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Catheters malfunction

Flavie Frémondière, Franck Lacoeuille, Avigaëlle Sher, Olivier Couturier, Philippe Menei, Isabelle Richard, Mickaël Dinomais
Intrathecal baclofen is now an admitted treatment of generalized and disabling spasticity. Technical incidents of the device remain frequent, mainly due to catheter problems. Consequences can be abrupt with life-threatening withdrawal syndrome or progressive with spasticity reappearance. In case of progressive withdrawal syndrome, the assessment process has to be meticulous to find the cause of inefficiency and to avoid useless revision surgery. This assessment includes medical examination, radiographs, intrathecal baclofen bolus, after what, if no conclusion can be drawn, a more invasive imaging exam has to be performed...
September 2016: Annals of Physical and Rehabilitation Medicine
Aurelia B Fu, Erica I Hodgman, Lorraine S Burkhalter, Rachel Renkes, Tamra Slone, Adam C Alder
BACKGROUND: Central venous access devices (CVADs) play an important role in the management of pediatric oncology patients; unfortunately, they are also associated with potentially serious complication rates. We hypothesized that, despite the significantly different disease courses typical of acute lymphoblastic leukemia and acute myelogenous leukemia, there would be identifiable risk factors for premature CVAD removal. METHODS: We retrospectively studied clinical characteristics and procedure records for all patients admitted with a leukemia diagnosis at our institution from May 2009 to July 2014...
October 2016: Journal of Surgical Research
Shaoyong Wu, Jingxiu Huang, Zongming Jiang, Zhimei Huang, Handong Ouyang, Li Deng, Wenqian Lin, Jin Guo, Weian Zeng
BACKGROUND: A totally implantable venous access device (TIVAD) provides reliable, long-term vascular access and improves patients' quality of life. The wide use of TIVADs is associated with important complications. A meta-analysis was undertaken to compare the internal jugular vein (IJV) with the subclavian vein (SCV) as the percutaneous access site for TIVAD to determine whether IJV has any advantages. METHODS: All randomized controlled trials (RCTs) and cohort studies assessing the two access sites, IJV and SCV, were retrieved from PubMed, Web of Science, Embase, and OVID EMB Reviews from their inception to December 2015...
2016: BMC Cancer
Francesco Esposito, Marco Di Serafino, Concetta Ambrosio, Maria Rita Panico, Francesca Malacario, Carmela Mercogliano, Carmine Pecoraro, Patrizia Oresta
PURPOSE: Over the past two decades, continuous ambulatory peritoneal dialysis has emerged as the first-choice dialysis modality in children awaiting for transplantation. Despite the improvements observed in catheter survival over the past several years, the obstruction is one of the reasons for immediate catheter non-function. This study assessed usefulness of ultrasound (US) in visualizing the obstruction of chronic peritoneal dialysis (CPD) catheter and identifying the etiology. MATERIALS AND METHODS: Between January 2000 and November 2012, 38 patients (20 M, 18 F) were treated with CPD and examined with US...
September 2016: Journal of Ultrasound
Alison A Smith, Adam N Fonseca, Mihran V Naljayan, Anil S Paramesh
BACKGROUND: We present the unusual complication of peritoneal dialysis catheter dysfunction in a patient who developed a retroperitoneal hematoma following an endoscopic procedure and review the existing literature regarding this rare complication. CASE REPORT: A 60-year-old male with end stage renal disease presented with PD catheter dysfunction. A computerized tomography scan of his abdomen showed a large left retroperitoneal hematoma. He underwent a diagnostic laparoscopy and PD catheter revision...
July 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Brian J Kim, Willa Jin, Alexander Baldwin, Lawrence Yu, Eisha Christian, Mark D Krieger, J Gordon McComb, Ellis Meng
Neurosurgical ventricular shunts inserted to treat hydrocephalus experience a cumulative failure rate of 80 % over 12 years; obstruction is responsible for most failures with a majority occurring at the proximal catheter. Current diagnosis of shunt malfunction is imprecise and involves neuroimaging studies and shunt tapping, an invasive measurement of intracranial pressure and shunt patency. These patients often present emergently and a delay in care has dire consequences. A microelectromechanical systems (MEMS) patency sensor was developed to enable direct and quantitative tracking of shunt patency in order to detect proximal shunt occlusion prior to the development of clinical symptoms thereby avoiding delays in treatment...
October 2016: Biomedical Microdevices
Ziev B Moses, Alp Ozpinar, Muhammad M Abd-El-Barr, Luis G Quinonez, Sitaram M Emani, Liliana C Goumnerova
The authors report a complex case of an 18-year-old male with a history of hydrocephalus secondary to intraventricular hemorrhage of prematurity, with more than 30 previous shunt revisions, who presented to the authors' institution with shunt malfunction. After exhausting his peritoneal cavity and pleural space as possible distal sites of shunt placement, he underwent a direct heart shunt placement when it was discovered he had thrombosis of his subclavian vein precluding a standard wire-guided atrial cannulation...
September 2, 2016: Journal of Neurosurgery. Pediatrics
Mingliang He, Leping Ouyang, Shengwen Wang, Meiguang Zheng, Anmin Liu
OBJECTIVE Ventriculoperitoneal (VP) shunt treatment is the main treatment method for hydrocephalus. The traditional operative approach for peritoneal catheter insertion is mini-laparotomy. In recent years, laparoscopy-assisted insertion has become increasingly popular. It seems likely that use of an endoscope could lower the incidence of shunt malfunction. However, there is no consensus about the benefits of laparoscopy-assisted peritoneal catheter insertion. METHODS A systematic search was performed using the PubMed, Embase, ScienceDirect, and Cochrane Library databases...
September 2016: Neurosurgical Focus
Stefano Avanzini, Leila Mameli, Nicola Disma, Clelia Zanaboni, Andrea Dato, Giovanni Montobbio, Luigi Montagnini, Michela Bevilacqua, Filomena Pierri, Massimo Conte, Loredana Amoroso, Giovanna Pala, Sara Pestarino, Elio Castagnola, Angelo Claudio Molinari, Concetta Micalizzi, Giuseppe Morreale, Girolamo Mattioli, A Pini Prato
BACKGROUND: Ultrasound-guided (USG) cannulation of the brachiocephalic vein (BCV) is gaining worldwide consensus for central venous access in children. This study reports a 20-month experience with this approach in children. METHODS: All patients who underwent percutaneous USG central venous catheter (CVC) positioning in the BCV between August 2013 and March 2015 have been included. Devices inserted during this period were open-ended, either single or double-lumen tunneled CVC...
August 31, 2016: Pediatric Blood & Cancer
D A Mirsadykov
Substantiation of the shunt failure diagnosis and subsequent consideration of indications for surgical elimination of the malfunction is a laborious and challenging process. Identification of a malfunction in doubtful cases requires, in addition to standard examinations, extra diagnostic procedures, which may delay making a decision for several weeks to several months. The article describes a case of mechanical CSF shunt malfunction (breakage and failure of a peritoneal catheter in a 7-year-old girl) with intracranial hypertension symptoms, but without typical enlargement of the brain ventricles...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Ahmed M Elshal, Yasser Eldemerdash, Ramy Mekkawy, Diaa-Eldin Taha, Mahmoud Laymon, Ahmed R El-Nahas, Ahmed El-Assmy
OBJECTIVES: To review non-morcellation approaches for tissue retrieval after holmium laser enucleation of the prostate (HoLEP) and whether these approaches demolish the advantages of the HoLEP procedure. PATIENTS AND METHODS: We reviewed our prospectively maintained laser prostate database for HoLEP procedures where non-morcellation approaches were used for retrieval of the enucleated adenoma. Non-morcellation approaches were adopted in cases of morcellator malfunction or whenever concomitant pathology indicated laparotomy...
June 2016: Arab Journal of Urology
Michael Saulino, Michael Turner, Keith Miesel, Felicia R Cochran, Katherine Stromberg, Elizabeth Fehrmann, Mary Markert, Robert Spencer
OBJECTIVE: The catheter status of patients who presented with loss of intrathecal baclofen (ITB) therapy effectiveness was investigated using measurements of cerebrospinal fluid (CSF) pressure transmitted through the catheter fluid path to the pump. The aim of the study was to estimate the appropriate threshold separating catheter complications from "normal" catheter function, and to compare catheter status based on CSF pressure with the clinical diagnosis. METHODS: This was a prospective, masked nonsignificant risk, research study...
August 1, 2016: Neuromodulation: Journal of the International Neuromodulation Society
J H Leopold, R T M van Hooijdonk, M Boshuizen, T Winters, L D Bos, A Abu-Hanna, A M T Hoek, J C Fischer, E C van Dongen-Lases, M J Schultz
BACKGROUND: Microdialysis is a well-established technology that can be used for continuous blood glucose monitoring. We determined point and trend accuracy, and reliability of a microdialysis-based continuous blood glucose-monitoring device (EIRUS(®)) in critically ill patients. METHODS: Prospective study involving patients with an expected intensive care unit stay of ≥48 h. Every 15 min, device readings were compared with blood glucose values measured in arterial blood during blocks of 8 h per day for a maximum of 3 days...
December 2016: Annals of Intensive Care
Prakash S Gudsoorkar, Todd Penner, S Vanita Jassal, Joanne M Bargman
Successful performance of peritoneal dialysis (PD) depends on a properly functioning PD catheter. Catheter malfunction remains a significant cause of technique failure, especially early in the course of therapy. Common causes of catheter malfunction include catheter displacement, omental or bowel wrapping, and fibrin clots. Less commonly, various intraperitoneal structures have been reported to lead to obstruction, including appendices epiploicae of sigmoid colon and the fallopian tube. Peritoneal dialysis catheter blockage due to fimbriae of the fallopian tube is being recognized as an important cause of catheter malfunction in females due to the increasing availability of diagnostic laparoscopy...
July 2016: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
Alison A Smith, Adam N Fonseca, Mihran V Naljayan, Anil S Paramesh
BACKGROUND: We present the unusual complication of peritoneal dialysis (PD) catheter dysfunction in a patient who developed a retroperitoneal hematoma following an endoscopic procedure and review the existing literature regarding this rare complication. CASE REPORT: A 60-year-old man with end stage renal disease presented with PD catheter dysfunction. Computed tomography scan of his abdomen showed a large left retroperitoneal hematoma. He underwent a diagnostic laparoscopy and PD catheter revision...
March 2016: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
Arin L Madenci, Alyssa Stetson, Christopher B Weldon, Leslie E Lehmann
Hepatic VOD (veno-occlusive disease) is a serious complication of HSCT (hematopoietic stem cell transplantation) and has historically been associated with high mortality. This obstruction to hepatic flow often results in fluid collections in the peritoneal and pleural cavities. Catheter placement to drain ascites or pleural fluid may reduce intra-abdominal hypertension and/or improve respiratory parameters. The safety of these interventions among critically ill, immunocompromised children is unknown. Among 32 HSCT recipients (2000-2012) with severe VOD, we assessed the primary outcome of procedural complication from peritoneal drain placement...
August 2016: Pediatric Transplantation
Yang Zhang, Xiaobo Zhu, Jinchuan Zhao, Kun Hou, Xianfeng Gao, Yang Sun, Wei Wang, Xiaona Zhang
Ventriculoperitoneal shunting (VPS) is a major therapy for hydrocephalus, but has a significant risk of device malfunctioning. In this study, we explored a novel distal shunt catheter placement method in VPS for the treatment of hydrocephalus. Five patients with different etiologies of hydrocephalus underwent VPS with open distant shunt catheter attached outside. We analyzed different variables (age, gender, medical history, clinical presentation, indication for surgery and surgical technique, postoperative complications) and occurrence of shunt failure and infection...
November 2015: Cell Biochemistry and Biophysics
Gregor Novljan, Rina R Rus, Vladimir Premru, Rafael Ponikvar, Nina Battelino
When peritoneal dialysis is inapplicable, chronic hemodialysis (HD) becomes the only available treatment option in small children. Due to small patient size, central venous catheters (CVC) are mainly used for vascular access. Over the past 4 years, four children weighing less than 15 kg received chronic HD in our unit. A total of 848 dialysis sessions were performed. Altogether, 21 catheters were inserted. In all but one occasion, uncuffed catheters were used. Catheter revision was performed 15 times during the study period, either due to infection or catheter malfunction...
June 2016: Therapeutic Apheresis and Dialysis
Jackson Wang, Tuan A Nguyen, Andrew I Chin, Jamie L Ross
INTRODUCTION: Exchange procedures involve tunneled dialysis catheter (TDC) removal and exchange over a wire, using the same exit site and venotomy site. Diagnostic imaging or intervention was generally not performed in exchange procedures. Revision procedures involve placement of new TDC using the previous venotomy site and a new tunnel and exit site. The majority of revisions usually include diagnostic imaging and intervention in the central circulation if needed. METHODS: A retrospective single review of 70 patients who underwent 97 TDC replacements from 2010 to early 2012 because of catheter malfunction was evaluated for either infection or malfunction within 30 days of the procedure...
July 12, 2016: Journal of Vascular Access
Ralph Gnannt, Bairbre L Connolly, Dimitri A Parra, Joao Amaral, Rahim Moineddin, Avnesh S Thakor
BACKGROUND: The position of the tip of a peripherally inserted central catheter (PICC) is crucial; malposition can lead to malfunction of the line or life-threatening events (e.g., arrhythmias, perforation). OBJECTIVE: To determine what factors other than arm position and accessed vein might influence the tip position of a PICC. MATERIALS AND METHODS: Inclusion criteria were upper limb PICC placement, body weight <20 kg, intraoperative imaging with the arm in 0°, 45° and 90° abduction and an arm view marking the skin entry site relative to the shoulder...
October 2016: Pediatric Radiology
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