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Evidence-based recommendations on transvenous obliteration for gastric varices. This involves inserting a tube with a tiny balloon on the end into a vein in the thigh or neck. The tube is then passed into the enlarged vein in the stomach (gastric varix) and the balloon is inflated to stop blood flowing into the vein. The vein is then blocked using one of several techniques. The aim is to reduce the risk of bleeding.
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Trabeculectomy with a biodegradable collagen matrix implant for glaucoma (HTG656)
Evidence-based recommendations on trabeculectomy with a biodegradable collagen matrix implant for glaucoma. This involves cutting a small flap in the white of the eye and putting a patch over the flap to help healing and prevent scarring. Fluid slowly drains out of the flap and the patch dissolves over time. The aim is to reduce pressure in the eye and slow or stop damage to sight.
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Laparoscopic insertion of a magnetic ring for gastro-oesophageal reflux disease (HTG654)
Evidence-based recommendations on laparoscopic insertion of a magnetic ring for gastro-oesophageal reflux disease. This involves placing a ring of beads outside of the food pipe, just above the stomach. Magnets inside the beads hold them together to keep the food pipe closed but are weak enough to move apart to allow food or liquid to be swallowed. The aim is to prevent acid reflux.
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Transcutaneous electrical stimulation of the trigeminal nerve for ADHD (HTG653)
Evidence-based recommendations on transcutaneous electrical stimulation of the trigeminal nerve for ADHD. This involves a single-use electrode patch stuck to the forehead, which sends small electrical pulses through the skin during sleep.
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Percutaneous image-guided cryoablation of peripheral neuroma for chronic pain (HTG652)
Evidence-based recommendations on percutaneous image-guided cryoablation of peripheral neuroma for chronic pain. This involves using a needle-like probe to freeze and destroy small parts of nerves in neuromas to stop the pain signals.
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Evidence-based recommendations on auditory brain stem implants for deafness caused by damage to the vestibulocochlear nerve due to tumours or surgery. This involves placing an implant in the part of the brain that processes sound signals, bypassing the nerve, to pick up electrical signals from a sound processor worn outside the ear.
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Tunnelled peritoneal drainage catheter insertion for refractory ascites in cirrhosis (HTG648)
Evidence-based recommendations on tunnelled peritoneal drainage catheter insertion for refractory ascites in cirrhosis. This involves inserting a catheter under the skin in the abdomen to drain excess fluid when needed, at home or in community care. The aim is to reduce the need for hospital admissions and improve quality of life.
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Evidence-based recommendations on ab interno canaloplasty for open-angle glaucoma. This involves widening the channel that drains fluid from the eye. The aim is to reduce pressure in the eye.
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Percutaneous ultrasound-guided microwave ablation for symptomatic benign thyroid nodules (HTG646)
Evidence-based recommendations on percutaneous ultrasound-guided microwave ablation for symptomatic benign thyroid nodules. This involves using microwaves from a wire inserted into the nodule to heat and destroy it (ablation).
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Extracorporeal shockwave therapy for calcific tendinopathy in the shoulder (HTG645)
Evidence-based recommendations on extracorporeal shockwave therapy for calcific tendinopathy in the shoulder. This involves placing a device on the skin that delivers short pulses of sound into the shoulder. The aim is to reduce pain and improve shoulder function.
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YAG laser vitreolysis for symptomatic vitreous floaters (HTG644)
Evidence-based recommendations on YAG laser vitreolysis for symptomatic vitreous floaters. This involves a special type of laser (YAG) firing short pulses of energy into the floaters, to break them up (vitreolysis) and reduce sight disturbances.
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Evidence-based recommendations on transcutaneous electrical stimulation of the supraorbital nerve for treating and preventing migraine in adults. This involves attaching a small device on the forehead to send small electrical currents to the nerves that bring sensation to the upper eyelids, forehead and scalp.
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Neurostimulation of lumbar muscles for refractory non-specific chronic low back pain (HTG641)
Evidence-based recommendations on neurostimulation of lumbar muscles for refractory non-specific chronic low back pain in adults. This involves implanting a pulse generator under the skin of the upper buttock or lower back, which the person can use to manage their pain.
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Evidence-based recommendations on removal, preservation and subsequent reimplantation of ovarian tissue to prevent symptoms from the menopause. This involves removing a small piece of ovarian tissue using keyhole surgery, freezing and storing it. After menopause starts, the tissue is thawed and transplanted under the skin of the armpit, abdomen or forearm, with the aim of producing oestrogen.
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Coil embolisation of ruptured intracranial aneurysms (HTG64)
Evidence-based recommendations on coil embolisation of ruptured intracranial aneurysms. This involves passing a thin tube through the body to place coils inside the aneurysm.
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Evidence-based recommendations on prostatic urethral temporary implant insertion for lower urinary tract symptoms caused by benign prostatic hyperplasia. This involves positioning a temporary implant in the urethra to increase the flow of urine.
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Superficial venous arterialisation for chronic limb threatening ischaemia (HTG637)
Evidence-based recommendations on superficial venous arterialisation for chronic limb threatening ischaemia in adults. This involves joining an artery in the lower leg to a large vein to divert blood flow through the vein towards the foot, bypassing the blocked arteries.
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Transcutaneous electrical neuromuscular stimulation for urinary incontinence (HTG636)
Evidence-based recommendations on transcutaneous electrical neuromuscular stimulation for urinary incontinence in adults. This involves stimulating nerves and muscles in the pelvic floor to strengthen the muscles and reduce urine leaks.
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Single-step scaffold insertion for repairing symptomatic chondral knee defects (HTG728)
Evidence-based recommendations on single-step scaffold insertion for repairing symptomatic chondral knee defects. This involves inserting a scaffold into the damaged area of the knee to support regrowth and repair of the cartilage.
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Phrenic nerve pacing for ventilator-dependent high cervical spinal cord injury (HTG727)
Evidence-based recommendations on phrenic nerve pacing for ventilator-dependent high cervical spinal cord injury. This involves stimulating the phrenic nerve to make the diaphragm contract, helping people to breathe without a ventilator.
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Phrenic nerve pacing for congenital central hypoventilation syndrome (HTG725)
Evidence-based recommendations on phrenic nerve pacing for congenital central hypoventilation syndrome. This involves direct stimulation of the phrenic nerve, to produce the inhalation phrase of breathing.
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Evidence-based recommendations on minimally invasive percutaneous surgical techniques with internal fixation for correcting hallux valgus. This involves cutting into the big toe to remove the bunion and securing the bones at the front of the foot.
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Endoscopic duodenal mucosal resurfacing for insulin resistance in type 2 diabetes (HTG721)
Evidence-based recommendations on endoscopic duodenal mucosal resurfacing for insulin resistance in type 2 diabetes. This involves using heat to destroy the lining of the duodenum to encourage a new lining to grow.
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Evidence-based recommendations on selective internal radiation therapy for neuroendocrine tumours that have metastasised to the liver. This involves injecting tiny radioactive spheres into the blood vessels that supply the liver metastases.
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Radiofrequency ablation for atrial fibrillation in association with other cardiac surgery (HTG72)
Evidence-based recommendations on radiofrequency ablation for atrial fibrillation in association with other cardiac surgery. This involves scarring the heart tissue using heat to interrupt abnormal electrical signals.
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Evidence-based recommendations on endoscopic dacryocystorhinostomy for treating lacrimal sac or nasolacrimal duct obstruction. This involves making a connection that bypasses the blocked area so that the tears can drain straight into the nose.
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Artificial trapeziometacarpal joint replacement for end-stage osteoarthritis (HTG67)
Evidence-based recommendations on artificial trapeziometacarpal joint replacement for treating end-stage osteoarthritis. This involves replacing the arthritic joint at the base of the thumb with an artificial joint.
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Focal therapy using high-intensity focused ultrasound for localised prostate cancer (HTG667)
Evidence-based recommendations on focal therapy using high-intensity focused ultrasound for localised prostate cancer. This involves using high-intensity focused ultrasound to heat up and destroy only the areas of the prostate with cancer (focal therapy). The aim is to destroy the cancer while reducing damage to healthy prostate tissue.
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Percutaneous thoracic duct embolisation for persistent chyle leak (HTG666)
Evidence-based recommendations on percutaneous thoracic duct embolisation for persistent chyle leak. In this procedure, under general anaesthesia, ultrasound and X-rays are used to create an image of the thoracic duct and find the leak. Then, using a needle, a tube is inserted through the abdominal wall (percutaneous) and guided into the thoracic duct. Small metal coils and medical glue are inserted through the tube and used to plug the leak (embolisation). The aim is to stop the leak.
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Percutaneous transluminal renal sympathetic denervation for resistant hypertension (HTG662)
Evidence-based recommendations on percutaneous transluminal renal sympathetic denervation for resistant hypertension. This involves inserting a device through the skin (percutaneous) into an artery in the thigh and then into the renal arteries (transluminal). It sends radio or sound waves to destroy the nerves in the renal arteries (sympathetic denervation). The aim is to lower blood pressure.
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Endoluminal gastroplication for gastro-oesophageal reflux disease (HTG661)
Evidence-based recommendations on endoluminal gastroplication for gastro-oesophageal reflux disease. This involves an endoscopic fastening device being inserted through the mouth and into the stomach, along with an endoscope for constant visualisation. The device is used to attach the fundus to the anterior and left lateral wall of the distal oesophagus slightly above the oesophagogastric junction.
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Artificial metacarpophalangeal and interphalangeal joint replacement for end-stage arthritis (HTG66)
Evidence-based recommendations on artificial metacarpophalangeal and interphalangeal joint replacement for end-stage arthritis. This involves removing the diseased joints and replacing them with artificial ones.
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Lung volume reduction surgery for advanced emphysema (HTG69)
Evidence-based recommendations on lung volume reduction surgery for treating advanced emphysema. This involves removing damaged lung tissue using a special stapling device, a laser, or both.
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Radiofrequency denervation for osteoarthritic knee pain (HTG686)
Evidence-based recommendations on radiofrequency denervation for osteoarthritic knee pain. This involves applying heat (radiofrequency) energy to damage the nerves (denervation) that are causing pain in the knee.
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Evidence-based recommendations on botulinum toxin type A injections into the urethral sphincter for idiopathic chronic non-obstructive urinary retention. This involves injecting botulinum toxin type A into the urethral sphincter.
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Evidence-based recommendations on minimally invasive fusionless posterior-approach surgery to correct idiopathic scoliosis in children and young people. This involves inserting a rod along the spine through a small cut in the back.
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Evidence-based recommendations on endoscopic ultrasound-guided gallbladder drainage for acute cholecystitis when surgery is not an option. This involves inserting a stent through an endoscope into the gallbladder.
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Arthroscopic trochleoplasty for patellar instability (HTG328)
Evidence-based recommendations on arthroscopic trochleoplasty for patellar instability. This involves reshaping the bony anatomy of the trochlea by deepening the groove or elevating the lateral wall.
Percutaneous closure of patent foramen ovale to prevent recurrent cerebral embolic events (HTG325)
Evidence-based recommendations on percutaneous closure of the patent foramen ovale for the prevention of cerebral embolic stroke. This involves placing a small device into the heart to close the hole.
Evidence-based recommendations on phrenic nerve transfer in brachial plexus injury. This involves finding the phrenic nerve, cutting it and joining it to the damaged nerve in the brachial plexus.
Negative pressure wound therapy for the open abdomen (HTG321)
Evidence-based recommendations on negative pressure wound therapy for the open abdomen. This involves using a small pump to remove infected material, stop fluid escaping and help the wound heal.
Evidence-based recommendations on subfascial endoscopic perforator vein surgery. This involves cutting and closing off, or heating and sealing, perforator veins so that blood can no longer go through them.
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Endoscopic radiofrequency ablation for gastro-oesophageal reflux disease (HTG318)
Evidence-based recommendations on endoscopic radiofrequency ablation for gastro-oesophageal reflux disease. This involves using heat from electrodes to change the tissues in the oesophagus, with the aim of reducing symptoms.
Evidence-based recommendations on translaryngeal tracheostomy (TLT). This involves passing a tube from inside the windpipe to outside the neck to aid breathing.
Evidence-based recommendations on insertion of customised exposed titanium implants, without soft tissue cover, for complex orofacial reconstruction. This involves making the titanium implants specially to fit the person using a model of their face.
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Corneal inlay implantation for correction of presbyopia (HTG311)
Evidence-based recommendations on corneal inlay implantation for correction of Presbyopia. This involves placing a disc inside a flap or pocket made in the cornea to improve near vision.
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Occipital nerve stimulation for intractable chronic migraine (HTG310)
Evidence-based recommendations on occipital nerve stimulation for intractable chronic migraine. This involves using implanted electrodes to deliver electrical impulses to the occipital nerve to mask migraine pain.
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Transpupillary thermotherapy for age-related macular degeneration (HTG31)
Evidence-based recommendations on transpupillary thermotherapy for age-related macular degeneration. This involves using a laser to heat and seal up the blood vessels that are causing the problems.
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Peripheral nerve-field stimulation for chronic low back pain (HTG309)
Evidence-based recommendations on peripheral nerve-field stimulation for chronic low back pain. This involves implanting electrodes in the back, connected to a neurostimulator under the skin to mask the back pain by modulating the transmission of pain signals to the brain.
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Percutaneous electrical nerve stimulation for refractory neuropathic pain (HTG308)
Evidence-based recommendations on percutaneous electrical nerve stimulation for refractory neuropathic pain. This involves inserting electrode needles underneath the skin connected to a stimulator device.
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