The introducer, loaded with the stylette for rigidity, is used to enter the nasolacrimal system. Once inside, the stylette is removed and one end of a bicanalicular stent is advanced through the hollow lumen of the tube.
The Ritleng stent is the bicanalicular stent of choice for some surgeons because the design minimizes manipulation inside the nose. Figure 4. A Silicone tubing of the Ritleng stent connecting the upper and lower puncta. This stent is used for bicanalicular intubation. It is commonly used in traumatic canalicular laceration repairs where the patency of the nasolacrimal duct remains intact. One end of the pigtail-shaped probe is designed for insertion through the upper canalicular system, while the opposite end is designed for insertion through the lower canalicular system.
The probe is passed through one puncta and rotated, following the natural curvature of canalicular system, then retrieved via the opposite punctum. A small islet at the tip of the probe facilitates passage of a guide-wire suture we prefer a nylon suture through the canalicular system.
A piece of hollow silicone tubing, cut to approximately 25 mm in adults, is then passed over the guide wire to successfully intubate the canalicular system. The suture is then cut and tied and the stent rotated to bury the knot. When viewing only the stent between the puncta, one can distinguish between a Crawford and a pigtail stent by the presence or absence of a black nylon or blue prolene suture within the stent lumen vs no suture or a white silk suture in the Crawford stent Figure 6.
Figure 5. Pigtail probe used to pass the guide-wire suture through the canalicular system. Figure 6. Pigtail stent with a black nylon suture visible within the stent lumen.
The Kaneka Lacriflow stent is a new system that was approved for bicanalicular intubation by the FDA in The ends are attached to stainless steel bougies allowing for insertion Figure 7. Once placed, the ends of the stent reside under the inferior turbinate without suture fixation. The benefit is that the stent is self-retaining with minimal intranasal manipulation allowing for placement under local anesthetic.
Figure 7. A Kaneka Lacriflow stent with attached bougies, B Schematic of the stent demonstrating variable diameter and openings in the system [10], images compliments of Kaneka Pharma America, Kaneka-eye. No suturing is necessary to keep it in place, although some surgeons prefer to secure the stent to the eyelid with a suture through the lip of the stent. This type of stent is used to treat nasolacrimal duct obstructions, canalicular stenosis, and it can be used for canalicular lacerations.
Like the full-size version, it is anchored at the punctum of the eye by a plug on the end of the stent. Figure 8. A Mini Monoka stent over a patient's eyelids prior to insertion[1]. B Diagram demonstrating insertion of the stent into the inferior punctum. The Jones tube is a Pyrex glass tube that is used to bypass an obstruction of the canalicular system in order to drain tears from the eye.
It is placed from the conjunctival cul-de-sac through a surgically created bony ostium, and exits into the nose Figure 2e. Some Jones tubes have a flexible silicone internal flange to resist extrusion. The Medtronic Driver Coronary Stent Systems are indicated for improving coronary luminal diameter in patients with symptomatic ischemic heart disease due to discrete de novo or restenotic lesions with reference vessel diameters of 3.
Please reference appropriate product Instructions for Use for a more detailed list of indications, warnings, precautions and potential adverse events.
The Medtronic Micro-Driver Coronary Stent Systems are indicated for improving coronary luminal diameter in patients with symptomatic ischemic heart disease due to discrete de novo lesions with reference vessel diameters of 2.
Outcome beyond days for this permanent implant is unknown at present. Send a link to this page by email along with your comments. Please enter the information below.
Proven Driver Stent. It is possible that some of the products on the other site are not approved in your region or country. With an updated browser, you will have a better Medtronic website experience. Update my browser now. The system's low profile is designed for flexibility and easy navigation to target lesions in the renal anatomy and as a palliative treatment in the biliary tree. Stenting is intended to improve and maintain artery luminal diameter.
Instructions for Use Find this technical manual in the product labeling supplied with each device. Cancel Continue. Your browser is out of date With an updated browser, you will have a better Medtronic website experience.
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