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intermediate catheter

Paul Abraham, Diego A Arroyo, Raphael Giraud, Henri Bounameaux, Karim Bendjelid
While systemic intravenous thrombolysis decreases mortality in patients with high-risk pulmonary embolism (PE), it clearly increases haemorrhagic risk. There are many contraindications to thrombolysis, and efforts should aim at selecting those patients who will benefit most, without suffering complications. The current review summarises the evidence for the use of thrombolytic therapy in PE. It clarifies the pathophysiological mechanisms in PE and acute cor pulmonale that increase the risk of bleeding following thrombolysis...
2018: Open Heart
Tarek Zghaib, Ali Keramati, Jonathan Chrispin, Dong Huang, Muhammad A Balouch, Luisa Ciuffo, Ronald D Berger, Joseph E Marine, Hiroshi Ashikaga, Hugh Calkins, Saman Nazarian, David D Spragg
Background: Bipolar voltage mapping, as part of atrial fibrillation (AF) ablation, is traditionally performed in a point-by-point (PBP) approach using single-tip ablation catheters. Alternative techniques for fibrosis-delineation include fast-anatomical mapping (FAM) with multi-electrode circular catheters, and late gadolinium-enhanced magnetic-resonance imaging (LGE-MRI). The correlation between PBP, FAM, and LGE-MRI fibrosis assessment is unknown. Objective: In this study, we examined AF substrate using different modalities (PBP, FAM, and LGE-MRI mapping) in patients presenting for an AF ablation...
January 2018: JACC. Clinical Electrophysiology
Xiu-Mei Sun, Guang-Qiang Chen, Hua-Wei Huang, Xuan He, Yan-Lin Yang, Zhong-Hua Shi, Ming Xu, Jian-Xin Zhou
BACKGROUND: Accurate measurement of esophageal pressure (Pes) depends on proper filling of the balloon. Esophageal wall elastance (Ees) may also influence the measurement. We examined the estimation of balloon-surrounding elastance in a bench model and investigated a simplified calibrating procedure of Pes in a balloon with relatively small volume. METHODS: The Cooper balloon catheter (geometric volume of 2.8 ml) was used in the present study. The balloon was progressively inflated in different gas-tight glass chambers with different inner volumes...
February 14, 2018: BMC Anesthesiology
Jason Klein, Alex Ghasem, Samuel Huntley, Nathan Donaldson, Martin Keisch, Sheila Conway
BACKGROUND: High-dose-rate brachytherapy (HDR-BT) and external-beam radiation therapy (EBRT) are two modalities used in the treatment of soft tissue sarcoma. Previous work at our institution showed early complications and outcomes for patients treated with HDR-BT, EBRT, or a combination of both radiation therapy modalities. As the general indications for each of these approaches to radiation therapy differ, it is important to evaluate the use of each in an algorithmic way, reflecting how they are used in contemporary practice at sites that use these treatments...
March 2018: Clinical Orthopaedics and related Research
Fabrizio Sallustio, Enrico Pampana, Alessandro Davoli, Stefano Merolla, Giacomo Koch, Fana Alemseged, Marta Panella, Vittoria Carla D'Agostino, Francesco Mori, Daniele Morosetti, Daniel Konda, Sebastiano Fabiano, Marina Diomedi, Roberto Gandini
BACKGROUND AND PURPOSE: To report clinical and procedural outcomes of acute ischemic stroke patients after endovascular treatment with the new thromboaspiration catheter AXS Catalyst 6. METHODS: Patients with anterior and posterior circulation stroke were selected. Successful reperfusion defined as a Thrombolysis in Cerebral Infarction (TICI) score ≥2 b and 3-month functional independence defined as a modified Rankin Scale (mRS) ≤2 were the main efficacy outcomes...
February 8, 2018: Journal of Neurointerventional Surgery
Dilek Ozdamar, Huban Dayioglu, Ihsan Anik, Seyhun Solakoglu, Mine Solak, Kamil Toker
Background: Spinal administration of dexmedetomidine has been proposed as an adjuvant in spinal anesthesia. However, there is limited information about its possible neurotoxic effect after its neuraxial administration. Potential spinal neurotoxicity should be investigated in animals before administering drugs through the spinal cord. Our aim was to investigate the neurotoxic effects of intrathecal dexmedetomidine in rats. Methods: Two groups were performed: the dexmedetomidine (D) group (n = 10) received 10 μg (0...
January 2018: Saudi Journal of Anaesthesia
Benjamin Gory, Mikael Mazighi, Julien Labreuche, Raphael Blanc, Michel Piotin, Francis Turjman, Bertrand Lapergue
BACKGROUND: Modern endovascular thrombectomy (MET), using stent retrievers or large-bore distal aspiration catheters in stroke patients with acute basilar artery occlusion (BAO), is routinely performed to date. However, more than 35% of BAO patients treated with MET die within 90 days despite high recanalization rates. The purpose of this study is to investigate the parameters associated with 90-day mortality in patients with BAO after MET. METHODS: We analyzed 117 consecutive BAO patients included in the Endovascular Treatment in Ischemic Stroke prospective clinical registry of consecutive acute ischemic stroke patients treated with MET (60 patients [51...
January 30, 2018: Cerebrovascular Diseases
Gregory J Keir, S John Wort, Maria Kokosi, Peter M George, Simon L F Walsh, Joseph Jacob, Laura Price, Simon Bax, Elisabetta A Renzoni, Toby M Maher, Peter MacDonald, David M Hansell, Athol U Wells
BACKGROUND AND OBJECTIVE: In interstitial lung disease (ILD), pulmonary hypertension (PH) is a major adverse prognostic determinant. Transthoracic echocardiography (TTE) is the most widely used tool when screening for PH, although discordance between TTE and right heart catheter (RHC) measured pulmonary haemodynamics is increasingly recognized. We evaluated the predictive utility of the updated European Society of Cardiology/European Respiratory Society (ESC/ERS) TTE screening recommendations against RHC testing in a large, well-characterized ILD cohort...
January 12, 2018: Respirology: Official Journal of the Asian Pacific Society of Respirology
Lucky Cuenza, Marianne P Collado, James Ho Khe Sui
Background: Risk stratification is an important component of left main percutaneous catheter intervention (PCI) which has emerged as a feasible alternative to cardiac surgery. We sought to compare the clinical SYNTAX score and the global risk score in predicting outcomes of patients undergoing unprotected left main PCI in our institution. Methods: Clinical, angiographic and procedural characteristics of 92 patients who underwent unprotected left main PCI (mean age 62 ± 12...
December 2017: Cardiology Research
Ahmet Korkmaz, Deniz Sahin, Umit Guray
AIM: Recently fragmented QRS (fQRS) on ECG has been introduced as a predictor of myocardial scarring and myocardial ischemia in coronary artery disease. OBJECTIVE: The aim of this study was to investigate the relationship between fQRS and fractional flow reserve (FFR) results in patients with the intermediate degree of coronary artery stenosis. METHODS: A total of 301 consecutive patients who underwent coronary angiography and FFR measurement for intermediate coronary artery stenosis were included in the study...
December 14, 2017: Biomarkers in Medicine
Alexandru Nicolae, Jure Murgic, Ivan Kruljac, Lior Dubnitzky, Laura D'Alimonte, Lin Lu, Aaron Cumal, Niki Law, Gerard Morton, Andrew Loblaw, Hans T Chung, Ananth Ravi
PURPOSE: To investigate the dosimetric impact of interobserver catheter reconstruction variability in transrectal ultrasound-guided prostate high-dose-rate (HDR) brachytherapy. METHODS AND MATERIALS: Twenty consecutive patients with intermediate- or high-risk prostate cancer were treated with a single, 15-Gy HDR brachytherapy boost as part of this study. The treated plan was used as the study reference plan (PR). Three expert treatment planners (observers) manually reconstructed the catheter paths on the static three-dimensional transrectal ultrasound images, and new plans were generated from the updated positions (POBS); subsequently, the dwell time and positions from the POBS plans were superimposed on the PR catheter paths to evaluate the dosimetric effect of the interobserver variations (PEVAL)...
November 24, 2017: Brachytherapy
Bing Liu, MingYuan Liu, LiHong Yan, JunWei Yan, Jiang Wu, XueFei Jiao, MingJin Guo
Objective This study was performed to evaluate the efficacy and feasibility of percutaneous mechanical thrombectomy (PMT) combined with catheter-directed thrombolysis (CDT) in patients with acute pulmonary embolism (APE) and lower extremity deep venous thrombosis (LEDVT). Methods In total, 20 consecutive patients with APE and LEDVT were prospectively selected for PMT combined with CDT. Mechanical thrombus fragmentation and aspiration using a pigtail rotation catheter followed by CDT was performed in each patient...
January 1, 2017: Journal of International Medical Research
Ewan D Fowler, Mark J Drinkhill, Rachel Stones, Ed White
Passive properties of the myocardium influence diastolic filling and cardiac output. In heart failure, changes in contributors to the passive properties of the ventricle, such as titin and collagen, and loss of the metabolic enzyme creatine kinase, increase resistance to filling resulting in diastolic dysfunction. Pulmonary artery hypertension (PAH) arises from interactions between the pulmonary vasculature and the right ventricle (RV) which ultimately leads to RV failure. Beta1-adrenergic receptor blockers (BB) act on the myocardium and are beneficial in left heart failure but are not used in PAH...
November 28, 2017: Clinical and Experimental Pharmacology & Physiology
Bedros Taslakian, Akhilesh K Sista
Acute pulmonary embolism (PE) is the third most common cause of death among hospitalized patients. Treatment escalation beyond anticoagulation therapy is necessary in patients with cardiogenic shock and may be of benefit in select normotensive patients with right heart strain. Percutaneous catheter-based techniques (catheter-directed mechanical thrombectomy, clot maceration, and/or pharmacologic thrombolysis) as an alternative or adjunct to systemic thrombolysis can rapidly debulk central clot in patients with shock...
January 2018: Interventional cardiology clinics
Manoj Jagani, Huy M Do, Jeremy J Heit
Background Intracranial atherosclerotic disease may result in ischemic infarction and has a high rate of recurrent ischemic strokes despite medical therapy. Patients who fail medical therapy may undergo endovascular treatment with cerebral artery angioplasty and possible Wingspan stent placement. We present a unique case of Wingspan delivery microcatheter fracture that resulted in a retained foreign body and an endovascular salvage maneuver. Case description An elderly patient presented with an acute ischemic stroke due to a severe stenosis in the proximal left middle cerebral artery (MCA)...
January 1, 2017: Interventional Neuroradiology
Billie-Jean Martin, Kandice Mah, Luke Eckersley, Joyce Harder, Charissa Pockett, Daryl Schantz, John Dyck, Mohammed Al Aklabi, Ivan M Rebeyka, David B Ross
BACKGROUND: An increasing proportion of those living with single ventricle physiology have hypoplastic left heart syndrome (HLHS). Our objective was to assess the association between HLHS and outcomes post Fontan operation. METHODS: All pediatric patients who underwent a Fontan procedure at the University of Alberta between 1996 and 2016 were included. Follow-up clinical data collected included early and late surgical or catheter reintervention, echocardiography, and long-term transplant-free survival...
December 2017: Annals of Thoracic Surgery
David Furfaro, R Scott Stephens, Michael B Streiff, Roy Brower
Intermediate-risk pulmonary embolism is common and carries a risk of progression to hemodynamic collapse and death. Catheter-directed thrombolysis is an increasingly used treatment option, based largely on the assumptions that it is more efficacious than anticoagulation alone and safer than systemic thrombolysis. In this review, we critically analyze the published data regarding catheter-directed thrombolysis for the treatment of intermediate-risk pulmonary embolism. Catheter-directed thrombolysis reduces right heart strain and lowers pulmonary artery pressures more quickly than anticoagulation alone...
February 2018: Annals of the American Thoracic Society
Russell Cerejo, Mark Bain, Thomas Masaryk
Delivery wire fracture of flow-diverter stents are rare but have been described. We describe a video case of a successful technique to retrieve such a fractured delivery wire by using a balloon microcatheter and the intermediate catheter when other proven methods may fail.
January 1, 2017: Interventional Neuroradiology
Murat Sütçü, Manolya Acar, Gonca Erköse Genç, İlknur Kökçü, Hacer Aktürk, Gürkan Atay, Selda Hançerli Törun, Nuran Salman, Zayre Erturan, Ayper Somer
AIM: Non-albicans Candida species and resistant microorganisms have been more commonly isolated in invasive candidiasis in recent years. The aim of this study was to evaluate the distrubution of Candida spp and antifungal resistance in our clinic. MATERIAL AND METHODS: Fifty-four Candida isolates and antifungal susceptibility results obtained from patients diagnosed as having invasive candidiasis between December 2012 and June 2016 were included. Clinical and laboratory data were retrospectively analyzed...
September 2017: Türk Pediatri Arşivi
Shelley A Hall, Nir Uriel, Sandra A Carey, Michelle Edens, Geoffrey Gong, Michele Esposito, Ryan O'Kelly, Shiva Annamalai, Nima Aghili, S Adatya, Navin K Kapur
BACKGROUND: Prognosis is poor for patients with decompensated advanced heart failure (HF) refractory to medical therapy. Evaluating candidacy for durable mechanical circulatory support (MCS), cardiac transplantation, or palliative care is complex, and time is often needed to stabilize the patient hemodynamically. The Impella 5.0 (Abiomed, Danvers, MA) is a minimally invasive axial-flow catheter capable of providing full temporary hemodynamic support. We report a multicenter series on the use of this device for bridge to decision (BTD) in decompensated advanced HF patients...
September 30, 2017: Journal of Heart and Lung Transplantation
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