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Mehmet Akif Cakar, Ersun Tatli, Alptug Tokatli, Harun Kilic, Huseyin Gunduz, Ramazan Akdemir
INTRODUCTION: Percutaneous endovascular therapy is an accepted and preferred procedure for symptomatic subclavian artery disease. However, the technical feasibility and effectiveness of treating chronic total occlusion of the subclavian artery with this approach is uncertain. We aimed to evaluate the initial and mid-term results of endovascular therapy for patients with symptomatic chronic total occlusion of the left subclavian artery. METHODS: Consecutive patients who underwent balloon angioplasty and stenting for chronic total occlusion of the left subclavian artery between January 2010 and February 2014 were included...
March 16, 2018: Singapore Medical Journal
Ran Kornowski, Hana Vaknin-Assa, Abid Assali, Gabriel Greenberg, Orna Valtzer, Ifat Lavi
OBJECTIVES: To assess the diagnostic performance of angiography-derived fractional flow reserve (FFRangio) measurements in patients with stable coronary artery disease when used online in the catheterization laboratory during routine coronary angiography. BACKGROUND: FFR, an index of the hemodynamic severity of coronary stenosis, is derived from invasive measurements using a pressure-monitoring guidewire and hyperemic stimulus. While FFR is the gold standard, it remains under-utilized...
March 15, 2018: Journal of Invasive Cardiology
Benito Velayos, L Del Olmo, L Merino, M Valsero, J M González
INTRODUCTION: The development of novel mechanical endoscopic closure systems allows now the management of some gastrointestinal fistula types in a minimally invasive way. However, the correct location of the fistulous tract is essential to achieve successful endoscopic closure. CASE REPORT: A 69-year-old woman with high risk for surgery presented with recurrent cystitis, pneumaturia, and enteruria 2 months after medical-treated diverticulitis. Computerized tomography demonstrated colovesical fistula but colonoscopy could not locate the fistulous opening...
March 12, 2018: International Journal of Colorectal Disease
Hoon Suk Park, Joonsung Choi, Hyung Wook Kim, Jun Hyun Baik, Cheol Whee Park, Young Ok Kim, Chul Woo Yang, Dong Chan Jin
PURPOSE: The exchange from a non-tunneled hemodialysis catheter to a tunneled one over a guidewire using a previous venotomy has been reported to be safe. However, some concerns that it may increase infection risk prevent its clinical application. This approach seems particularly useful for acute kidney injury patients requiring initial renal replacement therapy, in whom we frequently worry about the choice of non-tunneled versus tunneled catheters. MATERIALS AND METHODS: From March 2012 to February 2016, 88 cases to receive the over-the-guidewire exchange method from a non-tunneled to a tunneled catheter and 521 cases to receive de novo tunneled catheter placement from the hemodialysis vascular access cohort were compared retrospectively...
March 1, 2018: Journal of Vascular Access
Keith S Boniface, Maxine A LeSaux, Sohaib Mandoorah, Amit Patel, Kai L Neander, Hamid Shokoohi
PURPOSE: We evaluated the performance of an encapsulated guidewire designed for single-handed use with ultrasound-guided vascular access (SonoStik) with Seldinger technique, as compared with conventional intravenous catheters placed under ultrasound guidance in healthy subjects. METHODS: This is a prospective cohort trial in healthy subjects in which each subject served as his/her own control by having a SonoStik ultrasound intravenous cannulation placed in one arm and a conventionally placed, standard ultrasound intravenous cannulation placed in the other arm...
March 1, 2018: Journal of Vascular Access
Mauro Sergio Martins Marrocos, Thais Marques S Gentil, Fernanda de C Lima, Sandra Maria R Laranja
PURPOSE: Real-time ultrasound is indicated for hemodialysis catheters' insertion in internal jugular veins. We evaluated unsuccessful implantation of short-term hemodialysis catheters in internal jugular veins using real-time ultrasound between patients with and without previous short-term catheters. METHODS: Observational open-label study of unsuccessful implantation of short-term hemodialysis catheters in internal jugular veins using real-time ultrasound from July 2013 to August 2014...
March 1, 2018: Journal of Vascular Access
Alec Vishnevsky, Michael P Savage, David L Fischman
Percutaneous coronary intervention (PCI) of mammary artery bypass grafts through a trans-radial (TR) approach can present unique challenges, including coaxial vessel engagement of the guiding catheter, adequate visualization of the target lesion, sufficient backup support for equipment delivery, and the ability to reach very distal lesions. The GuideLiner catheter, a rapid exchange monorail mother-in-daughter system, facilitates successful interventions in such challenging anatomy. We present a case of a patient undergoing PCI of a right internal mammary artery (RIMA) graft via TR access in whom the graft could not be engaged with any guiding catheter...
March 9, 2018: Catheterization and Cardiovascular Interventions
Joseph M DeCunha, Shirin A Enger
PURPOSE: Renewed interest is being expressed in intravascular brachytherapy (IVBT). A number of unresolved issues exist in the discipline. Providing a homogeneous and adequate dose to the target remains difficult in IVBT. The guidewire that delivers the device to the target, arterial plaques, and stent struts are all known to reduce the dose delivered to target. The viability and efficacy of a proposed IVBT delivery system designed to resolve the issue of guidewire attenuation is evaluated and compared to that of a popular and commercially available IVBT device...
March 5, 2018: Brachytherapy
Masahide Komagamine, Nobuyuki Furukawa, Jan Gummert, Jochen Börgermann
Transapical transcatheter aortic valve implantation is a well-established alternative in patients at a high risk for conventional aortic valve replacement. We performed transapical transcatheter aortic valve implantation on an 83-year-old woman with symptomatic severe aortic stenosis. Intraoperative transoesophageal echocardiography (TOE) after transcatheter aortic valve implantation showed mild mitral regurgitation without intracardiac structural injury. In the intensive care unit, the patient gradually had haemodynamic instability; TOE revealed severe mitral regurgitation with A2 and A3 prolapse due to rupture of the posterior papillary muscle...
March 5, 2018: European Journal of Cardio-thoracic Surgery
Folkert Steinhagen, Maximilian Kanthak, Guido Kukuk, Christian Bode, Andreas Hoeft, Stefan Weber, Se-Chan Kim
INTRODUCTION: A significant increase of the p-wave of a real-time intracavitary electrocardiography is a reliable and safe method to confirm the central venous catheter tip position close to the atrium. However, conflicting data about the feasibility of electrocardiography exist in patients with atrial fibrillation. METHODS: An observational prospective case-control cohort study was set up to study the feasibility and accuracy of the electrocardiography-controlled central venous catheter tip placement in 13 patients with atrial fibrillation versus 10 patients with sinus rhythm scheduled for elective surgery...
February 1, 2018: Journal of Vascular Access
Sina Javidmehr, Mohammad Reza Golbakhsh, Babak Siavashi, Parham Talebian, Morteza Dehnokhalaji, Mohammad Javad Zehtab, Mohammadreza Bozorgmanesh
Study Design: Methodological study. Purpose: To our knowledge, this is the first study to introduce a new modified method for inserting iliosacral screws and to compare its results with those of a conventional method. Overview of Literature: Previous techniques, such as open reduction and internal fixation, are associated with perioperative hemorrhage, postoperative infection, and neurological deficits. Although percutaneous iliosacral screw insertion confers the advantage of being minimally invasive, leading to less blood loss and a low postoperative infection rate, it harbors the risk of screw malpositioning due to narrow sacral proportions and a high interindividual variability...
February 2018: Asian Spine Journal
Gursimran Kochhar, Bo Shen
BACKGROUND AND AIMS: Fistulas in patients with inflammatory bowel disease (IBD) poses a key challenge in the management of the IBD patients. We aimed to describe a novel endoscopic method to treat the IBD patients who have fistulas. METHODS: A cohort of 29 consecutive patients with a fistula and IBD were identified in the registry of our interventional IBD unit. The endoscopic fistulotomy with needle-knife was performed. The primary outcome was healing of the fistula without the need for surgical intervention...
February 28, 2018: Gastrointestinal Endoscopy
Kuniyasu Ikeoka, Shiro Hoshida, Tetsuya Watanabe, Yukinori Shinoda, Tomoko Minamisaka, Hidetada Fukuoka, Hirooki Inui, Keisuke Ueno, Yasushi Sakata
AIM: Maximal hyperemic response, leading to examination of microvascular resistance in lower-limb lesions is not well understood. This study aimed to investigate the infrainguinal arterial physiological response through a hyperemic condition and the pathophysiological significance of microvascular resistance in peripheral artery disease. METHODS: Sixteen limbs with focal stenosis of the superficial femoral artery (SFA) and 16 control limbs were analyzed. We assessed the fractional flow reserve (FFR), vascular flow reserve (VFR), and hyperemic microvascular resistance (h-MR) of the SFA with a pressure/Doppler flow sensor-tipped combination guidewire before and after endovascular therapy (EVT)...
February 28, 2018: Journal of Atherosclerosis and Thrombosis
Phuoc Vy, Vincent Auffret, Miguel Castro, Pierre Badel, Michel Rochette, Pascal Haigron, Stéphane Avril
Transcatheter Aortic Valve Implantation (TAVI) is a recent mini-invasive procedure to implant an aortic valve prosthesis. Prosthesis positioning in TAVI appears as an important aspect for the success of the intervention. Accordingly, we developed a patient-specific Finite Element framework to predict the insertion of the stiff guidewire, used to position the aortic valve. We simulated the guidewire insertion for 2 patients based on their pre-operative CT scans. The model was designed to primarily predict the position and the angle of the guidewires in the aortic valve and the results were successfully compared to intra-operative images...
February 27, 2018: International Journal for Numerical Methods in Biomedical Engineering
Yoshito Kadoya, Kan Zen, Yohei Oda, Satoaki Matoba
Tip separation of a Crosser catheter is a serious complication; however, there is limited information on bailout methods. Here, we describe a case of successful retrieval of the separated tip of a Crosser catheter using a 2-wire technique with a gooseneck snare. A 76-year-old woman with a history of hemodialysis and diabetes mellitus who developed ulcers on her right toes was diagnosed as having critical limb ischemia and underwent transfemoral antegrade endovascular treatment of the anterior tibial artery (ATA)...
January 1, 2018: Vascular and Endovascular Surgery
Ilker Ince, Muhammet Ali Arı, Muhammet Mustafa Sulak, Mehmet Aksoy
BACKGROUND AND OBJECTIVES: There are different ultrasound probe positions used for internal jugular venous catheter placement. Also, in-plane or out of plane needle approach may be used for catheterization. Transverse short-axis classic approach is the most popular performed approach in literature. "Syringe-Free" is a new described technique that is performed with oblique long-axis approach. We aimed to compare performance of these two approaches. METHODS: This study was conducted as a prospective and randomized study...
February 22, 2018: Revista Brasileira de Anestesiologia
Harminder Singh, Donald R Duerksen, Gale Schultz, Carol Reidy, Pat DeGagne, Nancy Olson, Zoann Nugent, Kathryn A Bernard, Michelle J Alfa
BACKGROUND AND AIMS: We aimed to at determine whether monitoring of duodenoscope cleaning by rapid adenosine-tri-phosphate (ATP) combined with channel-purge storage could eliminate high-concern microorganisms. METHODS: In a simulated-use study, suction channels from two duodenoscopes models and the unsealed elevator guidewire (EGW) channel from one of these two duodenoscopes (the other model has a sealed EGW) were perfused with ATS2015 containing approximately 8 Log10 CFU/mL of both Enterococcus faecalis and Escherichia coli...
February 21, 2018: Gastrointestinal Endoscopy
Yon Kwon Ihn, Shang Hun Shin, Seung Kug Baik, In Sup Choi
Endovascular coiling for intracranial aneurysms has become an accepted treatment with good clinical results and provides adequate protection against rebleeding and rupture of aneurysms. However, despite the experience, preparation, or skill of the physician, complications during endovascular treatment still occur. The main complications of endovascular coiling are: procedural aneurysmal perforations by the microcatheter, micro-guidewire, or coil, and thromboembolic events. Such situations are unexpected, complex, and can have devastating consequences...
January 1, 2018: Interventional Neuroradiology
Luca Bertoglio, Tommaso Cambiaghi, Alessandro Grandi, Andrea Kahlberg, Germano Melissano, Roberto Chiesa
PURPOSE: To present a technique that creates a neofenestration in the dissecting lamella of chronic aortic dissections using standard or intravenous ultrasound (IVUS)-guided reentry devices. TECHNIQUE: To create a neofenestration, a standard or IVUS-guided reentry device is deployed in either the true or false aortic lumen while a balloon is simultaneously inflated in the opposite lumen to stabilize the lamella, provide needle counterforce, and prevent displacement of the lamella away from the reentry needle...
February 1, 2018: Journal of Endovascular Therapy
Krister Liungman, Kevin Mani, Anders Wanhainen, Linus Bosaeus, Mario Lachat
OBJECTIVE: A new endovascular tool, the Liungman Guidewire Fixator, has been developed to simplify endovascular treatment in complex aortic aneurysms. The device has been extensively tested in bench models and animal trials. To verify the safety and functionality demonstrated in the porcine model, the device was tested in ten patients undergoing endovascular aortic repair (EVAR) or fenestrated endovascular aortic repair (f-EVAR) treatment for abdominal aortic aneurysm. METHODS: The Liungman Guidewire Fixator consists of a braided stent-like, cylindrical structure with conical ends and a central channel for a 0...
January 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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