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https://www.readbyqxmd.com/read/28109525/wire-and-needle-potentials-facilitating-transseptal-puncture
#1
Konstantin M Heinroth, Thomas Hartkopf, Alexander Plehn, Joachim Wilhelm, Susanne Unverzagt, Stefan Frantz, Alexander Schirdewan
BACKGROUND: Transseptal puncture for left heart interventions became a routine procedure guided by fluoroscopy and echocardiography. The use of intracardiac potentials derived from the sheath-transseptal-needle/guidewire-combination may provide helpful information to increase safety of this procedure. METHODS AND RESULTS: We recorded the intracardiac potentials from the sheath-transseptal-needle/guidewire-combination during the transseptal puncture procedure in 31 consecutive patients (mean age 67...
January 15, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28106923/ercp-cannulation-in-the-difficult-duct-which-technique-should-you-pull-out-of-your-bag
#2
EDITORIAL
A M Ahmed, C M Wilcox
Golf and endoscopic retrograde cholangiopancreaticography (ERCP) share a commonality where the highs of the successes are balanced by the lows of the frustrations. ERCP cannulation is one of the most difficult maneuvers in gastrointestinal endoscopy and is a requirement for the procedure's therapeutic benefit. As such, many different techniques have been developed to facilitate cannulation. The mission of the procedure is to provide access to the biliary or pancreatic duct typically with a guidewire, which can then be utilized as a platform for therapeutic and diagnostic procedures...
January 20, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28105993/percutaneous-coronary-intervention-using-a-combination-of-robotics-and-telecommunications-by-an-operator-in-a-separate-physical-location-from-the-patient-an-early-exploration-into-the-feasibility-of-telestenting-the-remote-pci-study
#3
Ryan D Madder, Stacie M VanOosterhout, Mark E Jacoby, J Stewart Collins, Andrew S Borgman, Abbey N Mulder, Matthew A Elmore, Jessica L Campbell, Richard F McNamara, David H Wohns
AIMS: The present study explores the feasibility of telestenting, wherein a physician operator performs stenting on a patient in a separate physical location using a combination of robotics and telecommunications. METHODS AND RESULTS: Patients undergoing robotic stenting were eligible for inclusion. All manipulations of guidewires, balloons, and stents were performed robotically by a physician operator located in an isolated separate room outside the procedure room housing the patient...
January 20, 2017: EuroIntervention
https://www.readbyqxmd.com/read/28105600/approach-to-cto-intervention-overview-of-techniques
#4
REVIEW
Aris Karatasakis, Barbara Anna Danek, Dimitri Karmpaliotis, Khaldoon Alaswad, Minh Vo, Mauro Carlino, Mitul P Patel, Stéphane Rinfret, Emmanouil S Brilakis
Successful percutaneous coronary intervention (PCI) of chronic total occlusions (CTOs) has been associated with significant clinical benefits, but remains technically demanding. Failure to cross the CTO with a guidewire is the most common cause of CTO PCI failure. CTO crossing can be achieved in the antegrade or retrograde direction and can be accomplished by maintaining true lumen position throughout or via subintimal dissection/reentry techniques. A procedural plan should be created prior to the procedure through careful angiographic review of four key parameters: (a) morphology of the proximal occlusion cap; (b) length of the occlusion; (c) quality of the distal vessel and presence of bifurcation at the distal cap; and (d) suitability of collateral circulation for retrograde crossing...
January 2017: Current Treatment Options in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28100152/rare-iatrogenic-cardiovascular-embolization-following-dialysis
#5
Arun Sharma, Sharmila Duraisamy, Priya Jagia, Gurpreet S Gulati
Intracardiac or intrapulmonary dislodgement of dialysis catheter or guidewire coating is extremely rare. When present, it can be potentially lethal as it may get complicated by arrhythmias, myocardial or pulmonary artery rupture, valvular perforation, pulmonary thromboembolism, infarction, and infective endocarditis. Percutaneous removal should be attempted as an initial measure and is usually effective in most of the cases. We report 2 such cases, where in first patient it was the hemodialysis catheter which broke, with a large part migrating into the heart, while in second patient, it was the hydrophilic coating of the guidewire that migrated into the pulmonary arteries...
January 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28097937/an-assembly-type-master-slave-catheter-and-guidewire-driving-system-for-vascular-intervention
#6
Hyo-Jeong Cha, Byung-Ju Yi, Jong Yun Won
Current vascular intervention inevitably exposes a large amount of X-ray to both an operator and a patient during the procedure. The purpose of this study is to propose a new catheter driving system which assists the operator in aspects of less X-ray exposure and convenient user interface. For this, an assembly-type 4-degree-of-freedom master-slave system was designed and tested to verify the efficiency. First, current vascular intervention procedures are analyzed to develop a new robotic procedure that enables us to use conventional vascular intervention devices such as catheter and guidewire which are commercially available in the market...
January 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28091832/utility-and-safety-of-the-safesept%C3%A2-transseptal-guidewire-for-electrophysiology-studies-with-catheter-ablation-in-pediatric-and-congenital-heart-disease
#7
Joseph J Knadler, Jeffrey B Anderson, Ahmad S Chaouki, Richard J Czosek, Chad Connor, Timothy K Knilans, David S Spar
PURPOSE: The atrial transseptal procedure is used in catheter ablation of left-sided arrhythmias. Studies in adult patients have shown the SafeSept™ transseptal guidewire (SSTG) to be effective in atrial transseptal procedures. We analyzed our 5-year experience with SSTG use in pediatric and congenital heart disease patients undergoing catheter ablation. METHODS: This is a single-center retrospective analysis of patients undergoing catheter ablation from 2009 to 2014...
January 14, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28072800/modified-percutaneous-lumbar-foraminoplasty-and-percutaneous-endoscopic-lumbar-discectomy-instrument-design-technique-notes-and-5-years-follow-up
#8
Zhen-Zhou Li, Shu-Xun Hou, Wei-Lin Shang, Ke-Ran Song, Hong-Liang Zhao
BACKGROUND: Conventional percutaneous endoscopic lumbar discectomy (PELD) with an "inside-outside" technique has 4.3% - 10.3% surgical failure rate, especially in central herniated discs (HDs), migrated HDs, and axillary type HDs. PELD with foraminoplasty has been used for complex HDs. Percutaneous lumbar foraminoplasty (PLF), which is performed with a trephine or bone reamer introduced over a guidewire without a protective working cannula in the original Tessys technique, can quickly cut the hypertrophied bony structure under fluoroscopic guidance, and risk injury to the exiting and traversing nerve roots...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28070229/novel-device-for-removal-of-blot-clot-obstructions-in-drainage-tubes
#9
Scott M Thompson, Cornelius A Thiels, Johnathon M Aho
Medical drains frequently become obstructed requiring removal or re-intervention. Currently, there is no widely accepted practice for maintaining drain patency. A simple device to remove obstructions from medical drains may have significant benefit. We manufactured a prototype drain clot extractor (DCE) for extracting obstructions. Fresh nonanticoagulated swine blood was instilled within drainage tubes of 16, 20, and 32 French (n = 2 for each size) to generate a 4 cm blood clot. The operator was then equipped with a 0...
March 2017: Journal of Medical Devices
https://www.readbyqxmd.com/read/28068716/advanced-biliary-access-techniques-is-the-double-guidewire-technique-considered-a-wednesday-s-child
#10
Phonthep Angsuwatcharakon, Pradermchai Kongkam, Rungsun Rerknimitr
No abstract text is available yet for this article.
January 2017: Endoscopy
https://www.readbyqxmd.com/read/28067615/intracranial-atherosclerosis-from-anatomy-to-pathophysiology
#11
Yuehua Pu, Linfang Lan, Xinyi Leng, Lawrence Ks Wong, Liping Liu
Background Intracranial atherosclerotic stenosis is an important etiology subtype of ischemic stroke. Stenosis severity was thought to be the main reference index for clinical treatment and research. However, stenosis could not reflect the ischemia risk completely, instead the hemodynamic state across the lesion, the extent of collateral circulation, and perfusion impairment downstream the stenosis are more important. Aims We write this review aimed to summarize novel angiographic methods applied in the evaluation of functional severity of ICAS, and commented on their limitations and prospects in future research...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/28066983/endoscopic-ultrasound-guided-antegrade-biliary-stenting-for-unresectable-malignant-biliary-obstruction-in-patients-with-surgically-altered-anatomy-a-single-center-prospective-pilot-study
#12
Takuji Iwashita, Ichiro Yasuda, Tsuyoshi Mukai, Keisuke Iwata, Shinpei Doi, Shinya Uemura, Masatoshi Mabuchi, Mitsuru Okuno, Masahito Shimizu
BACKGROUND AND AIMS: Endoscopic retrograde cholangiography (ERCP) with biliary stenting for the treatment of unresectable malignant biliary obstruction (MBO) is challenging among patients with surgically altered anatomy. Endoscopic ultrasound-guided antegrade biliary stenting (EUS-ABS) was introduced as an alternative biliary drainage method, although it has not been well studied yet. In this single-center prospective pilot study, we aimed to evaluate the feasibility and safety of EUS-ABS for MBO in patients with surgically altered anatomy...
January 9, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28064251/self-taught-axillary-vein-access-without-venography-for-pacemaker-implantation-prospective-randomized-comparison-with-the-cephalic-vein-access
#13
Fabien Squara, Julien Tomi, Didier Scarlatti, Guillaume Theodore, Pamela Moceri, Emile Ferrari
AIM: Axillary vein access for pacemaker implantation is uncommon in many centres because of the lack of training in this technique. We assessed whether the introduction of the axillary vein technique was safe and efficient as compared with cephalic vein access, in a centre where no operators had any previous experience in axillary vein puncture. METHODS AND RESULTS: Patients undergoing pacemaker implantation were randomized to axillary or cephalic vein access. All three operators had no experience nor training in axillary vein puncture, and self-learned the technique by reading a published review...
January 6, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28062801/wire-escalation-in-emergent-revascularization-procedures-of-internal-carotid-artery-occlusions-the-use-of-high-tip-stiffness-microguidewires
#14
José E Cohen, Ronen R Leker, John M Gomori, Eyal Itshayek
OBJECTIVE: We examined the usefulness and safety of high tip stiffness cardiac microguidewires in the endovascular revascularization of selected cases of internal carotid artery (ICA) occlusion. METHODS: Files of patients with acute ischemic symptoms due to ICA occlusions managed from August 2010 to August 2016 by urgent endovascular revascularization were retrospectively reviewed with a waiver of informed consent. Cases where there was escalation to stiff tipped cardiovascular microguidewires after at least two failed attempts to cross the carotid occlusion with standard neuro-microguidewires were included...
January 6, 2017: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/28057045/validation-of-a-new-method-for-the-endoscopic-measurement-of-post-bariatric-gastric-outlet-using-a-standard-guidewire-an-observer-agreement-study
#15
Luiz Gustavo de Quadros, Manoel Dos Passos Galvão Neto, Josemberg Marins Campos, Roberto Luiz Kaiser Junior, Eduardo Grecco, Mario Flamini Junior, Marcelo Falcao de Santana, Idiberto Jose Zotarelli Filho, Adriano Augusto Tomas Vasconcelos Almeida Alexandre
BACKGROUND AND AIMS: Between 10 and 20% of all patients undergoing bariatric surgery procedures regain weight secondary to a gastrojejunostomy enlargement. The aim of this study was to validate the interobserver agreement while measuring gastric outlet diameters using a new standard guidewire. METHODS: We selected thirty-five videos of consecutive endoscopic procedures on patients undergoing esophagogastroduodenoscopy after a Roux-en-Y gastric bypass procedure. All videos were evaluated by four raters: two expert endoscopists and two trainees...
January 3, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28056942/the-guidewire-coil-technique-to-prevent-retrograde-stone-migration-of-ureteric-calculi-during-intracorporeal-lithothripsy
#16
Nici Markus Dreger, Friedrich Carl von Rundstedt, Stephan Roth, Alexander Sascha Brandt, Stephan Degener
BACKGROUND: Stone retropulsion represents a challenge for intracorporeal lithotripsy of ureteral calculi. The consequences are an increased duration and cost of surgery as well as decreased stone-free rates. The use of additional tools to prevent proximal stone migration entails further costs and risks for ureteral injuries. We present the simple technique of using a coil of the routinely used guidewire to prevent stone retropulsion. METHODS: We retrospectively evaluated all patients with mid-to-proximal ureteral stones in 2014, which were treated by ureteroscopic lithotripsy (Ho: YAG and/or pneumatic lithotripsy)...
January 5, 2017: BMC Urology
https://www.readbyqxmd.com/read/28045933/optimization-of-peripheral-vascular-sizing-with-conductance-guidewire-theory-and-experiment
#17
Hyo Won Choi, Zachary C Berwick, Matthew S Sulkin, Christopher D Owens, Ghassan S Kassab
Although the clinical range of interventions for coronary arteries is about 2 to 5 mm, the range of diameters of peripheral vasculature is significantly larger (about 10 mm for human iliac artery). When the vessel diameter is increased, the spacing between excitation electrodes on a conductance sizing device must also increase to accommodate the greater range of vessel diameters. The increase in the excitation electrodes distance, however, causes higher parallel conductance or current losses outside of artery lumen...
2017: PloS One
https://www.readbyqxmd.com/read/28033300/the-degree-of-intubation-difficulties-and-the-frequency-of-complications-in-obese-patients-at-the-hospital-emergency-department-and-the-intensive-care-unit-case-control-study
#18
Marcin Cierniak, Renata Sobczak, Dariusz Timler, Andrzej Wieczorek, Bartosz Borkowski, Tomasz Gaszyński
The intubation difficulties in obese patients are not a new problem. They may result from an accumulation of fat in the oral cavity and cheeks. A thick tongue is also a significant factor. The literature reports that some tests to determine the intubation difficulties in obese people may be unreliable. The observed predictors of difficult intubation were the thyromental and sternomental distance and the intubation difficulty scale: FRONT score.The aim of this study was to assess the degree of difficult intubation in obese patients by the parameters such as the thyromental and sternomental distance...
December 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28032131/endovascular-mechanical-thromboaspiration-of-right-hepatic-arterial-thrombosis-after-liver-transplantation
#19
Roberto Gandini, Daniel Konda, Luca Toti, Sergio Abrignani, Stefano Merolla, Giuseppe Tisone, Roberto Floris
A 56-year-old male Patient presented 27 days after a liver transplantation (LT) with fever and hyperbilirubinemia. He underwent CT examination resulting in a diagnosis of right hepatic artery (HA) occlusion with hepatic bilomas. Once placed a long right femoral 6F introducer at the origin of the HA, a 0.014" guidewire was advanced over the thrombus, in a segmental branch. A 4MAX (Penumbra, Alameda, USA) catheter was advanced and withdrawn under constant aspiration until complete clot removal was achieved. Follow-up CT and D-US assessments at 12 months demonstrated regular HA patency and bilomas reduction...
December 28, 2016: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28017316/guidewire-self-extrusion-after-entrapment-of-distal-protection-device-during-saphenous-vein-graft-angioplasty
#20
Rodrigo Vugman Wainstein, Felipe Homem Valle, Fernando Pivatto Júnior, Ivan Morzoletto Pedrollo, Luiz Carlos Corsetti Bergoli, Marco Vugman Wainstein
No abstract text is available yet for this article.
December 1, 2016: JACC. Cardiovascular Interventions
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