of p|
|00004090| 65 72 6d 61 6e 65 6e 74 | 20 69 6e 66 6c 61 74 69 |ermanent| inflati|
|000040a0| 6f 6e 20 6f 66 20 64 65 | 74 61 63 68 61 62 6c 65 |on of de|tachable|
|000040b0| 20 62 61 6c 6c 6f 6f 6e | 73 20 77 61 73 0d 0a 64 | balloon|s was..d|
|000040c0| 65 76 65 6c 6f 70 65 64 | 20 62 61 73 65 64 20 6f |eveloped| based o|
|000040d0| 6e 20 32 2d 68 79 64 72 | 6f 78 79 65 74 68 79 6c |n 2-hydr|oxyethyl|
|000040e0| 20 6d 65 74 68 61 63 72 | 79 6c 61 74 65 20 28 48 | methacr|ylate (H|
|000040f0| 45 4d 41 29 20 61 73 20 | 74 68 65 20 6d 6f 6e 6f |EMA) as |the mono|
|00004100| 6d 65 72 20 69 6e 0d 0a | 63 6f 6d 62 69 6e 61 74 |mer in..|combinat|
|00004110| 69 6f 6e 20 77 69 74 68 | 20 61 20 63 72 6f 73 73 |ion with| a cross|
|00004120| 2d 6c 69 6e 6b 69 6e 67 | 20 61 67 65 6e 74 20 61 |-linking| agent a|
|00004130| 6e 64 20 61 20 77 61 74 | 65 72 2d 73 6f 6c 75 62 |nd a wat|er-solub|
|00004140| 6c 65 20 63 75 72 69 6e | 67 20 73 79 73 74 65 6d |le curin|g system|
|00004150| 2e 0d 0a 20 20 20 20 20 | 54 68 65 20 6c 6f 77 2d |... |The low-|
|00004160| 76 69 73 63 6f 73 69 74 | 79 2c 20 68 79 64 72 6f |viscosit|y, hydro|
|00004170| 70 68 69 6c 69 63 20 6d | 69 78 74 75 72 65 20 63 |philic m|ixture c|
|00004180| 61 6e 20 62 65 20 65 78 | 63 68 61 6e 67 65 64 20 |an be ex|changed |
|00004190| 74 68 72 6f 75 67 68 20 | 61 0d 0a 73 6d 61 6c 6c |through |a..small|
|000041a0| 2d 62 6f 72 65 20 63 61 | 74 68 65 74 65 72 20 69 |-bore ca|theter i|
|000041b0| 6e 74 6f 20 61 20 64 65 | 74 61 63 68 61 62 6c 65 |nto a de|tachable|
|000041c0| 20 62 61 6c 6c 6f 6f 6e | 20 77 68 65 72 65 20 69 | balloon| where i|
|000041d0| 74 20 70 6f 6c 79 6d 65 | 72 69 7a 65 73 20 69 6e |t polyme|rizes in|
|000041e0| 20 34 30 2d 36 30 0d 0a | 6d 69 6e 75 74 65 73 20 | 40-60..|minutes |
|000041f0| 61 74 20 62 6f 64 79 20 | 74 65 6d 70 65 72 61 74 |at body |temperat|
|00004200| 75 72 65 2e 20 20 41 20 | 73 65 72 69 65 73 20 6f |ure. A |series o|
|00004210| 66 20 65 78 70 65 72 69 | 6d 65 6e 74 73 20 77 61 |f experi|ments wa|
|00004220| 73 20 63 61 72 72 69 65 | 64 20 6f 75 74 20 74 6f |s carrie|d out to|
|00004230| 0d 0a 64 65 74 65 72 6d | 69 6e 65 20 74 68 65 20 |..determ|ine the |
|00004240| 72 61 74 69 6f 20 6f 66 | 20 61 63 74 69 76 61 74 |ratio of| activat|
|00004250| 65 64 20 48 45 4d 41 20 | 6e 65 65 64 65 64 20 66 |ed HEMA |needed f|
|00004260| 6f 72 20 63 6f 6d 70 6c | 65 74 65 20 73 6f 6c 69 |or compl|ete soli|
|00004270| 64 69 66 69 63 61 74 69 | 6f 6e 20 61 6e 64 0d 0a |dificati|on and..|
|00004280| 74 6f 20 66 6f 6c 6c 6f | 77 20 74 68 65 20 65 76 |to follo|w the ev|
|00004290| 6f 6c 75 74 69 6f 6e 20 | 6f 66 20 74 68 65 20 61 |olution |of the a|
|000042a0| 70 70 65 61 72 61 6e 63 | 65 20 6f 66 20 48 45 4d |ppearanc|e of HEM|
|000042b0| 41 2d 66 69 6c 6c 65 64 | 20 62 61 6c 6c 6f 6f 6e |A-filled| balloon|
|000042c0| 73 20 6f 6e 20 73 65 72 | 69 61 6c 0d 0a 72 61 64 |s on ser|ial..rad|
|000042d0| 69 6f 67 72 61 70 68 73 | 2e 0d 0a 20 20 20 20 20 |iographs|... |
|000042e0| 4f 6e 6c 79 20 62 61 6c | 6c 6f 6f 6e 73 20 63 6f |Only bal|loons co|
|000042f0| 6e 74 61 69 6e 69 6e 67 | 20 61 74 20 6c 65 61 73 |ntaining| at leas|
|00004300| 74 20 34 32 25 20 6f 66 | 20 61 63 74 69 76 61 74 |t 42% of| activat|
|00004310| 65 64 20 48 45 4d 41 20 | 62 79 20 76 6f 6c 75 6d |ed HEMA |by volum|
|00004320| 65 20 62 65 63 61 6d 65 | 0d 0a 73 6f 6c 69 64 69 |e became|..solidi|
|00004330| 66 69 65 64 2e 20 20 54 | 68 65 20 65 76 6f 6c 75 |fied. T|he evolu|
|00004340| 74 69 6f 6e 20 6f 66 20 | 74 68 65 20 72 61 64 69 |tion of |the radi|
|00004350| 6f 67 72 61 70 68 69 63 | 20 61 70 70 65 61 72 61 |ographic| appeara|
|00004360| 6e 63 65 20 6f 66 20 48 | 45 4d 41 2d 66 69 6c 6c |nce of H|EMA-fill|
|00004370| 65 64 0d 0a 62 61 6c 6c | 6f 6f 6e 73 20 70 72 6f |ed..ball|oons pro|
|00004380| 76 65 64 20 70 72 65 64 | 69 63 74 61 62 6c 65 2e |ved pred|ictable.|
|00004390| 20 20 50 6f 6c 79 6d 65 | 72 69 7a 65 64 20 48 45 | Polyme|rized HE|
|000043a0| 4d 41 20 63 61 75 73 65 | 64 20 6e 6f 20 73 69 67 |MA cause|d no sig|
|000043b0| 6e 69 66 69 63 61 6e 74 | 20 74 69 73 73 75 65 0d |nificant| tissue.|
|000043c0| 0a 72 65 61 63 74 69 6f | 6e 73 2e 20 20 54 68 65 |.reactio|ns. The|
|000043d0| 20 75 73 65 20 6f 66 20 | 74 68 69 73 20 73 79 73 | use of |this sys|
|000043e0| 74 65 6d 20 69 6e 20 68 | 75 6d 61 6e 73 20 68 61 |tem in h|umans ha|
|000043f0| 73 20 6e 6f 74 20 79 65 | 74 20 62 65 65 6e 20 61 |s not ye|t been a|
|00004400| 70 70 72 6f 76 65 64 20 | 62 79 20 74 68 65 0d 0a |pproved |by the..|
|00004410| 46 44 41 2e 0d 0a 0d 0a | 50 6f 73 74 2d 43 6f 6d |FDA.....|Post-Com|
|00004420| 6d 65 6e 74 0d 0a 0d 0a | 20 20 20 20 20 54 68 69 |ment....| Thi|
|00004430| 73 20 46 44 41 20 70 72 | 6f 74 6f 63 6f 6c 20 6d |s FDA pr|otocol m|
|00004440| 61 74 65 72 69 61 6c 20 | 69 73 20 63 72 69 74 69 |aterial |is criti|
|00004450| 63 61 6c 20 74 6f 20 61 | 6e 79 20 64 65 74 61 63 |cal to a|ny detac|
|00004460| 68 61 62 6c 65 20 62 61 | 6c 6c 6f 6f 6e 0d 0a 70 |hable ba|lloon..p|
|00004470| 72 6f 63 65 64 75 72 65 | 20 69 6e 20 77 68 69 63 |rocedure| in whic|
|00004480| 68 20 64 65 66 6c 61 74 | 69 6f 6e 20 63 61 6e 6e |h deflat|ion cann|
|00004490| 6f 74 20 62 65 20 74 6f | 6c 65 72 61 74 65 64 2e |ot be to|lerated.|
|000044a0| 20 20 41 6e 20 69 6e 76 | 65 73 74 69 67 61 74 6f | An inv|estigato|
|000044b0| 72 20 63 61 6e 20 67 65 | 74 0d 0a 61 70 70 72 6f |r can ge|t..appro|
|000044c0| 76 61 6c 20 74 6f 20 75 | 73 65 20 74 68 69 73 20 |val to u|se this |
|000044d0| 76 61 6c 75 61 62 6c 65 | 20 6d 61 74 65 72 69 61 |valuable| materia|
|000044e0| 6c 2e 2d 2d 46 2e 4a 2e | 20 4d 69 6c 6c 65 72 2c |l.--F.J.| Miller,|
|000044f0| 20 4a 72 2e 2c 20 4d 2e | 44 2e 0d 0a 24 55 6e 69 | Jr., M.|D...$Uni|
|00004500| 71 75 65 5f 49 44 7b 59 | 52 42 30 39 35 30 36 7d |que_ID{Y|RB09506}|
|00004510| 0d 0a 24 54 69 74 6c 65 | 7b 54 72 61 6e 73 6c 75 |..$Title|{Translu|
|00004520| 6d 69 6e 61 6c 20 52 65 | 70 61 69 72 20 6f 66 20 |minal Re|pair of |
|00004530| 4c 61 72 67 65 20 49 6e | 74 72 61 72 65 6e 61 6c |Large In|trarenal|
|00004540| 20 41 72 74 65 72 69 6f | 76 65 6e 6f 75 73 20 46 | Arterio|venous F|
|00004550| 69 73 74 75 6c 61 73 7d | 0d 0a 24 41 75 74 68 6f |istulas}|..$Autho|
|00004560| 72 7b 46 72 65 65 6d 61 | 6e 2c 20 4d 42 0d 0a 41 |r{Freema|n, MB..A|
|00004570| 6e 64 72 69 6f 6c 65 2c | 20 47 4c 0d 0a 53 69 63 |ndriole,| GL..Sic|
|00004580| 61 72 64 2c 20 47 41 0d | 0a 54 6f 72 72 65 6e 63 |ard, GA.|.Torrenc|
|00004590| 65 2c 20 52 4a 0d 0a 41 | 6e 64 65 72 73 6f 6e 2c |e, RJ..A|nderson,|
|000045a0| 20 43 42 7d 0d 0a 24 41 | 66 66 69 6c 69 61 74 69 | CB}..$A|ffiliati|
|000045b0| 6f 6e 7b 57 61 73 68 69 | 6e 67 74 6f 6e 20 55 6e |on{Washi|ngton Un|
|000045c0| 69 76 2c 20 53 74 20 4c | 6f 75 69 73 7d 0d 0a 24 |iv, St L|ouis}..$|
|000045d0| 4a 6f 75 72 6e 61 6c 7b | 4a 20 55 72 6f 6c 7d 0d |Journal{|J Urol}.|
|000045e0| 0a 24 56 6f 6c 75 6d 65 | 7b 31 33 39 7d 0d 0a 24 |.$Volume|{139}..$|
|000045f0| 50 61 67 65 7b 31 32 39 | 32 2d 31 32 39 35 7d 0d |Page{129|2-1295}.|
|00004600| 0a 24 44 61 74 65 7b 4a | 75 6e 65 20 31 39 38 38 |.$Date{J|une 1988|
|00004610| 7d 0d 0a 24 59 42 56 6f | 6c 7b 31 39 39 30 20 59 |}..$YBVo|l{1990 Y|
|00004620| 65 61 72 20 42 6f 6f 6b | 20 6f 66 20 44 69 61 67 |ear Book| of Diag|
|00004630| 6e 6f 73 74 69 63 20 52 | 61 64 69 6f 6c 6f 67 79 |nostic R|adiology|
|00004640| 7d 0d 0a 24 43 68 61 70 | 74 65 72 7b 32 2d 32 30 |}..$Chap|ter{2-20|
|00004650| 7d 0d 0a 24 59 42 45 64 | 69 74 6f 72 7b 44 72 73 |}..$YBEd|itor{Drs|
|00004660| 2e 20 42 72 61 67 67 2c | 20 48 65 6e 64 65 65 2c |. Bragg,| Hendee,|
|00004670| 20 4b 65 61 74 73 2c 20 | 4b 69 72 6b 70 61 74 72 | Keats, |Kirkpatr|
|00004680| 69 63 6b 2c 20 4d 69 6c | 6c 65 72 2c 20 4f 73 62 |ick, Mil|ler, Osb|
|00004690| 6f 72 6e 2c 20 61 6e 64 | 20 54 68 6f 6d 70 73 6f |orn, and| Thompso|
|000046a0| 6e 7d 0d 0a 24 54 61 62 | 6c 65 7b 7d 0d 0a 24 43 |n}..$Tab|le{}..$C|
|000046b0| 6f 6d 6d 65 6e 74 61 74 | 6f 72 7b 46 2e 4a 2e 20 |ommentat|or{F.J. |
|000046c0| 4d 69 6c 6c 65 72 2c 20 | 4a 72 2e 2c 20 4d 2e 44 |Miller, |Jr., M.D|
|000046d0| 2e 7d 0d 0a 0d 0a 43 6f | 70 79 72 69 67 68 74 20 |.}....Co|pyright |
|000046e0| 28 63 29 20 59 65 61 72 | 62 6f 6f 6b 20 4d 65 64 |(c) Year|book Med|
|000046f0| 69 63 61 6c 20 50 75 62 | 6c 69 73 68 65 72 73 2c |ical Pub|lishers,|
|00004700| 20 49 6e 63 2e 2c 20 31 | 39 39 30 0d 0a 0d 0a 31 | Inc., 1|990....1|
|00004710| 39 39 30 20 59 65 61 72 | 20 42 6f 6f 6b 20 6f 66 |990 Year| Book of|
|00004720| 20 44 69 61 67 6e 6f 73 | 74 69 63 20 52 61 64 69 | Diagnos|tic Radi|
|00004730| 6f 6c 6f 67 79 20 28 52 | 29 0d 0a 0d 0a 43 68 61 |ology (R|)....Cha|
|00004740| 70 74 65 72 20 32 2d 2d | 43 61 72 64 69 6f 76 61 |pter 2--|Cardiova|
|00004750| 73 63 75 6c 61 72 20 61 | 6e 64 20 49 6e 74 65 72 |scular a|nd Inter|
|00004760| 76 65 6e 74 69 6f 6e 61 | 6c 20 52 61 64 69 6f 6c |ventiona|l Radiol|
|00004770| 6f 67 79 0d 0a 0d 0a 56 | 61 73 63 75 6c 61 72 20 |ogy....V|ascular |
|00004780| 49 6e 74 65 72 76 65 6e | 74 69 6f 6e 0d 0a 0d 0a |Interven|tion....|
|00004790| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000047a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000047b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000047c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000047d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 0d 0a |--------|------..|
|000047e0| 54 72 61 6e 73 6c 75 6d | 69 6e 61 6c 20 52 65 70 |Translum|inal Rep|
|000047f0| 61 69 72 20 6f 66 20 4c | 61 72 67 65 20 49 6e 74 |air of L|arge Int|
|00004800| 72 61 72 65 6e 61 6c 20 | 41 72 74 65 72 69 6f 76 |rarenal |Arteriov|
|00004810| 65 6e 6f 75 73 20 46 69 | 73 74 75 6c 61 73 0d 0a |enous Fi|stulas..|
|00004820| 0d 0a 46 72 65 65 6d 61 | 6e 20 4d 42 2c 20 41 6e |..Freema|n MB, An|
|00004830| 64 72 69 6f 6c 65 20 47 | 4c 2c 20 53 69 63 61 72 |driole G|L, Sicar|
|00004840| 64 20 47 41 2c 20 54 6f | 72 72 65 6e 63 65 20 52 |d GA, To|rrence R|
|00004850| 4a 2c 20 41 6e 64 65 72 | 73 6f 6e 20 43 42 0d 0a |J, Ander|son CB..|
|00004860| 28 57 61 73 68 69 6e 67 | 74 6f 6e 20 55 6e 69 76 |(Washing|ton Univ|
|00004870| 2c 20 53 74 20 4c 6f 75 | 69 73 29 0d 0a 4a 20 55 |, St Lou|is)..J U|
|00004880| 72 6f 6c 20 31 33 39 3a | 31 32 39 32 2d 31 32 39 |rol 139:|1292-129|
|00004890| 35 2c 20 4a 75 6e 65 20 | 31 39 38 38 0d 0a 2d 2d |5, June |1988..--|
|000048a0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000048b0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000048c0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000048d0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 2d 2d 2d 2d |--------|--------|
|000048e0| 2d 2d 2d 2d 2d 2d 2d 2d | 2d 2d 2d 2d 0d 0a 0d 0a |--------|----....|
|000048f0| 41 62 73 74 72 61 63 74 | 0d 0a 0d 0a 20 20 20 20 |Abstract|.... |
|00004900| 20 52 61 64 69 6f 6c 6f | 67 69 63 20 65 6d 62 6f | Radiolo|gic embo|
|00004910| 6c 69 7a 61 74 69 6f 6e | 20 68 61 73 20 72 65 63 |lization| has rec|
|00004920| 65 6e 74 6c 79 20 62 65 | 65 6e 20 72 65 63 6f 6d |ently be|en recom|
|00004930| 6d 65 6e 64 65 64 20 66 | 6f 72 20 74 72 65 61 74 |mended f|or treat|
|00004940| 6d 65 6e 74 20 6f 66 0d | 0a 72 65 6e 61 6c 20 61 |ment of.|.renal a|
|00004950| 72 74 65 72 69 6f 76 65 | 6e 6f 75 73 20 66 69 73 |rteriove|nous fis|
|00004960| 74 75 6c 61 73 3b 20 68 | 6f 77 65 76 65 72 2c 20 |tulas; h|owever, |
|00004970| 73 69 67 6e 69 66 69 63 | 61 6e 74 20 6d 6f 72 62 |signific|ant morb|
|00004980| 69 64 69 74 79 20 63 61 | 6e 20 62 65 20 61 73 73 |idity ca|n be ass|
|00004990| 6f 63 69 61 74 65 64 0d | 0a 77 69 74 68 20 74 68 |ociated.|.with th|
|000049a0| 69 73 20 74 68 65 72 61 | 70 79 20 77 68 65 6e 20 |is thera|py when |
|000049b0| 74 68 65 20 66 69 73 74 | 75 6c 61 20 69 73 20 6c |the fist|ula is l|
|000049c0| 61 72 67 65 2e 20 20 54 | 68 72 65 65 20 70 61 74 |arge. T|hree pat|
|000049d0| 69 65 6e 74 73 20 68 61 | 64 20 6c 61 72 67 65 0d |ients ha|d large.|
|000049e0| 0a 69 6e 74 72 61 72 65 | 6e 61 6c 20 61 72 74 65 |.intrare|nal arte|
|000049f0| 72 69 6f 76 65 6e 6f 75 | 73 20 66 69 73 74 75 6c |riovenou|s fistul|
|00004a00| 61 73 20 74 72 65 61 74 | 65 64 20 62 79 20 74 72 |as treat|ed by tr|
|00004a10| 61 6e 73 70 61 72 65 6e | 63 68 79 6d 61 6c 20 72 |ansparen|chymal r|
|00004a20| 65 70 61 69 72 2e 0d 0a | 0d 0a 20 20 20 20 20 4d |epair...|.. M|
|00004a30| 61 6e 2c 20 36 30 2c 20 | 77 69 74 68 20 70 6f 6f |an, 60, |with poo|
|00004a40| 72 6c 79 20 63 6f 6e 74 | 72 6f 6c 6c 65 64 20 6c |rly cont|rolled l|
|00004a50| 6f 6e 67 2d 73 74 61 6e | 64 69 6e 67 20 68 79 70 |ong-stan|ding hyp|
|00004a60| 65 72 74 65 6e 73 69 6f | 6e 20 63 6f 6d 70 6c 61 |ertensio|n compla|
|00004a70| 69 6e 65 64 20 6f 66 0d | 0a 67 72 6f 73 73 20 68 |ined of.|.gross h|
|00004a80| 65 6d 61 74 75 72 69 61 | 20 61 6e 64 20 72 69 67 |ematuria| and rig|
|00004a90| 68 74 20 66 6c 61 6e 6b | 20 70 61 69 6e 2e 20 20 |ht flank| pain. |
|00004aa0| 41 6e 20 65 78 63 72 65 | 74 6f 72 79 20 75 72 6f |An excre|tory uro|
|00004ab0| 67 72 61 6d 20 73 75 67 | 67 65 73 74 65 64 20 61 |gram sug|gested a|
|00004ac0| 20 6d 61 73 73 0d 0a 69 | 6e 20 74 68 65 20 75 70 | mass..i|n the up|
|00004ad0| 70 65 72 20 70 6f 6c 65 | 20 6f 66 20 74 68 65 20 |per pole| of the |
|00004ae0| 72 69 67 68 74 20 6b 69 | 64 6e 65 79 2e 20 20 43 |right ki|dney. C|
|00004af0| 6f 6d 70 75 74 65 64 20 | 74 6f 6d 6f 67 72 61 70 |omputed |tomograp|
|00004b00| 68 79 2c 20 61 6f 72 74 | 6f 67 72 61 70 68 79 2c |hy, aort|ography,|
|00004b10| 20 61 6e 64 0d 0a 73 65 | 6c 65 63 74 69 76 65 20 | and..se|lective |
|00004b20| 72 65 6e 61 6c 20 61 6e | 67 69 6f 67 72 61 70 68 |renal an|giograph|
|00004b30| 79 20 63 6f 6e 66 69 72 | 6d 65 64 20 61 20 34 2d |y confir|med a 4-|
|00004b40| 63 6d 20 69 6e 74 72 61 | 72 65 6e 61 6c 20 61 72 |cm intra|renal ar|
|00004b50| 74 65 72 69 6f 76 65 6e | 6f 75 73 20 66 69 73 74 |terioven|ous fist|
|00004b60| 75 6c 61 0d 0a 6f 66 20 | 74 68 65 20 72 69 67 68 |ula..of |the righ|
|00004b70| 74 20 6b 69 64 6e 65 79 | 2e 20 20 41 6e 20 6f 70 |t kidney|. An op|
|00004b80| 65 6e 20 73 75 72 67 69 | 63 61 6c 20 61 70 70 72 |en surgi|cal appr|
|00004b90| 6f 61 63 68 20 77 61 73 | 20 75 73 65 64 2e 20 20 |oach was| used. |
|00004ba0| 54 68 65 20 61 72 74 65 | 72 69 6f 76 65 6e 6f 75 |The arte|riovenou|
|00004bb0| 73 0d 0a 66 69 73 74 75 | 6c 61 20 77 61 73 20 65 |s..fistu|la was e|
|00004bc0| 6e 74 65 72 65 64 20 62 | 79 20 69 6e 63 69 73 69 |ntered b|y incisi|
|00004bd0| 6f 6e 20 6f 66 20 74 68 | 65 20 6f 76 65 72 6c 79 |on of th|e overly|
|00004be0| 69 6e 67 20 61 74 74 65 | 6e 75 61 74 65 64 20 72 |ing atte|nuated r|
|00004bf0| 65 6e 61 6c 20 70 61 72 | 65 6e 63 68 79 6d 61 0d |enal par|enchyma.|
|00004c00| 0a 69 6e 20 74 68 65 20 | 64 69 72 65 63 74 69 6f |.in the |directio|
|00004c10| 6e 20 6f 66 20 42 72 6f | 64 65 6c 27 73 20 6c 69 |n of Bro|del's li|
|00004c20| 6e 65 2e 20 20 54 68 65 | 20 73 69 74 65 73 20 6f |ne. The| sites o|
|00004c30| 66 20 61 72 74 65 72 69 | 61 6c 20 69 6e 66 6c 6f |f arteri|al inflo|
|00004c40| 77 20 61 6e 64 20 76 65 | 6e 6f 75 73 0d 0a 6f 75 |w and ve|nous..ou|
|00004c50| 74 66 6c 6f 77 20 77 65 | 72 65 20 73 75 74 75 72 |tflow we|re sutur|
|00004c60| 65 2d 6c 69 67 61 74 65 | 64 20 66 72 6f 6d 20 77 |e-ligate|d from w|
|00004c70| 69 74 68 69 6e 20 74 68 | 65 20 66 69 73 74 75 6c |ithin th|e fistul|
|00004c80| 61 2e 20 20 54 68 65 72 | 65 20 77 61 73 20 6e 6f |a. Ther|e was no|
|00004c90| 20 65 76 69 64 65 6e 63 | 65 20 6f 66 0d 0a 68 65 | evidenc|e of..he|
|00004ca0| 6d 6f 72 72 68 61 67 65 | 2e 20 20 54 68 65 20 65 |morrhage|. The e|
|00004cb0| 6e 74 69 72 65 20 6b 69 | 64 6e 65 79 20 77 61 73 |ntire ki|dney was|
|00004cc0| 20 73 61 74 69 73 66 61 | 63 74 6f 72 69 6c 79 20 | satisfa|ctorily |
|00004cd0| 70 65 72 66 75 73 65 64 | 2e 20 20 41 20 72 65 6e |perfused|. A ren|
|00004ce0| 61 6c 20 61 6e 67 69 6f | 67 72 61 6d 0d 0a 32 20 |al angio|gram..2 |
|00004cf0| 6d 6f 6e 74 68 73 20 70 | 6f 73 74 6f 70 65 72 61 |months p|ostopera|
|00004d00| 74 69 76 65 6c 79 20 73 | 68 6f 77 65 64 20 65 78 |tively s|howed ex|
|00004d10| 63 65 6c 6c 65 6e 74 20 | 70 65 72 66 75 73 69 6f |cellent |perfusio|
|00004d20| 6e 20 6f 66 20 74 68 65 | 20 65 6e 74 69 72 65 20 |n of the| entire |
|00004d30| 72 65 6e 61 6c 0d 0a 70 | 61 72 65 6e 63 68 79 6d |renal..p|arenchym|
|00004d40| 61 20 61 6e 64 20 6e 6f | 20 65 76 69 64 65 6e 63 |a and no| evidenc|
|00004d50| 65 20 6f 66 20 74 68 65 | 20 66 69 73 74 75 6c 61 |e of the| fistula|
|00004d60| 2e 20 20 53 65 72 75 6d | 20 63 72 65 61 74 69 6e |. Serum| creatin|
|00004d70| 69 6e 65 20 72 65 6d 61 | 69 6e 73 20 6e 6f 72 6d |ine rema|ins norm|
|00004d80| 61 6c 2e 0d 0a 0d 0a 20 | 20 20 20 20 53 75 72 67 |al..... | Surg|
|00004d90| 69 63 61 6c 20 6d 61 6e | 61 67 65 6d 65 6e 74 20 |ical man|agement |
|00004da0| 77 69 74 68 20 61 20 72 | 65 6e 61 6c 2d 73 70 61 |with a r|enal-spa|
|00004db0| 72 69 6e 67 20 70 72 6f | 63 65 64 75 72 65 20 70 |ring pro|cedure p|
|00004dc0| 72 6f 76 69 64 65 73 20 | 6f 70 74 69 6d 61 6c 0d |rovides |optimal.|
|00004dd0| 0a 72 65 73 75 6c 74 73 | 20 69 6e 20 70 61 74 69 |.results| in pati|
|00004de0| 65 6e 74 73 20 77 69 74 | 68 20 6c 61 72 67 65 20 |ents wit|h large |
|00004df0| 61 72 74 65 72 69 6f 76 | 65 6e 6f 75 73 20 66 69 |arteriov|enous fi|
|00004e00| 73 74 75 6c 61 73 2e 20 | 20 54 68 65 72 65 20 69 |stulas. | There i|
|00004e10| 73 20 61 20 68 69 67 68 | 0d 0a 6c 69 6b 65 6c 69 |s a high|..likeli|
|00004e20| 68 6f 6f 64 20 6f 66 20 | 63 6f 6d 70 6c 65 74 65 |hood of |complete|
|00004e30| 20 65 72 61 64 69 63 61 | 74 69 6f 6e 20 6f 66 20 | eradica|tion of |
|00004e40| 74 68 65 20 66 69 73 74 | 75 6c 61 20 77 69 74 68 |the fist|ula with|
|00004e50| 20 6c 69 74 74 6c 65 20 | 64 69 73 72 75 70 74 69 | little |disrupti|
|00004e60| 6f 6e 20 6f 72 0d 0a 64 | 65 76 61 73 63 75 6c 61 |on or..d|evascula|
|00004e70| 72 69 7a 61 74 69 6f 6e | 20 6f 66 20 66 75 6e 63 |rization| of func|
|00004e80| 74 69 6f 6e 61 6c 20 72 | 65 6e 61 6c 20 70 61 72 |tional r|enal par|
|00004e90| 65 6e 63 68 79 6d 61 2e | 0d 0a 0d 0a 50 6f 73 74 |enchyma.|....Post|
|00004ea0| 2d 43 6f 6d 6d 65 6e 74 | 0d 0a 0d 0a 20 20 20 20 |-Comment|.... |
|00004eb0| 20 54 68 65 20 61 75 74 | 68 6f 72 73 20 63 6f 72 | The aut|hors cor|
|00004ec0| 72 65 63 74 6c 79 20 70 | 6f 69 6e 74 20 6f 75 74 |rectly p|oint out|
|00004ed0| 20 74 68 65 20 75 74 69 | 6c 69 74 79 20 6f 66 20 | the uti|lity of |
|00004ee0| 65 6d 62 6f 6c 69 7a 61 | 74 69 6f 6e 20 74 65 63 |emboliza|tion tec|
|00004ef0| 68 6e 69 71 75 65 73 0d | 0a 66 6f 72 20 73 6d 61 |hniques.|.for sma|
|00004f00| 6c 6c 20 61 72 74 65 72 | 69 6f 76 65 6e 6f 75 73 |ll arter|iovenous|
|00004f10| 20 66 69 73 74 75 6c 61 | 73 20 69 6e 20 74 68 65 | fistula|s in the|
|00004f20| 20 6b 69 64 6e 65 79 2e | 20 20 48 6f 77 65 76 65 | kidney.| Howeve|
|00004f30| 72 2c 20 69 6e 20 6c 61 | 72 67 65 20 66 69 73 74 |r, in la|rge fist|
|00004f40| 75 6c 61 73 20 61 73 0d | 0a 69 6e 20 74 68 65 20 |ulas as.|.in the |
|00004f50| 33 20 70 61 74 69 65 6e | 74 73 20 64 65 73 63 72 |3 patien|ts descr|
|00004f60| 69 62 65 64 20 62 79 20 | 74 68 65 20 61 75 74 68 |ibed by |the auth|
|00004f70| 6f 72 73 2c 20 73 75 72 | 67 69 63 61 6c 20 72 65 |ors, sur|gical re|
|00004f80| 70 61 69 72 20 6d 61 79 | 20 62 65 20 6e 65 65 64 |pair may| be need|
|00004f90| 65 64 2e 0d 0a 49 6e 74 | 65 72 76 65 6e 74 69 6f |ed...Int|erventio|
|00004fa0| 6e 61 6c 20 74 65 63 68 | 6e 69 71 75 65 73 20 63 |nal tech|niques c|
|00004fb0| 61 6e 20 62 65 20 75 73 | 65 64 20 66 6f 72 20 6c |an be us|ed for l|
|00004fc0| 61 72 67 65 20 66 69 73 | 74 75 6c 61 73 20 75 73 |arge fis|tulas us|
|00004fd0| 69 6e 67 20 31 35 2d 32 | 35 20 6d 6d 20 63 6f 69 |ing 15-2|5 mm coi|
|00004fe0| 6c 73 0d 0a 66 6f 6c 6c | 6f 77 65 64 20 62 79 20 |ls..foll|owed by |
|00004ff0| 44 65 62 72 75 6e 20 62 | 61 6c 6c 6f 6f 6e 73 2e |Debrun b|alloons.|
|00005000| 20 20 54 68 65 73 65 20 | 63 61 73 65 73 20 72 65 | These |cases re|
|00005010| 71 75 69 72 65 20 6d 6f | 72 65 20 65 66 66 6f 72 |quire mo|re effor|
|00005020| 74 20 61 6e 64 20 65 78 | 70 65 72 74 69 73 65 20 |t and ex|pertise |
|00005030| 74 6f 0d 0a 62 65 20 61 | 63 63 6f 6d 70 6c 69 73 |to..be a|ccomplis|
|00005040| 68 65 64 20 73 61 66 65 | 6c 79 2c 20 61 6e 64 20 |hed safe|ly, and |
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|00005d80| 4a 2e 20 4d 69 6c 6c 65 | 72 2c 20 4a 72 2e 2c 20 |J. Mille|r, Jr., |
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