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https://www.readbyqxmd.com/read/28544618/a-method-for-maintaining-vascular-access-when-impella-exchange-is-required
#1
B Scott Cook, Cleve Wilson, Brooke Kaiser, Raj Baljepally
A 45-year old male with no prior cardiac history, presented with cardiogenic shock in the setting of an anterolateral ST elevation myocardial infarction. We first placed a 2.5 Impella for hemodynamic support, and proceeded with emergent percutaneous coronary intervention to the proximal LAD. Several hours following percutaneous coronary intervention (PCI), the patient became acutely hypotensive and an echocardiogram revealed the Impella catheter was kinked within the left ventricle. The patient was taken back to the cath lab for Impella adjustment; however, damage to the distal catheter required the Impella be exchanged...
May 22, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28515407/comparison-of-the-outback-%C3%A2-elite-reentry-catheter-and-the-bi-directional-approach-after-failed-antegrade-approach-for-femoro-popliteal-occlusive-disease
#2
Daizo Kawasaki, Masashi Fukunaga, Tsuyoshi Nakata, Masaaki Kato, Nobukazu Ohkubo
AIM: A successful antegrade wire crossing for femoro-popliteal chronic total occlusion (FP-CTO) is still a technical challenge. We attempted to demonstrate the safety and feasibility of the OUTBACK(®) Elite reentry catheter and the bi-directional approach for failed FP-CTO cases with the antegrade approach. METHODS: Endovascular therapy for FP-CTO was performed in 219 lesions from May 2013 to December 2016 at Morinomiya Hospital. We retrospectively analyzed the data of 43 consecutive lesions which underwent endovascular therapy using the bi-directional approach with distal access and the mono-directional approach with the OUTBACK(®) Elite reentry catheter for FP-CTO lesions...
May 17, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/28510805/interventional-radiology-in-iatrogenic-ureteral-leaks-case-series-and-literature-review
#3
Claudia Trombatore, Giuseppe Giordano, Vincenzo Magnano San Lio
Iatrogenic ureteral injuries are a dramatic complication in medical practice. Nowadays there are no universal guidelines for their management. The aim of our study was to evaluate the feasibility of the percutaneous treatment in restoring ureteral integrity in 19 patients that came to our attention. In each case retrograde stenting failed and patients were candidates for re-surgery. Our strategy consists of two phases. The first step is the nephrostomy that allows an external urinary diversion putting dry the damaged ureteral segment...
May 16, 2017: La Radiologia Medica
https://www.readbyqxmd.com/read/28468975/physiology-of-angina-and-its-alleviation-with-nitroglycerine-insights-from-invasive-catheter-laboratory-measurements-during-exercise
#4
Kaleab N Asrress, Rupert Williams, Timothy P Lockie, Muhammed Z Khawaja, Kalpa De Silva, Matthew Lumley, Tiffany Patterson, Satpal S Arri, Sana Ihsan, Howard Ellis, Antoine Guilcher, Brian R Clapp, Philip J Chowienczyk, Sven Plein, Divaka Perera, Michael Marber, Simon R Redwood
Background -The mechanisms governing exercise-induced angina and its alleviation by the most commonly used anti-anginal drug, nitroglycerine (GTN), are incompletely understood. The purpose of this study was to develop a method with which the effects of anti-anginal drugs could be evaluated invasively during physiological exercise to gain further understanding as to the clinical impact of angina and GTN. Methods -40 Patients (mean 65.2±7.6 years) with exertional angina and coronary artery disease underwent cardiac catheterisation via radial access and performed incremental exercise using a supine cycle ergometer...
May 3, 2017: Circulation
https://www.readbyqxmd.com/read/28440110/in-parallel-connected-intermittent-hemodialysis-through-ecmo-does-not-affect-hemodynamic-parameters-derived-from-transpulmonary-thermodilution
#5
Tobias Lahmer, Ulrich Mayr, Sebastian Rasch, Gonzalo Batres Baires, Roland M Schmid, Wolfgang Huber
INTRODUCTION: We report a case of renal replacement therapy (RRT) during extracorporeal membrane oxygenation (ECMO) via a single venous access and analyze the feasibility of transpulmonary thermodilution (TPTD) for hemodynamic monitoring. CASE REPORT: ECMO and RRT connected into the ECMO-extracorporeal circuit were performed via a single venous access because of multiple venous thromboses. An indicator for TPTD and pulse contour analysis (PCA) was applied into the central venous catheter (CVC) placed in the right vena jugularis...
April 1, 2017: Perfusion
https://www.readbyqxmd.com/read/28431023/safety-and-efficacy-of-the-sofia-6f-plus-distal-access-reperfusion-catheter-in-the-endovascular-treatment-of-acute-ischemic-stroke
#6
Hussain Shallwani, Hakeem J Shakir, Leonardo Rangel-Castilla, Jason M Davies, Ashish Sonig, Mithun G Sattur, Bernard R Bendok, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy
BACKGROUND: Neuroendovascular intervention has become a key treatment option for acute ischemic stroke. The Sofia (6F) PLUS catheter was designed for neurovascular access for diagnostic or therapeutic interventions. OBJECTIVE: To report the first series describing use of the Sofia PLUS intermediate/distal access reperfusion catheter in the treatment of acute ischemic stroke. METHODS: In this retrospective study, 41 stroke cases were identified in which the catheter was utilized for thrombolysis/thrombectomy...
April 19, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28419527/the-rectosigmoid-brake-review-of-an-emerging-neuromodulation-target-for-colorectal-functional-disorders
#7
Anthony Y Lin, Phil G Dinning, Tony Milne, Ian P Bissett, Gregory O'Grady
The regulation of gastrointestinal motility encompasses several overlapping mechanisms including highly regulated and coordinated neurohormonal circuits. Various feedback mechanisms or 'brakes' have been proposed. While duodenal, jejunal, and ileal brakes are well described, a putative distal colonic brake is less well defined. Despite the high prevalence of colonic motility disorders, there is little knowledge of colonic motility owing to difficulties with organ access and technical difficulties in recording detailed motor patterns along its entire length...
April 16, 2017: Clinical and Experimental Pharmacology & Physiology
https://www.readbyqxmd.com/read/28366062/initial-experience-with-a-multiple-parallel-guidewire-support-system-for-complex-tortuous-aortic-arch-navigation-and-great-vessel-catheterization-technical-note
#8
Leonardo Rangel-Castilla, Hakeem J Shakir, Adnan H Siddiqui
The ability to traverse an anatomically challenging and complex arch is paramount to the success of any neuroendovascular procedure. With age, the aortic arch becomes elongated, calcified, and less compliant. The authors present the initial experience with a multiple parallel guidewire system (ZigiWire Mode 3) for catheterization through a complex tortuous aortic arch to access extracranial vessels. The ZigiWire is an organized guidewire system that uses consecutive delivery of 3 small-diameter (0.014-inch) guidewires that are progressively advanced in parallel to secure support-wire access...
April 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28366057/development-of-a-recalcitrant-large-clot-burden-bifurcation-occlusion-model-for-mechanical-thrombectomy
#9
Visish M Srinivasan, Stephen R Chen, Kevin M Camstra, Gouthami Chintalapani, Peter Kan
OBJECTIVE Stroke is a major cause of disability and death in adults. Several large randomized clinical trials have shown the significant benefit of mechanical thrombectomy with modern stent retrievers in the treatment of large-vessel occlusions. However, large clots located at bifurcations remain challenging to treat. An in vivo model of these recalcitrant clots needs to be developed to test future generations of devices. METHODS Autologous blood was drawn from anesthetized swine via a femoral sheath. Blood was then mixed with thrombin, calcium chloride, and saline, and injected into silicone tubing to form cylindrical clots in the standard fashion...
April 2017: Neurosurgical Focus
https://www.readbyqxmd.com/read/28341502/significance-of-blunted-venous-waveforms-seen-on-upper-extremity-ultrasound
#10
Xuan-Binh D Pham, Ezinne J Ihenachor, Hoover Wu, Jerry J Kim, Amy H Kaji, Matthew C Koopmann, Timothy J Ryan, Christian de Virgilio
INTRODUCTION: Current guidelines recommend vascular mapping ultrasound (US) prior to arteriovenous fistula creation. Blunted venous waveforms (BVW) suggest central venous stenosis; however, this relationship and one between BVW and the presence of a central venous catheter (CVC) remain unclear. MATERIAL AND METHODS: All patients who received upper-extremity vascular mapping US between January 2013 and October 2014 at a single institution were retrospectively reviewed...
March 21, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28340927/resuscitative-endovascular-balloon-occlusion-of-the-aorta-for-control-of-noncompressible-truncal-hemorrhage-in-the-abdomen-and-pelvis
#11
Laura J Moore, Clay D Martin, John A Harvin, Charles E Wade, John B Holcomb
BACKGROUND: Noncompressible truncal hemorrhage is a leading cause of potentially preventable death in trauma and acute care surgery patients. These patients are at high risk of exsanguination before potentially life-saving surgical intervention may be performed. Temporary aortic occlusion is an effective means of augmenting systolic blood pressure and perfusion of the heart and brain in these patients. Aortic occlusion temporarily controls distal bleeding until permanent hemostasis can be achieved...
December 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/28316869/forced-arterial-suction-thrombectomy-using-distal-access-catheter-in-acute-ischemic-stroke
#12
Ho-Cheol Lee, Dong-Hun Kang, Yang-Ha Hwang, Yong-Sun Kim, Yong-Won Kim
Historical innovations in mechanical thrombectomy devices and strategies for ischemic stroke have resulted in improved angiographic outcomes and better clinical outcomes. Various devices have been used, but the two most common approaches are aspiration thrombectomy and stent-retrieval thrombectomy. Aspiration thrombectomy has advanced from the traditional Penumbra system to forced arterial suction thrombectomy and a direct aspiration first-pass technique. Newer generation aspiration catheters with flexible distal tips and a larger bore have demonstrated faster and better recanalization relative to older devices...
March 2017: Neurointervention
https://www.readbyqxmd.com/read/28304200/advance-an-effective-and-feasible-technique-in-acute-stroke-treatment
#13
Erdem Gurkas, Cetin Kursad Akpinar, Emrah Aytac
Background and purpose Different techniques regarding efficient utilization of thrombectomy devices have been reported. Here, we described a novel technique named ADVANCE that is based on advancing a distal access catheter over the stent retriever. In this study, we aimed to report our initial results with this novel thrombectomy technique. Methods and results Sixty-seven consecutive acute anterior circulation ischemic stroke patients (35 male, 32 female) between January 2015 and January 2016 who were treated by mechanical thrombectomy were included in this prospective study...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28259730/incidence-of-central-venous-catheter-hub-contamination
#14
Julie L Holroyd, Terrie Vasilopoulos, Mark J Rice, Kenneth H Rand, Brenda G Fahy
PURPOSE: To investigate microorganisms causing central venous catheter contamination and how this contamination differs across different catheter metrics. MATERIALS AND METHODS: After obtaining IRB approval and informed consent, 830 cultures were prospectively obtained from 45 ICU patients with central venous catheter or peripherally inserted central catheter. Bacterial colonies were identified by mass spectrometry. RESULTS: Bacterial contamination of central catheter hubs occurred 44% of the time in this study in the ICU setting...
June 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28240382/minimal-invasive-left-ventricular-lead-repositioning-is-safe-and-effective-in-distal-left-ventricular-lead-positions
#15
István Osztheimer, Szabolcs Szilágyi, Zsuzsanna Pongor, Endre Zima, Levente Molnár, Tamás Tahin, Béla Merkely, László Gellér
BACKGROUND: Treatment of left ventricular electrode dislocation and phrenic nerve stimulation remains an issue in the era of new electrode designs. METHODS: Safety and efficacy of minimal invasive lead repositioning and pocket opening reposition procedures were evaluated between December 2005 and December 2012 at our center. Minimal invasive method was developed and widely utilized at our center to treat phrenic nerve stimulation. The distally positioned left ventricular lead is looped around by a deflectable catheter in the right atrium introduced from the femoral vein access and then pulled back...
May 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28157261/mediguide-assisted-transseptal-puncture-without-echocardiographic-guidance
#16
Gabriel Ballesteros, Pablo Ramos Ardanaz, Renzo Neglia, Marcel Palacio Solís, Cristina Díaz Fernández, Graciela López González, Elene Janiashvili, Ignacio García-Bolao
BACKGROUND: First description of a technique for left atrium transseptal puncture (TSP) with minimal radiation exposure by using the nonfluoroscopic MediGuide™ tracking system (MG; St. Jude Medical, St. Paul, MN, USA) without the assistance of intracardiac echocardiography. METHODS: This study included 31 consecutive patients with atrial fibrillation undergoing an MG-assisted percutaneous catheter ablation procedure. A Brockenbrough transseptal needle (BRK) is connected to a standard pressure transducer through a two-input valve...
May 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28138123/initial-experience-and-feasibility-of-the-new-low-profile-stingray-catheter-as-part-of-the-antegrade-dissection-and-re-entry-revascularization-strategy-for-coronary-chronic-total-occlusions
#17
Joren Maeremans, Pieter-Jan Palmers, Joseph Dens
BACKGROUND During antegrade dissection re-entry (ADR) of chronic total occlusions (CTO), the first-generation Stingray catheter requires the use of large-bore guides (sheathless 7.5 Fr or 8 Fr), which increases the risk for access site-related complications and compromises radial approaches. Smaller guiding sizes necessitate long guidewires (e.g., 300 cm) or guidewire extensions for catheter advancement or removal. However, friction between guides and the Stingray catheter can result in unstable guidewire position or unintentional removal...
January 31, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28093811/routine-use-of-distal-arterial-perfusion-in-pediatric-femoral-venoarterial-extracorporeal-membrane-oxygenation
#18
Christine A Schad, Brian P Fallon, Julie Monteagudo, Shunpei Okochi, Eva W Cheung, Nicholas J Morrissey, Angela V Kadenhe-Chiweshe, Gudrun Aspelund, Steven Stylianos, William Middlesworth
Lower-extremity ischemia is a significant complication in children on femoral venoarterial extracorporeal membrane oxygenation (VA ECMO). Our institution currently routinely uses distal perfusion catheters (DPCs) in all femoral arterial cannulations in attempts to reduce ischemia. We performed a single-center, retrospective review of pediatric patients supported with femoral VA ECMO from January 2005 to November 2015. The outcomes of patients with prophylactic DPC placement at cannulation (prophylactic DPC) were compared to a historical group with DPCs placed in response only to clinically evident ischemic changes (reactive DPC)...
January 2017: Artificial Organs
https://www.readbyqxmd.com/read/27941747/a-case-report-on-percutaneous-coronary-intervention-in-chronic-total-occlusion-by-retrograde-visualization
#19
M A Muqueet, M Mahmood, M H Hoque, S M Zaman, J Arzu, M A Salim, F Rahman, S Rahman
As bilateral approach is paramount in chronic total occlusions with retrograde flow, the use of two radial arteries, two femoral arteries or combination technique using one radial and one femoral artery will probably be increasingly reported in the near future. After puncture of opposite groin, a diagnostic 6 Fr catheter is used to intubate the ostium of the contralateral artery. By visualizing the distal vessel in multiple projections, contralateral injections help to direct the progression of the wire in the occluded segment towards the distal true lumen and confirm the intraluminal position of the wire after the occluded segment...
October 2016: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/27919637/critical-hand-ischemia-treatment-via-orbital-atherectomy-a-single-center-observational-retrospective-analysis
#20
Abdul Bahro, Zsuzsanna Igyarto, Brad Martinsen
BACKGROUND/PURPOSE: Critical hand ischemia (CHI) can be devastating and may result in amputation. Distal vessel calcification has been shown to be a major factor in causing CHI. Atherectomy in the upper extremities is not typically considered due to the small anatomy; however, the Diamondback 360° Peripheral Orbital Atherectomy System (OAS) (Cardiovascular Systems, Inc.) can access treatment areas with a reference vessel diameter of 1.5mm. METHODS/MATERIALS: A retrospective, observational, single center (Merit Health Center, Jackson, MS) analysis of 11 CHI patients with calcific disease of the radial artery treated with orbital atherectomy (OAS) was completed...
March 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
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