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vascular puncture site

Alexandros Mallios, William Jennings, Benoit Boura, Alessandro Costanzo, Myriam Combes
Skin necrosis overlying an arteriovenous fistula at the cannulation site is a common and potentially life-threatening problem, often associated with underlying aneurysm formation. Arteriovenous fistula-skin necrosis generally requires resection of surrounding skin margins and the underlying aneurysmal vessel wall, allowing repair with healthy tissue of the arteriovenous fistula in addition to closure of soft tissue and skin. In patients with insufficient fistula length, salvage of these arteriovenous fistulas may result in difficult or insurmountable cannulation issues leading to attempts at one-needle cannulation dialysis or, most often, catheter placement...
March 1, 2018: Journal of Vascular Access
Yidan Zhang, Wei Guo, Xiaodong Tang, Rongli Yang, Taiqiang Yan, Sen Dong, Shidong Wang, Nikolas Zaphiros
BACKGROUND: Although aortic balloon occlusion has been shown to reduce blood loss during sacral tumor resections, it has not been validated in larger sacral tumors involving the lower lumbar spine. If such an approach were shown to be associated with less blood loss, it might aid the tumor surgeon in resecting these difficult tumors. QUESTIONS/PURPOSES: (1) Is the use of aortic balloon occlusion associated with reduced blood loss in sacral tumor resections when the lower lumbar spine is also involved? (2) Does the use of the aortic balloon prolong total operating time? (3) What complications are associated with the use of a balloon? METHODS: We retrospectively studied all 56 patients diagnosed with sacral tumors involving the lower lumbar spine (L4, L5) who were treated surgically between 2004 and 2015 at our institute...
March 2018: Clinical Orthopaedics and related Research
Luca Bertoglio, Daniele Mascia, Tommaso Cambiaghi, Andrea Kahlberg, Germano Melissano, Roberto Chiesa
OBJECTIVE: The aim of this study was to assess the safety and effectiveness of upper extremity access (UEA) with percutaneous closure of the axillary artery (AxA) during endovascular treatment of thoracoabdominal aortic aneurysms with fenestrated and branched endografts. METHODS: Between January 2014 and 2017, 34 out of 37 patients (92%) required UEA during a staged branched and fenestrated endovascular approach. A percutaneous AxA (pAxA) approach was used in 14 consecutive patients (41%) with the off-label use of two Perclose ProGlide (Abbott Vascular, Santa Clara, Calif) devices...
March 1, 2018: Journal of Vascular Surgery
Xue Lin, Hongchun Luo, Xingxing Yan, Zhixin Song, Xun Gao, Yun Xia, Liping Zhang, Yibing Yin, Ju Cao
OBJECTIVES: Sepsis is a devastating condition with a high mortality rate and limited treatments. Sepsis is characterized by a failed host immune response to contain the infection, resulting in organ dysfunction. Interleukin-34 is new cytokine involved in infection and immunity. Whether interleukin-34 is beneficial or deleterious to sepsis and the underlying mechanisms remains unknown. DESIGN: Prospective randomized animal investigation and in vitro studies. SETTING: Research laboratory at a university hospital...
January 30, 2018: Critical Care Medicine
Guillaume Marquis-Gravel, Maxime Tremblay-Gravel, Jonathan Lévesque, Philippe Généreux, Erick Schampaert, Donald Palisaitis, Michel Doucet, Thierry Charron, Paul Terriault, Pierre Tessier
OBJECTIVES: The objective was to assess the effect of ultrasound (US)-guidance compared to the anatomical landmark (AL) approach in patients requiring femoral artery (FA) access for coronary angiography/percutaneous coronary interventions (PCI). BACKGROUND: US-guidance has been proposed as a strategy to optimize FA access, potentially leading to decreased vascular complications. METHODS: Patients requiring FA access for coronary angiography/PCI were randomized to the US-guided or AL approaches...
January 25, 2018: Journal of Interventional Cardiology
Christoph Brenner, Julian Margreitter, Alexandra Gratl, Josef Klocker, Rudolf Kirchmair, Peter Marschang, Guy Friedrich, Bernhard Metzler, Nicolas Moes
AIMS AND BACKGROUND: Although guideline recommendations have shifted towards a transradial route, femoral puncture is still an established vascular access, especially for complex coronary interventions. The FemoSeal™ vascular closure device (FVCD) helps to reduce femoral compression time and access site complications after removal of the catheter sheath. To ensure safe use, an angiography of the femoral artery prior to FVCD deployment is recommended by the manufacturer. We postulate that omitting this angiography does not relevantly increase the risk for vascular complications...
January 24, 2018: Wiener Klinische Wochenschrift
Kurdow Nader, Saleh Lamin, Joseph Leyon, Swarupsinh Chavda, Allan Thomas, Sarin Kuruvath
BACKGROUND AND IMPORTANCE: Microguidewire entrapment and failure related to endovascular therapy is a rare complication with limited case reports available, most of which are from cardiac endovascular intervention. Migration of the microguidewire has been reported in coronary intervention with some resulting in severe complications, but there are no reported cases of spontaneous extrusion of wire fragment following a neurointerventional procedure. We report the first case of a microguidewire entrapment with subsequent fracture, followed by spontaneous extrusion of the wire fragment...
November 29, 2017: Operative Neurosurgery (Hagerstown, Md.)
Takashi Shimazui, Taka-Aki Nakada, Lisa Fujimura, Akemi Sakamoto, Masahiko Hatano, Shigeto Oda
INTRODUCTION: In vivo fluorescence imaging can quantify vascular permeability without requiring sacrifice of animals. However, use of this noninvasive approach for vascular permeability assessment in remote organ injury caused by systemic inflammatory disease has not been reported. METHODS: Evans blue (EB) and Genhance 750 fluorescent dye were mixed and injected into mice. The lung as a remote organ and the footpad as a noninvasive observational site were assessed in a cecal ligation and puncture (CLP)-induced systemic inflammation mouse model and compared with sham and hydrocortisone pretreated (CLP + HC) mouse models...
December 4, 2017: Shock
Suh Min Kim, Seung-Kee Min, Sanghyun Ahn, Sang-Il Min, Jongwon Ha, Jung Kee Chung
INTRODUCTION: Arteriovenous graft (AVG) infection can result in life-threatening sepsis and loss of vascular access. A retrospective study was performed to establish an appropriate treatment strategy for AVG infection. METHODS: A total of 50 cases of AVG infection were treated between January 2005 and June 2016. The surgical methods used were total graft excision (TGE) (n = 34), or partial graft excision (PGE) with interposition graft (n = 16). RESULTS: Infection was noted at a puncture site (n = 22), a prior incision for surgery or endovascular therapy (n = 20), and abandoned (currently unused) grafts (n = 5)...
November 11, 2017: Journal of Vascular Access
Kunakorn Atchaneeyasakul, Anita Tipirneni, Priyank Khandelwal, Vasu Saini, Richard Ronca, Steven Lord, Samir Sur, Luis Guada, Kevin Ramdas, Eric Peterson, Dileep Yavagal
Background and Purpose: Prior to thrombectomy for proximal anterior circulation large vessel occlusion (LVO) stroke, recent trials have utilized CT angiography (CTA) for vascular imaging immediately following noncontrast CT (NCCT) for decision-making, but thin-section NCCT with automated maximum intensity projection (MIP) reconstruction also has high accuracy in demonstrating the site of an occluding thrombus. We hypothesized that performing thin-section NCCT with MIP alone prior to thrombectomy improves the time to groin puncture (GP) compared to performing CTA after NCCT...
October 2017: Interventional Neurology
Emily Benham, Koen Deloose, Joren Callaert, Marc Bosiers, Tiffany Cox, Amy Lincourt, B Todd Heniford
INTRODUCTION: Vascular closure devices (VCDs) are designed to achieve rapid hemostasis during percutaneous coronary and peripheral vascular procedures. Studies demonstrate that VCDs improve time to hemostasis (TTH) and time to ambulation (TTA) in comparison to standard manual compression. The available products, however, typically have 13-17 steps in their application, often require hemostatic collagen or other agents as part of the process, and can result in significant scarring at the puncture site that can impact future access...
October 12, 2017: Surgical Technology International
Tao Zhou, Xuedong Liu, Zaifeng Fan
Virus-induced gene silencing (VIGS) is a genetic technology that exploits the RNA-mediated defense against virus. The method has great potential for plant reverse genetics as it could knock down gene expression in a rapid way, which is triggered by a replicating viral genome engineered to carry a fragment of host gene to be silenced. A number of efficient VIGS vectors are available for dicots, such as for model plant Nicotiana benthamiana; however, only a few of VIGS vectors for monocotyledonous cereal crops...
2018: Methods in Molecular Biology
Zoltan Ruzsa, Joanna Wojtasik-Bakalarz, Andras Nyerges, Tomasz Rakowski, Pawel Kleczynski, Stanislaw Bartus
OBJECTIVES: The aim of this study was to assess the safety of the retrograde procedure with long-term follow-up of 86 patients after retrograde recanalization of the superficial femoral artery (SFA). BACKGROUND: Chronic total occlusion (CTO) of SFAs occurs in >50% of the patient population with peripheral artery disease. The retrograde technique is an option for patients with unsuccessful antegrade percutaneous interventions, but data from long-term follow-up after retrograde recanalization are still limited...
October 2017: Journal of Invasive Cardiology
Suguru Honda, Fumio Hirano, Mariko Mouri, Hisanori Hasegawa, Hitoshi Kohsaka
A 40-year-old man with a history of oral and ileocecal ulcers, acneiform lesions, erythema nodosum and deep vein thrombosis presented with fever, abdominal pain and a pulsatile mass in the right groin. Two months prior to the presentation, he underwent stent grafting via the right femoral artery for an abdominal aortic aneurysm. Enhanced computed tomography disclosed aneurysms at the both ends of the stent (blue and green arrows in the panels A and B) and at the right femoral puncture site (blue arrowhead)...
October 3, 2017: Arthritis & Rheumatology
Martin Rabellino, Guillermo J Rosa-Diez, Sergio A Shinzato, Pablo Rodriguez, Oscar A Peralta, Maria S Crucelegui, Rosario Luxardo, Agustina Heredia-Martinez, Mariela I Bedini-Rocca, Ricardo D García-Mónaco
INTRODUCTION AND PURPOSE: The increasing number of patients undergoing hemodialysis and the limited number of access sites have resulted in an increasing number of techniques to maintain vascular access for hemodialysis. Thrombosed arteriovenous (AV) fistulas with large venous aneurysms have poor treatment results, with both endovascular and surgical techniques, leading to a high rate of definitive AV access loss. The purpose of this study was to review the feasibility and initial results of this novel endovascular treatment of thrombosed AV fistulas with large venous aneurysms...
2017: International Journal of Nephrology and Renovascular Disease
Filippo Bernasconi, Clelia Zanaboni, Andrea Dato, Andrea Dolcino, Michela Bevilacqua, Luigi Montagnini, Nicola Disma
INTRODUCTION: The peripherally inserted central catheters (PICCs) are vascular access devices (VAD) that are increasingly being used in the pediatric population. If a small vein caliber prevents positioning the catheter in the arm, the following step is to position the same catheter in the supraclavicular area, which can be defined as an off-label use or "atypical" approach, first described by Pittiruti. MATERIALS AND METHODS: We retrospectively reviewed PICC positioning with puncture-site in the supra-clavicular area ("atypical" PICC insertion) and then tunneled on the chest...
November 17, 2017: Journal of Vascular Access
Shunsaku Goto, Tomotaka Ohshima, Kojiro Ishikawa, Taiki Yamamoto, Toshihisa Nishizawa, Shinji Shimato, Kyozo Kato
PURPOSE: To establish the safety and efficacy of the 7-F ExoSeal device for the closure of femoral puncture sites made by 8-F or 9-F introducer sheaths. METHODS: Between January 2013 and December 2016, 332 patients (mean age 68.4±12.1 years; 195 men) underwent neurointerventional procedures via percutaneous puncture of the common femoral artery and an 8-F (n=272, 81.9%) or 9-F (n=60, 18.1%) introducer. The access sites were sealed with a 7-F ExoSeal in all cases...
August 2017: Journal of Endovascular Therapy
Jason H Anderson, Nathaniel W Taggart, Sarah L Edgerton, Susana Cantero Peral, Kimberly A Holst, Frank Cetta
In pigs, the deep location of the common carotid artery and overlying sternomastoideus muscle in the neck has led to the recommendation for a surgical cutdown for common carotid access, as opposed to minimally invasive techniques for vascular access. We sought to determine if direct percutaneous common carotid artery access in piglets is attainable. Seventeen piglets were anesthetized and intubated. Under two-dimensional and color flow Doppler ultrasound guidance, a 21 gauge needle was utilized to access the right common carotid artery...
January 1, 2017: Laboratory Animals
Ersan Akkaya, Alexander Berkowitsch, Sergej Zaltsberg, Nikolas Deubner, Harald Greiss, Andreas Hain, Christian W Hamm, Johannes Sperzel, Malte Kuniss, Thomas Neumann
INTRODUCTION: The aim of this observational study was to compare the postprocedural incidence of bleeding and thromboembolic complications associated with novel oral anticoagulants (NOACs) with that of interrupted and continuous phenprocoumon after pulmonary vein isolation (PVI) using a purse-string suture (PSS) closure of the puncture site. METHODS AND RESULTS: Consecutive patients who had undergone PVI via cryoballoon ablation were divided into the following groups: (1) interrupted phenprocoumon with heparin bridging (n=101), (2) continuous phenprocoumon targeting an internationally normalized ratio>2 (n=70), and (3) NOACs without bridging that were restarted 2-4h after the procedure (n=185)...
December 1, 2017: International Journal of Cardiology
Panagiotis Kallidonis, Christina Kalogeropoulou, Iason Kyriazis, Dimitrios Apostolopoulos, Panagiotis Kitrou, Dimitrios Kotsiris, Panteleeimon Ntasiotis, Evangelos Liatsikos
OBJECTIVE: To investigate the anatomical relations of the papillary, infundibular, and pelvic approach to percutaneous nephrolithotomy and evaluate the amount of vascularization at the respective sites. MATERIALS AND METHODS: (99m)Tc-dimercaptosuccinic acid single-photon emission computed tomography/computed tomography (SPECT/CT) renal scintigraphies or computed tomography perfusion (CTP) was performed in 40 patients (prone n = 20 or supine position n = 20)...
September 2017: Urology
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