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Ultrasound guided vascular access

Ahmed Amro, Kanaan Mansoor, Mohammad Amro, Amal Sobeih, Rameez Sayyed
We report a case of cardiac catheterization that was done entirely by accidentally accessing the inferior epigastric artery (IEA) through an unintentional puncture of the U-shaped portion of the inferior epigastric artery. Luckily the patient did not have any trauma to the IEA and was d/c home with no complications. A 48-year-old female with history of hypertension and CAD S/P left circumflex stent many years ago who presented to our facility with persistent crescendo angina for which decision was made to proceed with LHC...
2018: Case Reports in Cardiology
Bradley C Clark, Christopher M Janson, Lynn Nappo, Robert H Pass
BACKGROUND: Axillary venous access with ultrasound guidance for pediatric transvenous lead implantation may reduce risks for pneumothorax and hemothorax. The objective was to retrospectively evaluate ultrasound-guided axillary vein access as an alternative to the subclavian approach. METHODS: The technique consists of ultrasonographic identification of the axillary vein at the delto-pectoral groove after initial contrast venography. A micropuncture kit is used for initial ultrasound-guided percutaneous access with fluoroscopic confirmation of wire position...
December 4, 2018: Pacing and Clinical Electrophysiology: PACE
Monica L Schoch, Judy Currey, Liliana Orellana, Paul N Bennett, Vicki Smith, Alison M Hutchinson
Background: Point-of-care ultrasound (POCUS) has been used in various vascular access contexts; however, to date, it has not been widely adopted in haemodialysis clinics. People with end-stage kidney disease receiving haemodialysis require an arteriovenous fistula (AVF), arteriovenous graft (AVG), or central venous access device (CVAD) in order to access their blood for therapy/treatment. Cannulation issues, such as haematoma and extravasation, related to AVFs and AVGs are common. This pilot and feasibility study will assess the feasibility of a randomised controlled trial aimed at evaluating whether POCUS-guided cannulation results in more successful and accurate AVF needle placement than the standard practice of blind cannulation...
2018: Pilot and Feasibility Studies
Joseph R Pare, Samara E Pollock, James H Liu, Megan M Leo, Kerrie P Nelson
OBJECTIVES: Ultrasound guided peripheral intravenous catheters (USPIV) are frequently utilized in the Emergency Department (ED) and lead to reduced central venous catheter (CVC) placements. USPIVs, however, are reported to have high failure rates. Our primary objective was to determine the proportion of patients that required CVC after USPIV. Our secondary objective was to determine if classic risk factors for difficult vascular access were predictive of future CVC placement. METHODS: We performed a retrospective review for patients treated at a large academic hospital...
November 17, 2018: American Journal of Emergency Medicine
Ziming Wan, Qiquan Lai, Bo Tu
BACKGROUND: Kidney allograft loss becomes an important cause of end-stage kidney disease and requires dialysis reinitiation. We report a case of a patient who restarted hemodialysis after his second kidney graft failure using a long-discarded autologous arteriovenous fistula. CASE PRESENTATION: A 62-year-old man was diagnosed with end-stage renal disease 20 year ago, and a native arteriovenous fistula was created for hemodialysis. After the patient received his first kidney transplantation, the hemodialysis fistula was discarded and chronically thrombosed for 13 years...
October 26, 2018: BMC Nephrology
Mahmut Tuna Katırcıbaşı, Hakan Güneş, Ahmet Çağrı Aykan, Ekrem Aksu, Sami Özgül
Background: Many techniques, methods and closure devices have been developed in order to reduce vascular complications that occur after coronary and peripheral interventions. The aim of the present study was to identify which method i.e. ultrasound (US) guidance or traditional access technique, is better for common femoral artery cannulation. Methods: The study included 939 patients, who were assigned to either the US-guided cannulation group (n = 449) or manual technique group (n = 490)...
September 2018: Acta Cardiologica Sinica
Michael Wagner, Kirstin Hauser, Francesco Cardona, Georg M Schmölzer, Angelika Berger, Monika Olischar, Tobias Werther
OBJECTIVES: Critically ill neonatal and pediatric patients often require central vascular access. Real-time ultrasound guidance for central venous catheterization is beneficial. Because the diameter of central veins is much smaller in neonates than in adults, extensive training is needed to master the visualization and catheterization of central veins in neonates. This study assessed the learning effect of a standardized simulation-based teaching program on ultrasound-guided cannulation in a low-cost cadaver tissue model...
September 18, 2018: Pediatric Critical Care Medicine
Selvakumar Palaniappan, Venkatesh Subbiah, V Raja Gopalan, Poornima Vijaya Kumar, R John Santa Vinothan
Background and Aims: Arteriovenous (AV) fistula surgery is commonly performed for AV access for hemodialysis. However the ideal anaesthetic technique of choice remains debated. We aimed to assess operative conditions, vascular patency, and complication rate following AV fistula surgery with isolated brachial plexus block among end-stage renal disease (ESRD) patients. Methods: This prospective, observational study included 214 patients undergoing AV fistula surgery under isolated supraclavicular brachial plexus block between January and December 2017...
August 2018: Indian Journal of Anaesthesia
Zaghloul Elsafy Gouda, Mahmoud Mohamed Emara, Hany Said Elbarbary, Mahmoud Abdel Aziz Koura, Ahmed Rabie Elarbagy
INTRODUCTION: Internal jugular vein occlusion often makes necessary the use of less desirable routes as external jugular, subclavian, and femoral vein approaches in addition to inferior vena cava approaches. This a prospective cross-sectional follow-up study of the alternative approaches for placement of cuffed hemodialysis catheters in end-stage renal disease patients with bilateral internal jugular vein occlusion from the interventional nephrology point of view. METHOD: The study was conducted on 134 end-stage renal disease patients who were referred for insertion of a challenging hemodialysis catheter due to bilateral internal jugular vein occlusion...
August 24, 2018: Journal of Vascular Access
Danielle M Hundley, Aimee C Brooks, Elizabeth J Thomovsky, Paula A Johnson, Lynetta J Freeman, Ryan M Schafbuch, Hock Gan Heng, George E Moore
OBJECTIVE To compare time to achieve vascular access (TTVA) between an ultrasound-guided technique (UST) and landmark-based technique (LMT) for central venous catheter (CVC) placement in healthy anesthetized dogs. ANIMALS 39 purpose-bred hounds. PROCEDURES Anesthetized dogs that were hemodynamically stable following completion of a terminal surgical exercise were enrolled in the study during 2 phases, with a 45-day intermission between phases. For each dog, a UST and LMT were used for CVC placement via each external jugular vein by 2 operators (criticalist and resident)...
June 2018: American Journal of Veterinary Research
Julien Le Coz, Silvia Orlandini, Luigi Titomanlio, Victoria Elisa Rinaldi
IMPORTANCE: Point-of-care ultrasonography (POCUS) allows to obtain real-time images to correlate with the patient's presenting signs and symptoms. It can be used by various specialties and may be broadly divided into diagnostic and procedural applications. OBJECTIVE: We aimed at reviewing current knowledge on the use of POCUS in Pediatric Emergency Departments (PEDs). FINDINGS: US diagnostic capacity in paediatric patients with suspected pneumonia has been studied and debated whereas literature regarding the usefulness of point-of-care echocardiography in the pediatric setting is still limited...
July 27, 2018: Italian Journal of Pediatrics
Amit Bahl, Bophal Hang, Abigail Brackney, Steven Joseph, Patrick Karabon, Ammanee Mohammad, Ijeoma Nnanabu, Paul Shotkin
INTRODUCTION: Establishing peripheral intravenous (IV) access is a vital step in providing emergency care. Ten to 30% of Emergency Department (ED) patients have difficult vascular access (DVA). Even after cannulation, early failure of US-guided IV catheters is a common complication. The primary goal of this study was to compare survival of a standard long IV catheter to a longer extended dwell catheter. METHODS: This study was a prospective, randomized comparative evaluation of catheter longevity...
July 19, 2018: American Journal of Emergency Medicine
Yanji Lv, Haitao Liu, Pulin Yu, Guiyue Wang, Miao Liu, Yuhang Li, Hongliang Wang, Kaijiang Yu, Changsong Wang
BACKGROUND: Our goal was to conduct a network meta-analysis of randomized controlled trials to compare the effects of the long-axis (LAX), short-axis (SAX), and oblique-axis (OAX) ultrasound guidance approaches for vascular access cannulation. METHODS: We searched 5 databases, including the Cochrane Central Register of Controlled Trials in the Cochrane Library, Embase, MEDLINE, CINAHL, and Web of Science. Seven randomized clinical trials assessing ultrasound guidance for vascular access cannulation via the LAX, SAX, or OAX approach were included...
July 19, 2018: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
Mary E Mollie Meek, James C Meek, Blake Hollowoa, Ruizong Li, Linda A Deloney, Kevin D Phelan
RATIONALE AND OBJECTIVES: Competency in ultrasound (US) imaging and US-guided procedures is often difficult for medical students and residents to master. The use of simulation training has been strongly encouraged but the quality of phantom models available for US-guided procedures is limited. As a feasible alternative, we describe the innovative use of a lightly embalmed cadaver for realistic practice of common interventional radiology (IR) procedures prior to direct patient care. MATERIALS AND METHODS: Lightly embalmed cadavers were positioned as patients would be in the IR suite: supine, prone, and erect seated position...
July 14, 2018: Academic Radiology
Erwin Ströker, Carlo de Asmundis, Kaspars Kupics, Ken Takarada, Giacomo Mugnai, Jeroen De Cocker, Dirk Stockman, Juan Sieira, Bruno Schwagten, Pedro Brugada, Yves De Greef, Gian Battista Chierchia
Aims: Vascular complications are the most common complications of atrial fibrillation (AF) ablation. Cryoballoon (CB) ablation for AF needs the insertion of a large 15 Fr sheath in the femoral vein. Our aim was to investigate the impact of vascular ultrasound (US) in guiding access and evaluating post-procedural subclinical complications in a large, multi-centre patient cohort that underwent CB ablation. Methods and results: A total cohort of 1435 consecutive patients were subdivided in 870 US -/-, 265 US -/+, and 300 US +/+ patients depending on US performance for: venipuncture guidance/post-procedural evaluation...
July 11, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Céline Bridey, Nathalie Thilly, Thomas Lefevre, Adeline Maire-Richard, Maxime Morel, Bruno Levy, Nicolas Girerd, Antoine Kimmoun
OBJECTIVE: Establishing a peripheral intravenous catheter (PIVC) after a long intensive care unit (ICU) stay can be a challenge for nurses, as these patients may present vascular access issues. The aim of this study was to compare an ultrasound-guided method (UGM) versus the landmark method (LM) for the placement of a PIVC in ICU patients who no longer require a central intravenous catheter (CIVC). DESIGN: Randomised, controlled, prospective, open-label, single-centre study...
June 9, 2018: BMJ Open
Jason B Samarasena, Kenneth J Chang
A growing number of studies have explored endoscopic ultrasound (EUS)-guided vascular catheterization. Potential clinical applications of EUS-guided portal venous access include angiography, measurement of the portosystemic pressure gradient, EUS-guided transhepatic intrahepatic portosystemic shunt creation and portal vein sampling for the evaluation in gastrointestinal cancer. The following article reviews the different devices and techniques employed in these applications.
May 2018: Clinical Endoscopy
Joseph M Armstrong, Sorena Keihani, James M Hotaling
PURPOSE OF REVIEW: Male factor infertility is a complex and multifaceted problem facing the modern urologist and is identified in 30-40% of infertile couples. This review focuses on the use of ultrasound, as an adjunct screening tool, in the initial evaluation of male infertility. RECENT FINDINGS: Access to male reproductive urologist for assessment of male infertility is limited and about a quarter of infertile couples do not complete the male component in their infertility assessment...
May 28, 2018: Current Urology Reports
José M López Álvarez, Olivia Pérez Quevedo, Teresa Ramírez Lorenzo, José M Limiñana Cañal, Juan F Loro Ferrer
INTRODUCTION: Central vascular cannulation in children is a highly complex technique and poses many difficulties. Vascular ultrasound can make this procedure easier. OBJECTIVE: To describe the characteristics of ultrasound-guided vascular cannulation in critically-ill pediatric patients. POPULATION AND METHODS: Outcome measures prospectively recorded were vessels most frequently cannulated, their localization, the measurement of their diameter/depth, the success rate and complications developed, among others...
June 1, 2018: Archivos Argentinos de Pediatría
Paolo Federico Beccaria, Simona Silvetti, Rosalba Lembo, Giovanni Landoni, Giacomo Monti, Massimo Zambon, Daniela Mamo, Alberto Zangrillo
BACKGROUND: Although many studies have compared success and complication rates for central line insertion sites with and without ultrasound, few have examined the use of the brachiocephalic vein for central venous access. The aim of this study was to describe the brachiocephalic vein as an alternative site for elective ultrasound vascular cannulation in adults, and to compare it with the more commonly used internal jugular vein site in terms of procedural difficulties, first pass failure rate, overall failure rate, and safety...
July 2018: Anesthesia and Analgesia
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