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Catheter directed

Yuya Kato, Miki Fujimura, Kenichi Sato, Hidenori Endo, Teiji Tominaga
Moyamoya syndrome (MMS) is an uncommon late complication after cranial irradiation. Its hemorrhagic presentation from the associated pseudo-aneurysm is extremely rare, and the optimal management strategy is undetermined. We herein report a 36-year-old man who developed intraventricular hemorrhage from a pseudo-aneurysm at the extended left anterior choroidal artery as an abnormal collateral of MMS 30 years after surgical removal and cranial irradiation for childhood craniopharyngioma. Catheter angiography confirmed the diagnosis of MMS, and multiple pseudo-aneurysms were evident at the ipsilateral abnormal choroidal collateral, one of which was considered to be a source of bleeding...
February 13, 2019: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Dominik Grieb, Martin Schlunz Hendann, Waleed Brinjikji, Katharina Melber, Bjoern Greling, Heinrich Lanfermann, Friedhelm Brassel, Dan Meila
BACKGROUND AND PURPOSE: The direct aspiration first pass technique (ADAPT) using distal access catheters (DAC) has proven to be an effective and safe endovascular treatment strategy of acute ischemic stroke with large vessel occlusions (LVO). However, data about direct aspiration using DAC in M2 segment occlusions is limited. We assess the safety and efficacy of DACs in acute M2 occlusions using ADAPT with large bore (5 French /6 French) aspiration catheters as the primary method for endovascular recanalization...
February 13, 2019: Journal of Neuroradiology. Journal de Neuroradiologie
Tyler Bm Hickey, Asaf Honig, Avrum J Ostry, Jason B Chew, James Caldwell, Michael A Seidman, Hamid Masoudi, John A Maguire
INTRODUCTION: Iatrogenic embolization following cardiac investigative procedures may result from hydrophilic polymer emboli (HPE) from catheter valve and vessel wall calcifications, and air embolism from open heart surgery. This retrospective clinical pathologic analysis was undertaken to ascertain the frequency and extent of these potentially fatal complications. METHODS: This retrospective clinical pathologic autopsy analysis with premortem diagnostic imaging correlation identified 110 individuals who had undergone endovascular procedures between 2010 and 2016 within 90 days of death and followed by hospital autopsy...
January 19, 2019: Cardiovascular Pathology: the Official Journal of the Society for Cardiovascular Pathology
Xiao-Jun Song, Zhi-Li Liu, Rong Zeng, Chang-Wei Liu, Wei Ye
OBJECTIVE: The aim of this study is to examine the efficacy and safety of Angiojet rheolytic thrombectomy for the treatment of subacute deep venous thrombosis (DVT) in lower limbs. METHODS: A retrospective study was performed on 90 patients with subacute DVT (15 ∼90 days) in lower limbss in our center from November 2015 to December 2016. In total, 27 patients with subacute DVT in lower limbs treated with Angiojet rheolytic thrombectomy were included in the study, including 17 males and 10 females...
February 12, 2019: Annals of Vascular Surgery
Matthew Thomas, Andrew Hollingsworth, Reza Mofidi
BACKGROUND: Deep vein thrombosis (DVT) is associated with significant complications, including the development of post-thrombotic syndrome (PTS). Traditional management is with oral anticoagulation, but the endovascular techniques of catheter-directed thrombolysis (CDT), pharmaco-mechanical thrombolysis and venous stenting are now increasingly used. This study aims to review the evidence for these endovascular techniques in the management of acute lower limb DVT, and their role in the reduction of complications such as PTS...
February 12, 2019: Annals of Vascular Surgery
Xiang-Yang Li, Jin-Bao Ye, Long-Guang Zhang, Yi-Zhen Jia, Ru-Ming Zhou, Pearl Pai
BACKGROUND: Central venous catheter (CVC) is commonly used to provide access for hemodialysis (HD) when arteriovenous access is not available. The misplacement of CVC into azygos vein (AV) is a rare but a potential serious complication. Previous reports communicated the opinion that left-sided catheterization predisposed to AV misplacement, but these reports concentrated on peripherally inserted CVCs, placed for indications rather than HD. Unintended AV misplacement of HD catheters (HDCs) has not been well studied...
February 14, 2019: Blood Purification
Jacques T YaDeau, David M Dines, Spencer S Liu, Michael A Gordon, Enrique A Goytizolo, Yi Lin, Aaron A Schweitzer, Kara G Fields, Lawrence V Gulotta
BACKGROUND: The pain experience for total shoulder arthroplasty (TSA) patients in the first 2 weeks after surgery has not been well described. Many approaches to pain management have been used, with none emerging as clearly superior; it is important that any approach minimizes postoperative opioid use. QUESTIONS/PURPOSES: (1) With a long-acting nerve block and comprehensive multimodal analgesia, what are the pain levels after TSA from day of surgery until postoperative day (POD) 14? (2) How many opioids do TSA patients take from the day of surgery until POD 14? (3) What are the PainOUT responses at POD 1 and POD 14, focusing on side effects from opioids usage? METHODS: From January 27, 2017 to December 6, 2017, 154 TSA patients were identified as potentially eligible for this prospective, institutional review board-approved observational study...
March 2019: Clinical Orthopaedics and related Research
Woosuk S Hur, Hannah Warner, Lindsay Machan, Christian J Kastrup
: To assess the effect of tissue plasminogen activator administered during catheter-directed thrombolysis (CDT) on coagulation factor XIII (FXIII). Thrombolytic therapy carries significant risks, such as life-threatening bleeds. The mechanisms responsible for major bleeds and intracerebral hemorrhages during thrombolysis are not fully understood. Activated FXIII (FXIII-A) lies at the intersection of coagulation and fibrinolysis. Using purified proteins and blood collected from nine deep vein thrombosis patients undergoing CDT, the stability of FXIII-A and FXIII were measured immediately before, immediately after and 1-day post thrombolysis...
February 11, 2019: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
S V Kotov, S V Belomyttsev, R I Guspanov, M K Semenov, M M Iritsyan, A M Ugurchiev
INTRODUCTION: Iatrogenic urethral damage is the leading etiologic factor for urethral stricture in men in developed countries and second after traumatic injury in developing ones. This study aimed to evaluate the frequency of iatrogenic strictures of the urethra and the results of their treatment. MATERIALS AND METHODS: This retrospective analysis comprised 133 patients who were treated for iatrogenic urethral stricture from 2011to 2016. Group I included 72 (54%) patients after trans(intra)urethral interventions (transurethral resection of the prostate or urinary bladder), urethral dilation, traumatic catheterization, etc...
October 2018: Urologii︠a︡
Tapan Mehta, Shailesh Male, Coridon Quinn, David F Kallmes, Adnan H Siddiqui, Aquilla Turk, Andrew Walker Grande, Ramachandra Prasad Tummala, Bharathi Dasan Jagadeesan
INTRODUCTION: Stent retriever combined with aspiration, or the 'Solumbra technique', has recently emerged as one of the popular methods of mechanical thrombectomy (MT). However, the variations in understanding and implementation of the Solumbra technique have not been reported. METHODS: An 18 part anonymous survey questionnaire was designed to extract information regarding technical variations of MT with a focus on the Solumbra technique. The survey link was posted on the Society of Neurointerventional Surgery (SNIS) website in 'SNIS connect'...
February 13, 2019: Journal of Neurointerventional Surgery
Carlos Rodrigues Almeida, Ana Raquel Oliveira, Pedro Cunha
Supplementary strategies, in combination with conventional analgesia, for pain control after lumbar fusion surgery remain limited. Here, we describe a 79-year-old woman who experienced pain (10/10 on a numerical rating scale) on post-operative day 1 after undergoing L2 to S1 spine fusion. Erector spinae plane (ESP) blocks were performed at T8 and, after a bolus of ropivacaine 0.2% (20 ml) per side, perineural catheters were placed bilaterally. Continuous infusion (5 ml/h) of ropivacaine 0.2% per side was maintained for 48 h...
February 13, 2019: Pain Practice: the Official Journal of World Institute of Pain
Ana João Pissarra, Mariana Malheiro, Carolina Gouveia, Patrícia Vicente, Leonor Matos
Intracranial dural arteriovenous fistula is an abnormal connection between an artery and a vein that has an increased risk of bleeding. This case report presents a 53-year-old man diagnosed with a dural arteriovenous malformation fistula in occipital topography, lacking therapeutic indication because of an extension. He was admitted to an intensive care unit due to a high-risk pulmonary thromboembolism with indication for thrombolysis. Taking into account the hemorrhagic risk associated with arteriovenous malformation, the authors discuss the therapeutic options and the inherent risks...
2019: European Journal of Case Reports in Internal Medicine
Richard N Lesperance, Colin M Carroll, James K Aden, Jason B Young, Timothy C Nunez
Tension pneumothorax is commonly treated with needle decompression (ND) at the 2nd intercostal space midclavicular line (2nd ICS MCL) but is thought to have a high failure rate. Few studies have attempted to directly measure the failure rate in patients receiving the intervention. We performed a retrospective analysis of 10 years of patients receiving prehospital ND. CT scans were reviewed to record the location of catheters left indwelling and the proportion of patients who did not have any pneumothorax. Chest wall thickness was measured on both injured and uninjured sides at the 2nd ICS MCL and compared with the recommended alternative, the 5th ICS anterior axillary line (5th ICS AAL)...
November 1, 2018: American Surgeon
May K Thet, Ma Lourdes F Pelobello, Milton Das, Mohammed M Alhaji, Vui Heng Chong, Muhammad Abdul Mabood Khalil, Terence Chinniah, Jackson Tan
We report a case series of seven patients with nonfermentative Gram-negative bacteria infections in a single dialysis center; four patients with Ralstonia pickettii and three patients with Stenotrophomonas maltophilia. Two of the seven patients were admitted to hospital for intravenous antibiotic treatment, while the rest were treated with oral antibiotics at home. Both the admitted patients had temporary vascular catheter infections from the aforementioned pathogens. We conclude that the outbreak is due to colonization of treated reverse osmosis water, presumably through contamination via polluted filters and compounded by the usage of reprocessed dialysers in the dialysis center...
February 12, 2019: Hemodialysis International
Lijian Xie, Yun Li, Xunwei Jiang, Jian Zhao, Tingting Xiao
BACKGROUND: Abernethy malformation is an extremely rare congenital malformation characterised by an extrahepatic portosystemic shunt. Children with Abernathy malformation can develop hepatopulmonary syndrome (HPS) with pulmonary arteriovenous fistulas (PAVF) or pulmonary hypertension. PAVF manifests as central cyanosis with effort intolerance. We report a case of PAVF in a Ten-year-old Boy. Persistent symptoms identified Abernathy malformation as the cause of progressive symptoms and current understanding of this rare malformation is reviewed...
February 11, 2019: BMC Pediatrics
Min Jang, Sooyoung Choi, In Lee, Inhyung Lee
OBJECTIVE: To describe computed tomographic (CT) features of intra-abdominal hypertension (IAH) in 3 dogs with abdominal distension. CASE SUMMARY: Three dogs with anorexia, distended abdomen, or labored breathing were presented for CT imaging. All 3 dogs were premedicated with IV butorphanol (0.2 mg/kg). A Foley urinary catheter was aseptically placed and the transvesical technique was used to obtain intra-abdominal pressure (IAP). The IAP measurements were obtained with the dogs in a standing position after a stabilization period of 5 minutes...
February 11, 2019: Journal of Veterinary Emergency and Critical Care
Roland Roelz, Christian Scheiwe, Volker A Coenen, Peter C Reinacher
Delayed Cerebral Infarction (DCI) due to Cerebral Vasospasm (CVS) is an important contributor to poor outcome after aneurysmal subarachnoid haemorrhage (aSAH). Despite established risk factors CVS and DCI are unpredictable at the individual patient level. Efficient treatments are lacking. We report a novel rescue therapy for DCI: Access to the basal cisterns by stereotactic catheter ventriculocisternostomy (STX-VCS) and direct cisternal application of the spasmolytic agent Nimodipine. On the basis of individual treatment decisions three aSAH patients who developed CVS underwent STX-VCS...
February 5, 2019: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Lars Mikael Broman, Fabio Silvio Taccone, Roberto Lorusso, Maximilian Valentin Malfertheiner, Federico Pappalardo, Matteo Di Nardo, Mirko Belliato, Melania M Bembea, Ryan P Barbaro, Rodrigo Diaz, Lorenzo Grazioli, Vincent Pellegrino, Malaika H Mendonca, Daniel Brodie, Eddy Fan, Robert H Bartlett, Michael M McMullan, Steven A Conrad
BACKGROUND: The Extracorporeal Life Support Organization (ELSO) Maastricht Treaty for Nomenclature in Extracorporeal Life Support (ECLS) established consensus nomenclature and abbreviations for ECLS to ensure accurate, concise communication. METHODS: We build on this consensus nomenclature by layering a framework of precise and efficient abbreviations for cannula configuration that describe flow direction, number of cannulae used, any additional ECLS-related catheters, and cannulation sites...
February 8, 2019: Critical Care: the Official Journal of the Critical Care Forum
Bedros Taslakian, Clayton Li, Samuel Z Goldhaber, Kathryn Z Mikkelsen, James M Horowitz, Christopher Kabrhel, Geoffrey D Barnes, Akhilesh K Sista
Keywords: pulmonary embolism; submassive; survey.
February 7, 2019: Journal of Clinical Medicine
Matthew R Krafft, John Y Nasr
The advancement of pancreatic endotherapy has increased the availability of minimally invasive endoscopic pancreatic ductal drainage techniques. In this regard, familiarity with endoscopic ultrasound-guided pancreatic duct drainage (EUS-PDD) is critical for treatment of obstructed pancreatic ductal systems, especially in nonsurgical candidates and in patients desiring a minimally invasive approach. Two distinct forms of EUS-PDD exist, viz. rendezvous-assisted endoscopic retrograde pancreatography (rendezvous-assisted ERP) and anterograde EUS-PDD...
February 7, 2019: Digestive Diseases and Sciences
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