Read by QxMD icon Read

Vascular access difficult

Sushant Govindan, Ashley Snyder, Scott A Flanders, Vineet Chopra
OBJECTIVES: To quantify variation in use and complications from peripherally inserted central catheters placed in the ICU versus peripherally inserted central catheters placed on the general ward. DESIGN: Retrospective cohort study. SETTING: Fifty-two hospital Michigan quality collaborative. PATIENTS: Twenty-seven-thousand two-hundred eighty-nine patients with peripherally inserted central catheters placed during hospitalization...
September 21, 2018: Critical Care Medicine
Ana M Togneri, Marcela P Pérez, Viviana Vilches, Ivana Martinelli, Roxana Sadorín, Silvia Marone, Mónica A Prieto, Rita I Armitano
Two cases of bacteremia caused by Helicobacter cinaedi are presented. The first case was diagnosed in a 76-year-old male patient, and was secondary to a vascular access device placement; the second case corresponded to a febrile infant of 37 days of life, and was associated with acute gastroenteritis. H. cinaedi is a microorganism difficult to grow in different culture media and also to identify to species level. In both cases, the microscopic observation of blood culture bottles, the use of mass spectrometry and the subsequent sequencing of the hsp60 gene were essential...
September 19, 2018: Revista Argentina de Microbiología
Ryan W Haines, Christopher J Kirwan, John R Prowle
PURPOSE OF REVIEW: Continuous renal replacement therapy (CRRT) is now the mainstay of renal organ support in the critically ill. As our understanding of CRRT delivery and its impact on patient outcomes improves there is a focus on researching the potential benefits of tailored, patient-specific treatments to meet dynamic needs. RECENT FINDINGS: The most up-to-date studies investigating aspects of CRRT prescription that can be individualized: CRRT dose, timing, fluid management, membrane selection, anticoagulation and vascular access are reviewed...
September 18, 2018: Current Opinion in Critical Care
G Kumar, M J Hamoudeh, N M Noureldin, I Alaqqad, N Airon, E Alkhasawneh
No abstract text is available yet for this article.
July 2018: Indian Journal of Nephrology
Junpei Koge, Tomonori Iwata, Tetsuya Hashimoto, Shigehisa Mizuta, Yukihiko Nakamura, Eri Tanaka, Masakazu Kawajiri, Shun-Ichi Matsumoto, Takeshi Yamada
PURPOSE: Transbrachial carotid artery stenting (TB-CAS) is performed as an alternative procedure for patients with hostile vascular anatomy of the aortic arch and aortic or peripheral artery disease. Proximal protection during TB-CAS is not generally feasible because a small size of the brachial artery may preclude using a large-diameter sheath introducer. We, herein present a novel method that enables proximal protection during TB-CAS by sheathless navigation of a 9-F balloon-guiding catheter equivalent to a 7-F sheath...
October 2018: Neuroradiology
Johannes B van Rees, Jose M Montero-Cabezas, Eidrees Ghariq, Martin J Schalij
No abstract text is available yet for this article.
September 10, 2018: JACC. Cardiovascular Interventions
N LeVasseur, C Stober, K Daigle, A Robinson, S McDiarmid, S Mazzarello, B Hutton, A Joy, D Fergusson, J Hilton, M McInnes, M Clemons
Background: Despite advances in systemic therapy choices for patients with early-stage breast cancer, optimal practices for intravenous (IV) access remain unknown. That lack of knowledge holds particularly true for the use of central venous access devices (cvads) such as peripherally inserted central catheters (piccs) and implanted vascular access devices (ports). Methods: Using a survey of Canadian oncologists and oncology nurses responsible for the care of breast cancer patients, we evaluated current access practices, perceptions of complications, and perceptions of risk, and we estimated complication rates and evaluated perceived risk factors for lymphedema...
August 2018: Current Oncology
Alexey N Shkarubo, Konstantin V Koval, Mikhail A Shkarubo, Ilia V Chernov, Dmitry N Andreev, Andrey A Panteleyev
OBJECTIVE: To present the basic topographic and anatomic features of the clivus and adjacent structures with an objective of possible improvements and optimization of the extended endoscopic endonasal posterior (transclival) approach when removing tumors of the clivus and anterior regions of the posterior cranial fossa. MATERIALS AND METHODS: A craniometric study was conducted on 125 human skulls. A topographic anatomic study was conducted on 25 cadaver head specimens with arterial and venous beds stained with colored silicone, according to the method developed by us, to visualize its features and individual variability...
August 7, 2018: World Neurosurgery
António Norton de Matos, Clemente N Sousa, Paulo Almeida, Paulo Teles, Duarte Rego, Gabriela Teixeira, Luís Loureiro, Sérgio Teixeira, Inês Antunes
Vascular access dysfunction is a serious problem in dialysis units. Some patients have complex dysfunctions that are difficult to resolve. In this article, we report the case a of two patients with radiocephalic arteriovenous fistulae (RC-AVF) who had stenosis/occlusion of the forearm median vein and where we used the basilic vein of the forearm as a solution. We reviewed the use of this surgical solution in RC-AVF. Two male patients on hemodialysis exhibited stenosis/occlusion of the forearm median vein. The forearm basilic vein was isolated and rotated toward the forearm median vein in order to solve RC-AVF problems...
July 25, 2018: Therapeutic Apheresis and Dialysis
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
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
G Trasimeni, F Laurino, D Lamusta, N Limbucci, S Mangiafico
We report a case in which navigation of the micro catheter (Headway 027) with the conventional single microwire technique became impossible because of the difficult intracranial vascular anatomy. In order to achieve access, we used two Terumo 012 inches micro guide-wires with a 45° angle inside a single micro catheter. The manoeuver was easy and can be reproduced in specific and challenging cases.
September 2018: Journal of Neuroradiology. Journal de Neuroradiologie
Nicholas Inston, Charmaine E Lok
The timing of referral for creation of vascular access in a patient with declining kidney function is difficult to predict. Current methods may result in patients undergoing unnecessary procedures and subsequent interventions on accesses that are never used. Multiple variables, including time for assessment, surgery and follow-up that considers the likelihood of access failure, and the estimated rate of kidney function decline, make vascular access planning challenging and difficult to balance. Better prediction tools that incorporate the risks of progressive decline in kidney function with the risk of access failure and the competing risk of death would facilitate decision-making in vascular access...
July 1, 2018: Journal of Vascular Access
Meghan P Horn, Minhaj S Khaja, Emily Z Stucken, Wael E Saad
Tetra-amelia is a rare congenital disorder characterized by the absence of limbs. We describe the anesthetic management of a 29-year-old woman with tetra-amelia who underwent general anesthesia for tympanomastoidectomy with meatoplasty for an extensive right ear cholesteatoma. Anesthetic challenges related to tetra-amelia include difficult intravenous access, lack of sites for blood pressure monitoring, and possible difficult airway management due to craniofacial anomalies. Our case report focuses on the complex establishment of iliac artery access for invasive blood pressure monitoring by initially cannulating the carotid artery...
July 5, 2018: A&A practice
Noga Lipschitz, Gavriel D Kohlberg, Mario Zuccarello, Ravi N Samy
PURPOSE OF REVIEW: To review the current literature on the extended middle cranial fossa (xMCF) approach and to provide a comprehensive description of the relevant anatomy, indications, surgical technique, results, and complications. RECENT FINDINGS: The xMCF approach expands the surgical exposure provided by the sMCF approach, allowing access to the internal auditory canal, cerebellopontine angle, prepontine cistern, anterior petrous apex, petrous carotid artery, Meckel's cave, cavernous sinus, mid and upper clivus, and posterior lesions approaching the jugular foramen...
October 2018: Current Opinion in Otolaryngology & Head and Neck Surgery
Barbara Smith Ehrhardt, Kelley E A Givens, Rebecca C Lee
: Background: Establishing peripheral IV access for infusions is one of the most common invasive procedures performed in the hospital setting, but it isn't always successful on the first attempt. Multiple attempts delay treatment and cause stress in patients and nurses. The literature reports that venipuncture skills are among the most challenging for novice nurses to master. OBJECTIVES: The goal of this quality improvement (QI) initiative was to develop, validate, and refine a simple evidence-based tool that novice nurses can use in the clinical setting to better identify those patients with preexisting conditions or anatomical variances that result in difficult IV access...
July 2018: American Journal of Nursing
L Ciércoles Ramírez, M Batllori Gastón, M E García Tinoco
Central venous cannulation is a commonly performed procedure in the hospital setting, while the internal jugular vein is one of the most frequently used to perform central venous access. The presence of venous valves in the jugular veins is a well-known fact, albeit often neglected during central venous cannulation. However, venous valves can make this procedure difficult, increasing the chance of developing complications. We report the case of a patient in whom the presence of a valve in the internal jugular vein did not permit a vascular access to be obtained through this vessel...
August 29, 2018: Anales del Sistema Sanitario de Navarra
I N Shchanitsyn, M R Sharafutdinov, R A Iakubov, I V Larin
A femoral approach is the main access in stenting of carotid arteries, mainly due to rapid training in how to perform the procedure and a possibility of using large-diameter catheters. However, this approach is not always feasible in atherosclerosis, tortuosity of lower-limb arteries and in certain anatomical peculiarities of the aortic arch. Using a transradial approach is based on the desire to diminish the incidence rate of haemorrhagic complications in the zone of the puncture and to avoid the necessity of a long-term bed rest...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Nicolas W Villelli, David M Lewis, Thomas J Leipzig, Andrew J DeNardo, Troy D Payner, Charles G Kulwin
OBJECTIVE Intraoperative angiography can be a valuable tool in the surgical management of vascular disorders in the CNS. This is typically accomplished via femoral artery puncture; however, this can be technically difficult in patients in the prone position. The authors describe the feasibility of intraoperative angiography via the popliteal artery in the prone patient. METHODS Three patients underwent intraoperative spinal angiography in the prone position via vascular access through the popliteal artery. Standard angiography techniques were used, along with ultrasound and a micropuncture needle for initial vascular access...
September 2018: Journal of Neurosurgery. Spine
Alonso Turrent-Carriles, Juan Pablo Herrera-Félix, Mary-Carmen Amigo
Antiphospholipid syndrome is a complex autoimmune disease, characterized by the presence of vascular thrombosis, obstetric, hematologic, cutaneous, and cardiac manifestations. Renal disease in patients with antiphospholipid syndrome was not recognized in the first descriptions of the disease, but later on, the renal manifestations of the syndrome have been investigated widely. Renal manifestations of antiphospholipid syndrome conform a wide spectrum of diverse renal syndromes. Hypertension is one of the most frequent, but less commonly recognized renal alteration...
2018: Frontiers in Immunology
Fetch more papers »
Fetching more papers... Fetching...
Read by QxMD. Sign in or create an account to discover new knowledge that matter to you.
Remove bar
Read by QxMD icon Read

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"