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Catheter directed

M Bretzner, L Estrade, M Ferrigno, F Bala, F Boustia, A Kazemi, J P Pruvo, H Henon, N Bricout
BACKGROUND AND PURPOSE: Direct thrombus aspiration is increasingly used as a first-line therapy in acute ischemic stroke with large vessel occlusion. We assessed the performance and safety of a novel aspiration catheter available: the 6-French AXS Catalyst catheter. MATERIALS AND METHODS: We conducted a cohort study from a prospective clinical registry of consecutive stroke patients treated by mechanical thrombectomy between March 2016 and July 2016. Baseline clinical and imaging characteristics, recanalization rates, complications, and clinical outcomes were analyzed...
October 16, 2018: Cardiovascular and Interventional Radiology
Saira Chaughtai, Bhavika Gandhi, Zeeshan Chaughtai, Dana Tarina, Mohammad A Hossain, Arif Asif
Recently, the incidence of Clostridium difficile- ( C. difficile- ) associated infection has increased significantly in hospital and ambulatory care settings in parallel to the increasing use of inappropriate antibiotics. According to the CDC, approximately 83,000 patients who developed C . difficile experienced at least one recurrence and 29,000 died within 30 days of the initial diagnosis. Patients on dialysis (particularly peritoneal dialysis) are predisposed to this infection due to an inherent immunocompromised state and transmural translocation of the bacteria due to the close association of gastrointestinal tract and peritoneal cavity...
2018: Case Reports in Medicine
Simon S Craig, Marc Auerbach, John Alexander Cheek, Franz E Babl, Ed Oakley, Lucia Nguyen, Arjun Rao, Sarah Dalton, Mark D Lyttle, Santiago Mintegi, Joshua Nagler, Rakesh D Mistry, Andrew Dixon, Pedro Rino, Guillermo Kohn-Loncarica, Stuart R Dalziel
OBJECTIVE: To describe senior paediatric emergency clinician perspectives on the optimal frequency of and preferred modalities for practising critical paediatric procedures. METHODS: Multicentre multicountry cross-sectional survey of senior paediatric emergency clinicians working in 96 EDs affiliated with the Pediatric Emergency Research Network. RESULTS: 1332/2446 (54%) clinicians provided information on suggested frequency of practice and preferred learning modalities for 18 critical procedures...
October 16, 2018: Emergency Medicine Journal: EMJ
Clara Ballber, Tracy L Hill, Nick X Bommer
BACKGROUND: Sino-nasal aspergillosis is a common nasal disease in dogs. Recommended treatment protocols typically involve trephination of the frontal sinuses or the use of an antifungal solution instilled into the frontal sinus under anesthesia, both of which have associated morbidity and complications. OBJECTIVES: To assess a minimally-invasive topical treatment protocol for sino-nasal aspergillosis in dogs. ANIMALS: Twelve client-owned dogs diagnosed with sino-nasal aspergillosis that completed recommended treatment...
October 16, 2018: Journal of Veterinary Internal Medicine
Larry Chinitz, Laura J Goldstein, Andrea Barnow, Sonia Maccioni, Mehmet Daskiran, Iftekhar Kalsekar, Rahul Khanna
Introduction: This study evaluated the real-world clinical and economic outcomes associated with the use of the ThermoCool® Surround Flow (SF) and ThermoCool® catheters in atrial fibrillation (AF) ablation. Methods: Adults with AF who underwent catheter ablation between January 1, 2013, and December 31, 2016, in a hospital outpatient setting were identified from the Premier Healthcare Database. Using a search strategy of hospital-charge descriptors, patients were classified into two mutually exclusive groups: ThermoCool® SF catheter and ThermoCool® catheter...
2018: ClinicoEconomics and Outcomes Research: CEOR
Jamshid H Karimov, Tomislav Mihaljevic, Shengqiang Gao, Gengo Sunagawa, Patrick Grady, Martin Sinkewich, Kiyotaka Fukamachi
OBJECTIVE: With heart disease increasing worldwide, demand for new minimally invasive techniques and transcatheter technologies to treat structural heart disease is rising. Cardioscopy has long been considered desirable, as it allows direct tissue visualization and intervention to deliver therapy via a closed chest, with real-time fiber-optic imaging of intracardiac structures. Herein, the feasibility of the advanced cardioscopic platform, allowing both transapical and fully percutaneous access is reported...
October 9, 2018: Seminars in Thoracic and Cardiovascular Surgery
Sungwoong Jeon, Ali Kafash Hoshiar, Kangho Kim, Seungmin Lee, Eunhee Kim, Sunkey Lee, Jin-Young Kim, Bradley J Nelson, Hyo-Jeong Cha, Byung-Ju Yi, Hongsoo Choi
Magnetically actuated soft robots may improve the treatment of disseminated intravascular coagulation. Significant progress has been made in the development of soft robotic systems that steer catheters. A more challenging task, however, is the development of systems that steer sub-millimeter-diameter guidewires during intravascular treatments; a novel microrobotic approach is required for steering. In this article, we develop a novel, magnetically actuated, soft microrobotic system, increasing the steerability of a conventional guidewire...
October 12, 2018: Soft Robotics
Eduardo Álvarez-Sarrado, Fernando Mingol Navarro, Raquel J Rosellón, Neus Ballester Pla, Francisco Javier Vaqué Urbaneja, Carmen Muniesa Gallardo, María López Rubio, Eduardo García-Granero Ximénez
BACKGROUND: Patients undergoing esophagectomy for cancer usually deal with malnourishment which increases postoperative morbimortality. The objective of this paper is to analyze the nutritional benefits of feeding jejunostomy (FJ) for early postoperative enteral nutrition (EN) and directly-related complications. MATERIAL AND METHODS: Retrospective study of 100 patients undergoing esophagectomy for cancer between 2008 and 2016. RESULTS: FJ was placed in 47 patients...
October 1, 2018: American Journal of Surgery
Erich M Gauger, Peter C Rhee
Posttraumatic elbow stiffness is common with the primary indication for contracture release being limited motion that affects functional activities which has not adequately improved after intensive therapy and rehabilitation. Preoperative evaluation focuses on the history of previous nonoperative and/or operative treatment, physical exam with particular attention paid to the status of the ulnar nerve, and imaging consisting of radiographs and computed tomography. There are multiple intrinsic and extrinsic causes of posttraumatic contracture...
October 8, 2018: Techniques in Hand & Upper Extremity Surgery
Jay N Lozier, Jason M Elinoff, Anthony F Suffredini, Douglas R Rosing, Stanislav Sidenko, Richard M Sherry, Adam R Metwalli, Vandana Sachdev, Robert L Danner, Richard Chang
: Guidelines-recommend thrombolytic therapy for pulmonary embolism in patients with severe hemodynamic compromise and low risk of bleeding. Thrombolytics in submassive pulmonary embolism have an unfavorable risk/benefit ratio and remain controversial. Based on our experience with extensive, lower extremity thrombi, nine patients with symptomatic, submassive pulmonary embolisms (five medical, four surgical) were treated with low-dose alteplase (<10 mg/day, infused over 6 h per treatment). Alteplase was delivered by pulse spray and/or directed or undirected central venous catheters depending on clot size and location...
October 8, 2018: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
Alison Coady, Anissa R Ramos, Joshua Olson, Victor Nizet, Kathryn A Patras
Urinary tract infections (UTIs) caused by the human fungal pathogen Candida albicans and related species are prevalent in hospitalized patients, especially those on antibiotic therapy, with indwelling catheters, or with predisposing conditions such as diabetes or immunodeficiency. Understanding of key host defenses against Candida UTI are critical for developing effective treatment strategies. Tamm-Horsfall glycoprotein (THP) is the most abundant urine protein with multiple roles in renal physiology and bladder protection...
October 8, 2018: Infection and Immunity
Hugo Jr Bonatti, Khalid H Kurtom
Background: Syringomyelia is an unusual accumulation of fluid within the spinal cord that may be associated with significant neurologic symptoms. Surgical drainage using various techniques is often required to reduce the intraparenchymal pressure and to alleviate symptoms. Syringopleural shunting seems to produce best results. Patients and methods: A simple technique to insert the distal limb of the syringopleural shunt into the pleural space is described in detail...
2018: Respiratory Medicine Case Reports
Pierre De Marini, Sanjeev Nayak, François Zhu, Serge Bracard, René Anxionnat, Romain Tonnelet, Liang Liao, Sébastien Richard, Lisa Humbertjean, Gioia Mione, Jean-Christophe Lacour, Anne-Laure Derelle, Benjamin Gory
Background and purpose A direct aspiration first pass technique involves first-line aspiration to remove the thrombus through a large-bore aspiration catheter in large vessel strokes. The aim of this study was to assess safety and clinical outcomes with a direct aspiration first pass technique using the new ARC catheter. Methods A retrospective analysis of prospectively collected data from three university hospitals was performed between June 2016 and May 2018. The following parameters of all acute ischemic stroke interventions using the ARC catheter were analyzed: use of intravenous thrombolysis, National Institutes of Health Stroke Scale scores at presentation and discharge, successful reperfusion (modified Thrombolysis in Cerebral Infarction 2b-3), procedure duration, procedure-related complications and 90-day clinical outcome (modified Rankin Scale score)...
October 5, 2018: Interventional Neuroradiology
Kohki Nakamura, Takehito Sasaki, Yutaka Take, Yoshinori Okazaki, Mitsuho Inoue, Hiroyuki Motoda, Yuko Miki, Katsura Niijima, Eiji Yamashita, Keiko Koyama, Nobusada Funabashi, Shigeto Naito
INTRODUCTION: This prospective observational study aimed to investigate the incidence of symptomatic and silent cerebral embolisms after balloon-based ablation of atrial fibrillation (AF) in patients receiving periprocedural anticoagulation with direct oral anticoagulants (DOACs), and compare that between cryoballoon and HotBalloon ablation (CBA and HBA). METHODS AND RESULTS: We enrolled 123 consecutive AF patients who underwent a balloon-based pulmonary vein isolation (PVI) and brain magnetic resonance (MR) imaging after the ablation procedure (CBA, n=65; HBA, n=58)...
October 4, 2018: Journal of Cardiovascular Electrophysiology
Simon Lammy, Joti Bhattacharya, James Dervin, Edward Jerome St George
This technical note describes a direct puncture of the superior sagittal sinus (SSS) to treat a complex dural arteriovenous fistula (dAVF). A 40-year-old female was admitted having a history of increasing confusion. Computer tomography revealed enlargement of the right superior ophthalmic vein and magnetic resonance imaging demonstrated extensive bilateral hemispheric venous engorgement. Digital subtraction angiography (DSA) demonstrated a high flow dAVF involving the right transverse sinus. There was extensive cortical venous rerouting with venous sinus occlusion at the right transverse and sigmoid junction...
July 2018: Asian Journal of Neurosurgery
Yoshifumi Morita, Takanori Sakaguchi, Ryo Kitajima, Satoru Furuhashi, Ryota Kiuchi, Makoto Takeda, Takanori Hiraide, Yasushi Shibasaki, Hirotoshi Kikuchi, Yuji Suzuki, Kei Tsukamoto, Tomoharu Matsuura, Hiroya Takeuchi
Pancreatic cancer often invades the duodenum and causes obstruction, but rarely causes massive duodenal bleeding. A 68-year-old male was admitted to our hospital because of vomiting. Enhanced abdominal CT showed a hypovascular tumor with air bubbles in the uncinate process of the pancreas. The tumor invaded the duodenum and metastasized to the liver and peritoneum. The main trunk of the superior mesenteric artery (SMA) was circumferentially involved. After admission, he had hematemesis and melena. Emergency gastroduodenoscopy revealed pulsating vessels in the third portion of the duodenum and he eventually experienced hemorrhagic shock...
May 2018: Case Reports in Gastroenterology
Tomoya Hasegawa, Hiroaki Tabata, Mitsuru Kagoshima
Although upper-extremity deep vein thrombosis (UEDVT) is considered rare, its prevalence appears to be increasing, and this may be related to expanding indications for catheter-based interventions. In contrast, few cases have been reported related to strenuous exercise, especially in healthy young adults with thoracic outlet syndrome (Paget-Schroetter syndrome). In contrast to lower-extremity DVT, optimal treatment strategies for UEDVT have not been robustly studied. In this report, we describe a 56-year-old man with primary UEDVT presenting with left arm swelling, paresthesia, and visible collateral veins around the shoulder...
December 2017: Journal of Cardiology Cases
Asra Khan, Srinath Gowda, Dhaval Parekh, Athar M Qureshi
OBJECTIVES: Acute vascular thrombosis is associated with significant morbidity and mortality in children. Traditional therapies with angioplasty and manual aspiration thrombectomy are described in the pediatric population; however, data regarding the use of ultrasound-assisted catheter-directed thrombolysis in a pediatric hospital are lacking. METHODS: All patients treated at our center with ultrasound-assisted catheter-directed thrombolysis from 2014-2018 were reviewed...
October 2018: Journal of Invasive Cardiology
Michael R Kendall, Stuart Swadron, Leonardo C Clavijo, Anilkumar K Mehra, Antotreas Hindoyan, Ray V Matthews, David M Shavelle
BACKGROUND: Patients with massive and submassive pulmonary embolism (PE) require rapid identification, triage, and consideration for reperfusion therapy. Use of an existing ST-segment elevation myocardial infarction (STEMI) team and activation protocol may be an effective means to care for these patients. OBJECTIVE: The objective of this analysis was to evaluate a pilot study using the STEMI team and a dedicated PE protocol for treatment of patients with massive and submassive PE...
October 2018: Journal of Invasive Cardiology
H P Ebben, H Yang, A W J Hoksbergen, W Wisselink, P J Ko, K K Yeung
INTRODUCTION: The incidence of peripheral arterial occlusions in Asian populations is likely to increase exponentially in the present and future decades due to the adapted Western lifestyle in metropolitan Asian life, extended life expectancies and high rates of smoking. The literature on thrombolytic treatment of peripheral arterial occlusions in Asian populations is limited. Therefore, we evaluated the thrombolysis results in a real world contemporary Asian cohort of patients with peripheral arterial occlusions...
September 29, 2018: Annals of Vascular Surgery
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