Angioplasty-induced dissections in human iliac arteries: management with Palmaz balloon-expandable intraluminal stents.

Intravascular stent placement may be an effective treatment for percutaneous transluminal angioplasty (PTA)-induced dissection. Among the first 228 patients treated with Palmaz balloon-expandable intraluminal stents (BEISs) for iliac artery stenosis, stents were used to treat PTA-induced dissection in at least 12 iliac arteries in 11 patients. All 12 vessels were shown by angiography to be severely dissected. Stents were placed at the time of PTA in six vessels and as a separate procedure in the other six. An average of three stents per vessel were employed. All arteries showed marked improvement at angiography. Angiographic follow-up was obtained for eight vessels in seven patients at a mean follow-up time of 12.9 months. All had patent stent lumens with neointima formation, although one stented lumen had narrowed, and another clinical failure occurred despite a patent stented vessel and an ankle-arm index (AAI) of 1.35. With a mean clinical follow-up of 9.5 months, the mean AAI for the stented extremities in the nine remaining patients is 0.91 +/- 0.15. Palmaz BEISs are effective in the management of PTA-induced human iliac artery dissection

Surgical treatment in newborns of necrotizing enterocolitis

Great controversy surrounds the indications for surgery in infants with NEC. While many respond to intensive medical treatment, in up to 50% more severe NEC develops, requiring surgical intervention. As with the lack of consensus regarding indications for surgical intervention, there is a lack of consensus concerning the ideal surgical management of infants with NEC. Surgical options depend primarily on the extent of intestinal disease and the clinical stability of the infant. In addition to surgery in the acute phase, a number of infants develop late complications of NEC, either following medical or previous surgical treatment, and these complications may require surgical intervention. Clear knowledge of these outcomes is important in counseling parents and in assessing the effectiveness of treatments