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https://www.readbyqxmd.com/read/28323763/prospective-randomized-clinical-trial-investigating-the-effect-of-the-reamer-irrigator-aspirator-on-the-volume-of-embolic-load-and-respiratory-function-during-intramedullary-nailing-of-femoral-shaft-fractures
#1
Jeremy A Hall, Michael D McKee, Milena R Vicente, Zachary A Morison, Niloofar Dehghan, Christine E Schemitsch, Hans J Kreder, Brad Petrisor, Emil H Schemitsch
OBJECTIVES: We sought to determine whether the use of the Reamer-Irrigator-Aspirator (RIA) device resulted in a decreased amount of fat emboli compared with standard reaming (SR) when performing intramedullary (IM) nailing of femoral shaft fractures. DESIGN: Prospective randomized clinical trial. SETTING: Multi-centered trial, level I trauma centers. PATIENTS/PARTICIPANTS: All eligible patients who presented to participating institutions with an isolated femoral shaft fracture amenable to fixation with antegrade IM nailing...
April 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28303648/subadventitial-techniques-for-chronic-total-occlusion-percutaneous-coronary-intervention-the-concept-of-vessel-architecture
#2
Lorenzo Azzalini, Mauro Carlino, Emmanouil S Brilakis, Minh Vo, Stéphane Rinfret, Barry F Uretsky, Dimitri Karmpaliotis, Antonio Colombo
Despite improvements in guidewire technologies, the traditional antegrade wire escalation approach to chronic total occlusion (CTO) recanalization is successful in only 60-80% of selected cases. In particular, long, calcified, and tortuous occlusions are less successfully approached with a true-to-true lumen approach. Frequently, the guidewire tracks into the subadventitial space, with no guarantee of distal re-entry into the true lumen. The ability to manage the subadventitial space has been a key step in the tremendous improvement in success rates of contemporary CTO percutaneous coronary intervention (PCI), whether operating antegradely or retrogradely...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28303610/new-rescue-technique-of-endoscopic-ultrasonography-guided-rendezvous-procedure-with-video
#3
Hiroshi Kawakami, Yoshimasa Kubota
The newly developed endoscopic ultrasonography-guided rendezvous procedure (EUS-RV) is used after failed endoscopic retrograde cholangiopancreatography (ERCP) [1,2]. Guidewire manipulation is one of the most challenging aspects of EUS-RV. A rescue technique that bounces back the guidewire from the perihilar bile duct in a long endoscopic position is commonly used. Herein, we describe a case using EUS-RV in a short endoscopic position. This article is protected by copyright. All rights reserved.
March 16, 2017: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
https://www.readbyqxmd.com/read/28301310/glass-fiber-based-mr-safe-guidewire-for-mr-imaging-guided-endovascular-interventions-in-vitro-and-preclinical-in-vivo-feasibility-study
#4
Alexander Massmann, Arno Buecker, Guenther K Schneider
Purpose To evaluate glass-fiber-based guidewires that are safe for magnetic resonance (MR) imaging-guided endovascular interventions by using a phantom and an in vivo swine model. Materials and Methods MR imaging-safe guidewires were made from micropultruded glass and/or aramid fibers and epoxy resin with diameters of 0.89 mm (0.035 inch) for standard and stiff guidewires and 0.36 mm (0.014 inch) for micro guidewires. MR imaging visibility and mechanical properties were assessed in a pulsatile flow model. After approval was obtained from the institutional animal care and use committee, MR imaging guidewires were evaluated for standard endovascular procedures in nine pigs...
March 14, 2017: Radiology
https://www.readbyqxmd.com/read/28296135/assessment-of-trans-aortic-pressure-gradient-using-a-coronary-pressure-wire-in-patients-with-mechanical-aortic-and-mitral-valve-prostheses
#5
Nisharahmed Kherada, Juan Carlos Brenes, Annapoorna S Kini, George D Dangas
Accurate evaluation of trans-aortic valvular pressure gradients is challenging in cases where dual mechanical aortic and mitral valve prostheses are present. Non-invasive Doppler echocardiographic imaging has its limitations due to multiple geometric assumptions. Invasive measurement of trans-valvular gradients with cardiac catheterization can provide further information in patients with two mechanical valves, where simultaneous pressure measurements in the left ventricle and ascending aorta must be obtained...
March 15, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28284924/angioplasty-of-the-occluded-persistent-sciatic-artery-using-the-retrograde-approach-from-superficial-femoral-artery
#6
Ryuta Sugihara, Yasunori Ueda, Yuji Nishimoto, Kuniaki Takahashi, Tomoaki Nakano, Yoshiharu Higuchi, Kazunori Kashiwase, Akio Hirata, Yasuharu Takeda, Yoshio Yasumura
Persistent sciatic artery is a rare developmental anomaly prone to atherosclerotic disease. We present a case of successful endovascular therapy for left persistent sciatic artery that was occluded at the distal site. The angioplasty was performed with both antegrade approach from contralateral common femoral artery and retrograde approach from ipsilateral superficial femoral artery. The guidewire was advanced via collateral channel and crossed through the lesion retrogradely. Rendez-vous technique was performed and the lesion was successfully dilated by balloon inflation...
March 8, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28283511/independent-modular-filter-for-embolic-protection-in-carotid-stenting
#7
Dierk Scheinert, Bernhard Reimers, Alberto Cremonesi, Andrej Schmidt, Horst Sievert, Stefan Rohde, Joachim Schofer, Harald G Mudra, Marc Bosiers, Thomas Zeller, Andrea Pacchioni, Uri Rosenschein
BACKGROUND: Embolic protection during carotid artery stenting reduces the rate of thromboembolic events. The Wirion Embolic Protection System is used to deploy an independent distal filter using any 0.014″ guidewire. WISE study (Wirion Study Europe) evaluated the safety and performance of Wirion Embolic Protection System in patients undergoing carotid artery stenting. METHODS AND RESULTS: A prospective, multicenter, nonrandomized, open-label, single-arm study of carotid artery stenting in high surgical risk patients was performed...
March 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28274578/comparison-of-ct-rector-and-j-cto-scores-to-predict-chronic-total-occlusion-difficulty-for-percutaneous-coronary-intervention
#8
Yahang Tan, Jia Zhou, Wei Zhang, Ying Zhou, Luoshan Du, Feng Tian, Jun Guo, Lian Chen, Feng Cao, Yundai Chen
BACKGROUND: We sought to evaluate the ability of the CT-RECTOR and J-CTO scores to predict time-efficient guidewire (GW) crossing through a chronic total occlusion (CTO) and final procedure success. METHODS: Data from 191 consecutive CTO lesions with pre-procedural coronary computed tomography angiography (CCTA) from our center were analyzed retrospectively. The difficulty of the procedure was classified as easy, intermediate, difficult, or very difficult according to CT-RECTOR and J-CTO scores...
February 4, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28273653/unusual-migration-of-fractured-ercp-guidewire-a-case-report
#9
Christy B Pomeranz, Natasha E Wehrli, Amy Tyberg, Lily M Belfi
Endoscopic retrograde cholangiopancreatography (ERCP) routinely uses hydrophilic guidewires to cannulate ducts and traverse stenoses. Fracture of these guidewires have been reported, however, migration of these fractured fragments is an extremely rare occurrence that has yet to be reported in the literature. We present a case of a fractured ERCP guidewire with extensive migration in the retroperitoneal and lower extremity soft tissues and vasculature with radiologic correlation across multiple modalities-MRI, CT, and radiographs-as well as pathologic correlation...
February 22, 2017: Clinical Imaging
https://www.readbyqxmd.com/read/28269994/holmium-yag-laser-and-guidewires-is-there-a-durability-difference-among-guidewires-against-laser-energy-an-in-vitro-experimental-study
#10
Sahin Bagbanci
Purpose To evaluate the durability differences between five different type of guidewire against laser energy in an in-vitro experimental ureteral model. Methods The study was performed at the Department of Urology, Medicine Faculty of Ahi Evran University. An in-vitro experimental ureteral model was created for the work; a silicon ureteral model in a saline filled container. Experiments were performed on five different type of guidewire; ZIPwire, Sensor PTFE Nitinol guidewire, Roadrunner® PC wire guide, Amplatz Super Stiff and Zebra Urologic Guidewire...
March 7, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/28267588/initial-international-multicenter-human-experience-with-a-novel-epicardial-access-needle-embedded-with-a-real-time-pressure-frequency-monitoring-to-facilitate-epicardial-access-feasibility-and-safety
#11
Luigi Di Biase, J David Burkhardt, Vivek Reddy, Jorge Romero, Petr Neuzil, Jan Petru, Lucie Sadiva, Jan Skoda, Miguel Ventura, Corrado Carbucicchio, Antonio Dello Russo, Zoltan Csanadi, Michela Casella, Gaetano M Fassini, Claudio Tondo, Frederic Sacher, Mike Theran, Srinivas Dukkipati, Jacob Koruth, Pierre Jais, Andrea Natale
BACKGROUD: Epicardial ablation is often necessary for the treatment of complex arrhythmias refractory to endocardial ablation. Conventional needle access into the pericardial space is considered quite challenging, and it is often associated with several potential complications particularly inadvertent right ventricular puncture. The novel EpiAccess Needle tip is embedded with a pressure sensor able to report the pressure waveform in real time when used with the EpiAccess System. OBJECTIVE: We evaluated the feasibility and safety of the EpiAccess®System by EpiEP, Inc...
March 3, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28259565/3-dimensional-printing-assisted-percutaneous-fixation-for-acute-scaphoid-fracture-1-shot-procedure
#12
REVIEW
Hua-Wei Yin, Jing Xu, Wen-Dong Xu
Scaphoid fractures are the most common carpal fractures. Percutaneous fixation is a popular treatment option for nondisplaced or minimally displaced scaphoid fractures. Placement of the guidewire in the percutaneous fixation procedure often requires several attempts and adjustments with the help of intraoperative fluoroscopy. This article describes a 1-shot procedure of percutaneous fixation for acute scaphoid fracture with patient-specific guiding templates made by computer reconstructions and 3-dimensional printing technique...
March 1, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28256175/recanalization-of-peripheral-chronic-total-occlusions-no-fancy-devices-just-a-crossing-catheter
#13
Alessandro Cannavale, Tariq Ali, Chen-Yang Shen, George Kassimis, Miltiadis Krokidis
BACKGROUND: Chronic total occlusions (CTOs) are challenging to treat endovascularly. Classic subintimal approach is offering only moderate success rates mainly due of the lack of dedicated crossing catheters. Purpose of this study is to assess the acute procedural success of the use of a novel hydrophilic crossing catheter in the recanalization of peripheral CTOs. MATERIALS AND METHODS: This is a retrospective, single-centre study of patients with femoropopliteal CTOs...
March 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28250900/clinical-utility-of-0-025-inch-guidewire-visiglide2-tm-in-the-endoscopic-retrograde-cholangiopancreatography-related-procedures
#14
Yuji Sakai, Toshio Tsuyuguchi, Nobuto Hirata, So Nakaji, Kenji Shimura, Takao Nishikawa, Tatsuya Fujimoto, Tetsuya Hamano, Takayoshi Nishino, Osamu Yokosuka
AIM: To examine the result of the use of 0.025-inch guidewire (GW) VisiGlide2(TM) as the first choice in the endoscopic retrograde cholangiopancreatography (ERCP)-related procedures without selecting the patient in a multicenter prospective study. METHODS: ERCP using 0.025-inch GW VisiGlide2(TM) as the first choice was conducted in patients who have needed ERCP, and its accomplishment rate of procedure, procedural time, incidence of accidental symptoms were compared with those of ERCP using 0...
February 16, 2017: World Journal of Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28249880/the-bumper-technique-for-advancing-a-large-profile-microcatheter
#15
Christopher P Kellner, Alexander G Chartrain, Claire Schwegel, Thomas J Oxley, Hazem Shoirah, J Mocco
Operators commonly encounter difficulty maneuvering a microcatheter beyond the distal lip of wide neck aneurysms and aneurysms in challenging locations. Few techniques have been described to guide operators in these particular situations. In this case report of a 56-year-old woman with a 16 mm ophthalmic artery aneurysm, the microcatheter continually snagged the distal aneurysm lip, preventing delivery of a flow diverter into the distal parent vessel. In troubleshooting this obstacle, a second microguidewire was introduced alongside the microcatheter and was used to cover the distal lip of the aneurysm to prevent further snagging...
March 1, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28231555/edge-preserving-denoising-for-intra-operative-cone-beam-ct-in-endovascular-aneurysm-repair
#16
Yi Liu, Miguel Castro, Mathieu Lederlin, Huazhong Shu, Adrien Kaladji, Pascal Haigron
C-arm cone-beam computed tomography (CBCT) acquisition during endovascular aneurysm repair (EVAR) is an emergent technology with more and more applications. It offers real time imaging with a stationary patient and provides 3-D information to achieve guidance of intervention. However, there is growing concern on the overall radiation doses delivered to patients all along the endovascular management due to pre-, intra-, and post-operative X-ray imaging. Manufactures may have their low dose protocols to realize reduction of radiation dose, but CBCT with a low dose protocol has too many artifacts, particularly streak artifacts, and decreased contrast-to-noise ratio (CNR)...
January 30, 2017: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
https://www.readbyqxmd.com/read/28216973/endoscopic-ultrasound-guided-gallbladder-drainage-for-acute-cholecystitis-long-term-outcomes-after-removal-of-a-self-expandable-metal-stent
#17
Ken Kamata, Mamoru Takenaka, Masayuki Kitano, Shunsuke Omoto, Takeshi Miyata, Kosuke Minaga, Kentaro Yamao, Hajime Imai, Toshiharu Sakurai, Tomohiro Watanabe, Naoshi Nishida, Masatoshi Kudo
AIM: To assess the long-term outcomes of this procedure after removal of self-expandable metal stent (SEMS). The efficacy and safety of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) with SEMS were also assessed. METHODS: Between January 2010 and April 2015, 12 patients with acute calculous cholecystitis, who were deemed unsuitable for cholecystectomy, underwent EUS-GBD with a SEMS. EUS-GBD was performed under the guidance of EUS and fluoroscopy, by puncturing the gallbladder with a needle, inserting a guidewire, dilating the puncture hole, and placing a SEMS...
January 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28215930/ultrasound-guided-resuscitative-endovascular-balloon-occlusion-of-the-aorta-in-the-resuscitation-area
#18
Takayuki Ogura, Alan Kawarai Lefor, Mitsunobu Nakamura, Kenji Fujizuka, Kousuke Shiroto, Minoru Nakano
BACKGROUND: In trauma resuscitation with resuscitative endovascular balloon occlusion of the aorta (REBOA), urgent and accurate placement of the catheter in the resuscitation area without fluoroscopy can shorten the time from admission to REBOA, allowing rapid, temporary control of bleeding. DISCUSSION: The experience-based protocol in our center for ultrasound-guided REBOA in the resuscitation area without fluoroscopy is as follows: the femoral artery is punctured and a guidewire inserted; sonography is used to verify that the guidewire is in the abdominal aorta; the position of the balloon is confirmed with ultrasound after estimating the distance to the clavicle, and the pressure in the radial artery and sheath is used to monitor correct positioning; connect the pressure transducer to the catheter sheath for continuous monitoring of the blood pressure in the sheath, and inflate the balloon until the blood pressure tracing at the sheath has disappeared; check the pulse in the left radial artery, and withdraw the catheter slightly if the pulse in the radial artery is not palpable or is decreased (if this pulse is not palpable or decreased, the balloon is in the aortic arch)...
February 17, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28215097/what-is-the-most-cost-effective-method-for-a-difficult-biliary-cannulation-in-ercp
#19
Jesús García-Cano
Editorial dealing with difficult biliary cannulation in ERCP. Pancreatic techniques that take advantage of a guidewire inserted in the Main Pancreatic Duct are preferred to needle-knife precut.
February 20, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/28208009/impact-of-a-newly-developed-short-double-balloon-enteroscope-on-stent-placement-in-patients-with-surgically-altered-anatomies
#20
Koichiro Tsutsumi, Hironari Kato, Hiroyuki Okada
A newly developed short double-balloon enteroscope with a working channel enlarged to a diameter of 3.2 mm is a novel innovation in stent placement for patients with surgically altered anatomies. Herein, we report three patients in whom this new scope contributed to an efficient technique and ideal treatment. In the first case, the double guidewire technique was efficient and effective for multiple stent placements. In the second case, covered self-expandable metal stent (SEMS) placement, which is the standard treatment for malignant biliary obstruction, could be performed in a technologically sound and safe manner...
March 15, 2017: Gut and Liver
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