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Catheter directed

Jacob Schultz, Asger Andersen, Erik Lerkevang Grove, Lars Bo Ilkjær, Jens Erik Nielsen-Kudsk
We present the successful treatment of a large solid right atrial thrombus by the catheter-based suction embolectomy system AngioVac® (AngioDynamics, NY, USA). A previously healthy 60-year-old male was referred with acute pulmonary embolism, a large deep vein thrombus and a large right atrial thrombus. After one week of anticoagulation, the size of the atrial thrombus was unaltered, and the patient was treated by catheter-directed embolectomy using the AngioVac system. The solid thrombus occluded the catheter during the procedure...
2018: Case Reports in Cardiology
Francesco Garzotto, Marta Zaccaria, Enrico Vidal, Zaccaria Ricci, Anna Lorenzin, Mauro Neri, Luisa Murer, Federico Nalesso, Alfredo Ruggeri, Claudio Ronco
OBJECTIVES: Renal replacement therapy in infants and small children is the treatment of choice for severe oligoanuric renal dysfunction, with an increasing consensus that early initiation might contribute to preventing acute kidney injury complications. Safer renal replacement therapy devices specifically designed for neonates may contribute to ameliorating outcomes and increasing chances of survival. One of the crucial factors to achieve an effective renal replacement therapy in small infants is adequate vascular access...
December 7, 2018: Pediatric Critical Care Medicine
Mohammad Anadani, Ali Alawieh, Jan Vargas, Arindam Rano Chatterjee, Aquilla Turk, Alejandro Spiotta
INTRODUCTION: The rate of first-attempt recanalization (FAR) with the newer-generation thrombectomy devices, and more specifically with aspiration devices, is not well known. Moreover, the effect of FAR on outcomes after mechanical thrombectomy is not properly understood. OBJECTIVE: To report the rate of FAR using a direct aspiration first pass technique (ADAPT), investigate the association between FAR and outcomes, and identify the predictors of FAR. METHODS: The ADAPT database was used to identify a subgroup of patients in whom FAR was achieved...
December 7, 2018: Journal of Neurointerventional Surgery
Denise Brunozzi, Sophia F Shakur, Ali Alaraj
Flow diversion technology has revolutionized the treatment of complex anterior circulation cerebral aneurysms. However, vessel tortuosity and atherosclerotic disease may hamper the standard transfemoral access used in these procedures. Percutaneous direct carotid puncture is a viable alternative, but adequate carotid closure must be achieved. Here, we present the first case of a giant partially thrombosed aneurysm of the cavernous internal carotid artery treated with Pipeline Embolization Device (PED; ev3 Neurovascular, Irvine, CA) via direct carotid puncture...
December 6, 2018: World Neurosurgery
Jian Cui, Mario D Gonzalez, Cheryl Blaha, Ashley Hill, Lawrence I Sinoway
Radiofrequency catheter ablation (RFCA) is a frequently performed procedure in patients with atrial fibrillation. Prior studies have shown that the RFCA may directly stimulate vagal afferents during the procedure, while the vagal tone assessed by heart rate variability (HRV) is lowered weeks post the RFCA procedure. The effects of RFCA performed in the left atrium on sympathetic nerve activity has not been assessed. In this study, we hypothesized that RFCA would lower muscle sympathetic nerve activity (MSNA) during ablation and would raise MSNA one day post-ablation...
December 7, 2018: American Journal of Physiology. Heart and Circulatory Physiology
Sean M Caples, Meghna P Mansukhani, Paul A Friedman, Virend K Somers
BACKGROUND: Observational data suggest that positive airway pressure (PAP) treatment of obstructive sleep apnea (OSA) can reduce the risk of recurrent atrial fibrillation (AF) post-direct current cardioversion (DCCV) or catheter ablation. METHODS: We conducted a study of adult patients with AF and sleep apnea, stratified by age and gender, who underwent successful DCCV to sinus rhythm, and who were randomized to receive PAP or usual care. Those with sleepiness, significant cardiac or respiratory disease were excluded...
November 20, 2018: International Journal of Cardiology
Colette Veyrat
In 1968, while cardiologists were focused on cardiac structures imaged by ultrasound, Daniel Kalmanson in Paris, France, devised a new ultrasonic modality, directional continuous-wave Doppler, enabling him to record instantaneous cardiovascular blood flow velocities with recognition of their direction (relative to the transducer) in vessels. An innovative presentation of Doppler data also made velocity traces physiologically understandable. Following the noninvasive study of the arterial and venous beds, flow velocity in the right (1969) and left (1970) cardiac chambers was studied by means of a directional Doppler catheter...
December 2018: Journal of the American Society of Echocardiography
Maxim Mokin, Muhammad Waqas, Swetadri Vasan Setlur Nagesh, Nitant Vivek Karkhanis, Elad I Levy, Ciprian N Ionita, Adnan H Siddiqui
BACKGROUND: The amount of force applied on a device is an important measure to evaluate the endovascular and surgical device manipulations. The measure has not been evaluated for neuroenodvascular procedures. PURPOSE: We aimed to study the use of force measure as a novel approach to test distal access catheter (DAC) performance during catheterization of cervical and intracranial vessels using patient specific 3-dimentional (3D) phantoms. METHODS: Using patient specific 3D phantoms of the cervical and intracranial circulation, we recorded measure of force required to deliver three types of DACs beyond the ophthalmic segment of the internal carotid artery...
December 4, 2018: Journal of Neurointerventional Surgery
Dan-Dan Zhang, Gan Lu, Xuan-Feng Zhu, Ling-Ling Zhang, Jia Gao, Li-Cheng Shi, Jian-Hua Gu, Jian-Nan Liu
Background: Neural respiratory drive (NRD) using diaphragm electromyography through an invasive transesophageal multi-electrode catheter can be used as a feasible clinical physiological parameter in patients with chronic obstructive pulmonary disease (COPD) to provide useful information on the treatment response. However, it remains unknown whether the surface diaphragm electromyogram (EMGdi) could be used to identify the deterioration of clinical symptoms and to predict the necessity of hospitalization in acute exacerbation of COPD (AECOPD) patients...
December 5, 2018: Chinese Medical Journal
Keisuke Nakabayashi, Daisuke Sunaga, Nobuhito Kaneko, Akihiro Matsui, Kazuhiko Tanaka, Hiroshi Ando, Minoru Shimizu
A bidirectional approach for percutaneous coronary intervention for chronic total occlusion (CTO-PCI) using ipsilateral collaterals with a single guiding catheter limits procedural choices. The CTO of the left circumflex artery with ipsilateral collateral artery was treated by the bidirectional approach using a single guiding catheter. While the retrograde wire directly crossed the CTO lesion, the microcatheter could not pass the CTO lesion despite the conventional strategies. Therefore, we performed the wire rendezvous and chasing wire techniques...
2018: Case Reports in Cardiology
Mohit K Turagam, Venkat Vuddanda, Donita Atkins, Rakesh Venkata, Bhavya Yarlagadda, Himabindu Korra, Jaya Pitchika, Sudharani Bommana, Dhanujaya R Lakkireddy
Background: There is limited data regarding effect of prolonged radiation exposure during electrophysiological (EP) procedures on direct DNA damage. Comet test has shown to assess DNA damage following radiation exposure. Methods: We performed a single-center prospective observational study assessing direct DNA damage using the quantitative comet assay in patients undergoing cardiac resynchronization (CRT) and atrial fibrillation (AF) catheter ablation procedures...
August 2018: Journal of Atrial Fibrillation
Donald S Rubenstein, Hang Yin, Sana A Azami
Background: Rotational circuits that occur between bipolar electrodes exhibit double potentials (DPs). It had been previously surmised that rotors could not be electrically tracked directly. Purpose: Our purpose was twofold; first, to show that the use of compass mapping, one can regionally identify rotational activity; and second, to show that by combining simultaneous compass map recordings, standard narrow-adjacent bipolar, and unipolar recordings, that specific signature recording patterns emerge that allow one to identify the accurate time, location, and path of a rotational mechanism...
August 2018: Journal of Atrial Fibrillation
Mehmet Semih Çakır, Tevfik Guzelbey, Erdem Kınacı, Mert Mahsuni Sevinc, Ozgur Kilickesmez
Bilhemia is very rare and serious complication of percutaneous transhepatic biliary drainage (PBD). Bile leakage occurs into the bloodstream through a fistula between the biliary tree and the hepatic venous system. We report a case of a 45-year-old woman with bilhemia complicated by PBD. She was successfully treated with primary coil embolization of biliovenous fistula tract. In the follow-up, bilirubin values dramatically regressed and returned to its normal limits. Rapid increase in total and direct bilirubin values after PBD without biliary tree dilatation almost always suggest biliovenous fistula...
February 2019: Radiology Case Reports
Paul Monagle, Fiona Newall
Venous thrombosis (VTE) in children and neonates presents numerous management challenges. Although increasing in frequency, VTE in children and neonates is still uncommon compared with adults. The epidemiology of VTE is vastly different in neonates vs children vs adolescents vs adults. In reality, pediatric thrombosis should be viewed as a multitude of rare diseases (eg, renal vein thrombosis, spontaneous thrombosis, catheter-related thrombosis, cerebral sinovenous thrombosis), all requiring different approaches to diagnosis and with different short- and long-term consequences, but linked by the use of common therapeutic agents...
November 30, 2018: Hematology—the Education Program of the American Society of Hematology
Jedrzej Kosiuk, Tobias Uhe, Clara Stegmann, Laura Ueberham, Livio Bertagnolli, Nikolaos Dagres, Borislav Dinov, Andreas Müssigbrodt, Sergio Richter, Ingo Paetsch, Cosima Jahnke, Sebastian Hilbert, Philipp Sommer, Gerhard Hindricks, Andreas Bollmann
BACKGROUND: Stage of platelet activation is an important modulator of stroke risk associated with atrial fibrillation (AF). However, factors determining such activation status of thrombocytes in patients with AF are still not well studied. METHODS AND RESULTS: We enrolled 83 patients (mean age 61 ± 10 years, 61% male, mean CHA2 DS2 -VASc 2.1 ± 1.4) with paroxysmal (75%) or persistent (25%) AF admitted for catheter ablation. Blood samples were collected directly from the left atrium (LA) and platelet activation status was measured by means of flow cytometric assessment in whole blood and light transmission aggregometry (LTA) in unstimulated and Thrombin-receptor-activated-peptide-6 (TRAP-6)-stimulated platelet rich plasma...
November 17, 2018: International Journal of Cardiology
Xiaohua Hu, Ang Chen, Yigang Luo, Chris Zhang, Edwin Zhang
The steerable catheter refers to the catheter that is manipulated by a mechanism which may be driven by operators or by actuators. The steerable catheter for minimally invasive surgery has rapidly become a rich and diverse area of research. Many important achievements in design, application and analysis of the steerable catheter have been made in the past decade. This paper aims to provide an overview of the state of arts of steerable catheters. Steerable catheters are classified into four main groups based on the actuation principle: (1) tendon driven catheters, (2) magnetic navigation catheters, (3) soft material driven catheters (shape memory effect catheters, steerable needles, concentric tubes, conducting polymer driven catheters and hydraulic pressure driven catheters), and (4) hybrid actuation catheters...
December 2018: Computer Assisted Surgery (Abingdon, England)
Junji Uno, Katsuharu Kameda, Ryosuke Otsuji, Nice Ren, Shintaro Nagaoka, Kazushi Maeda, Yoshiaki Ikai, Hidefuku Gi
BACKGROUND: It is debatable whether mechanical thrombectomy has benefits in a real-world setting outside the more rigid and selective clinical trial environment. OBJECTIVE: To evaluate clinical outcomes, efficacy, and safety of mechanical thrombectomy in single-center retrospective cohort case series. METHODS: We reviewed prospectively collected data from our large-vessel occlusion stroke database to identify patients undergoing mechanical thrombectomy using Penumbra catheters (Penumbra, Almeida, California) as first-line devices...
November 28, 2018: Operative Neurosurgery (Hagerstown, Md.)
Eri Okajima, Seigo Yamashita, Michihiro Yoshimura, Teiichi Yamane
A 59-year-old man who had undergone catheter ablations for paroxysmal atrial fibrillation (AF) twice was referred for a third procedure due to atrial tachycardia (AT) recurrence. In addition to pulmonary vein (PV) isolation, linear ablation (roof/mitral isthmus lines), cavo-tricuspid isthmus ablation and superior vena cava (SVC) isolation had been conducted in the previous procedures. The intracardiac electrograms showed AT with irregular cycle length, and a circular mapping catheter obliquely placed in the SVC showed both fibrillatory activation and organized activation simultaneously...
November 29, 2018: Journal of Cardiovascular Electrophysiology
Dierk Vorwerk, Stefan Triebe, Steffen Ziegler, Volker Ruppert
PURPOSE: To analyze the immediate outcome of percutaneous mechanical thromboembolectomy in acute infrainguinal leg ischemia in a consecutive cohort of patients with acute lower limb ischemia. MATERIAL AND METHOD: We retrospectively analyzed the data of 156 acute infrainguinal ischemic events in 148 patients. Patients presented with acute limb ischemia Rutherford category I in 68 cases (44%), Rutherford category II A in 64 instances (41%) and Rutherford II B in 24 instances (15%)...
November 28, 2018: Cardiovascular and Interventional Radiology
Joanne Wilkinson, Khalid Abd-Elaziz, Izaak den Daas, Johan Wemer, Michiel van Haastert, Victoria Hodgkinson, Michelle Foster, Cathal Coyle
OBJECTIVE: To investigate the intragastric acid neutralization activity of a combined alginate-antacid formulation. SIGNIFICANCE: Published studies have investigated the reflux-suppressing alginate component of Gaviscon Double Action (Gaviscon DA; RB, UK) but intragastric acid neutralization activity of the antacid component has not been evaluated in vivo. METHODS: Intragastric pH monitoring, using a custom-made 10-electrode catheter, was evaluated in a 2-part exploratory study in healthy subjects; Part I (n = 6) tested suitability of the catheter using antacid tablets (Rennie; Bayer, Germany); Part II (n = 12) evaluated gastric acid neutralization activity of Gaviscon DA liquid (20 ml) versus placebo in fasted subjects using a randomized, open-label, crossover design...
November 23, 2018: Drug Development and Industrial Pharmacy
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