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https://www.readbyqxmd.com/read/27931184/postprocedural-radial-artery-occlusion-rate-using-a-sheathless-guiding-catheter-for-left-ventricular-endomyocardial-biopsy-performed-by-transradial-approach
#1
Behrouz Kherad, Clemens Köhncke, Frank Spillmann, Heiner Post, Michel Noutsias, Burkert Pieske, Florian Krackhardt, Carsten Tschöpe
BACKGROUND: For coronary interventions the arterial access via the radial artery is associated with fewer vascular access site complications, and has been shown to reduce major bleeding when compared to the femoral approach. But the endomyocardial biopsy (EMB) approach is usually done by a transfemoral or cervical access known to be associated with an increased risk of artery puncture and its potential complications (i.e., false aneurysm, artery-venous fistula) and needs post-procedural immobilization...
December 8, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27886362/balloon-assisted-venous-access-salvage-through-a-thrombosed-arteriovenous-graft
#2
Chen Pong Wong, Karthikeyan Damodharan, Thijs A J Urlings, Sivanathan Chandramohan
INTRODUCTION: Maintaining vascular access by means of radiological intervention has become the mainstay of management of patients with central venous stenoses and occlusions (CVO), which can be challenging. We present a case of balloon-assisted percutaneous puncture of an occluded left subclavian vein, through a thrombosed arteriovenous graft, for a tunneled dialysis catheter insertion. METHODS: A thrombosed left arm arteriovenous graft was accessed, and the occluded left subclavian vein was traversed with 0...
November 22, 2016: Journal of Vascular Access
https://www.readbyqxmd.com/read/27879949/single-center-experience-with-vascular-closure-devices-in-real-world-endovascular-peripheral-interventions
#3
Bruno Freitas, Sabine Steiner, Yvonne Bausback, Holger Staab, Daniela Branzan, Ursula Banning-Eichenseer, Andrej Schmidt, Dierk Scheinert
BACKGROUND: To evaluate the efficacy and safety of vascular closure devices(VCDs) in non-cardiac endovascular interventions. METHODS: Retrospective analysis of consecutive patients submitted to endovascular interventions, with deployment of 2327 vascular closure devices. Demographic, clinical/periprocedural, post-operative, complication and reintervention data were reviewed. RESULTS: 2107 patients (1409(66.9%) men) were included. Perclose ProGlide®(Abbott Vascular, CA,USA) was employed 1683 times(72...
November 23, 2016: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/27871587/peripheral-nerve-blocks-in-the-management-of-postoperative-pain-challenges-and-opportunities
#4
REVIEW
Girish Joshi, Kishor Gandhi, Nishant Shah, Jeff Gadsden, Shelby L Corman
Peripheral nerve blocks (PNBs) are increasingly used as a component of multimodal analgesia and may be administered as a single injection (sPNB) or continuous infusion via a perineural catheter (cPNB). We undertook a qualitative review focusing on sPNB and cPNB with regard to benefits, risks, and opportunities for optimizing patient care. Meta-analyses of randomized controlled trials have shown superior pain control and reductions in opioid consumption in patients receiving PNB compared with those receiving intravenous opioids in a variety of upper and lower extremity surgical procedures...
December 2016: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/27769571/complications-associated-with-radiofrequency-ablation-of-pulmonary-veins
#5
J M Madrid Pérez, P M García Barquín, A J Villanueva Marcos, J I García Bolao, G Bastarrika Alemañ
OBJECTIVE: Radiofrequency ablation is an efficacious alternative in patients with symptomatic atrial fibrillation who do not respond to or are intolerant to at least one class I or class III antiarrhythmic drug. Although radiofrequency ablation is a safe procedure, complications can occur. Depending on the location, these complications can be classified into those that affect the pulmonary veins themselves, cardiac complications, extracardiac intrathoracic complications, remote complications, and those that result from vascular access...
October 18, 2016: Radiología
https://www.readbyqxmd.com/read/27682594/long-term-outcome-after-application-of-the-angio-seal-vascular-closure-device-in-minipigs
#6
Lisa Kabelitz, Andrea Nonn, Kay W Nolte, Omid Nikoubashman, Ahmed Othman, Sarah Heringer, Martin Kramer, Martin Wiesmann, Marc A Brockmann
Minipigs are frequently used in (neuro-)interventional research. Longitudinal experiments may require repeated vessel access via the femoral artery. Anticoagulation and incompliance of the animals necessitates the use of a vascular closure device (VCD). The effects of the Angio-Seal VCD in minipigs were longitudinally assessed. Minipig (42±8.4 kg body weight) femoral arteries were sealed using the 8F (n = 6) or 6F (n = 7) Angio-Seal VCD. The pre-interventional femoral artery diameter was 5.1±0.4 mm (4.3-5...
2016: PloS One
https://www.readbyqxmd.com/read/27679537/off-label-use-of-the-angioseal-vascular-closure-device-for-femoral-arteriotomy-retrospective-analysis-of-safety-and-efficacy
#7
Sumedh S Shah, Giancarlo Perez, Brian M Snelling, Diogo C Haussen, Samir Sur, Ishna Sharma, Dileep R Yavagal, Mohamed Samy Elhammady, Eric C Peterson
BACKGROUND: Angioseal, an arteriotomy closure device (ACD), functions as a collagen plug that physically closes arteriotomy sites and can simultaneously induce platelet activation and aggregation. When used 'on-label', the safety and efficacy profile of Angioseal is superior compared with those of other ACDs. However, Angioseal is sometimes deployed in less than ideal situations. Therefore, we sought to assess the safety and efficacy of 'off-label' Angioseal use in patients undergoing femoral arteriotomies...
September 27, 2016: Journal of Neurointerventional Surgery
https://www.readbyqxmd.com/read/27678339/buttonhole-cannulation-of-the-av-fistula-a-critical-analysis-of-the-technique
#8
Pierpaolo Di Nicolò, Marina Cornacchiari, Marco Mereghetti, Anna Mudoni
As a consequence of the central role of the arteriovenous fistula for dialysis (AVF) in the clinical management of the dialysis patient the necessity to limit the puncture-related complications to extend as much as possible the life of the vascular access. Accordingly, the AVF needling technique has gained growing attention. Alongside the traditional rope ladder (RL) puncture method, the buttonhole technique (BH) is increasingly popular; this technique employs the same cannulation sites of AVF in every dialysis associated with the use of dull needles to minimize vessels damage...
September 27, 2016: Seminars in Dialysis
https://www.readbyqxmd.com/read/27659152/superficial-femoral-artery-access-for-transcatheter-aortic-valve-replacement
#9
Marco Gennari, Piero Trabattoni, Maurizio Roberto, Marco Agrifoglio
Different vascular accesses have been described for the delivery of a transcatheter aortic bioprosthesis. We report the use of the superficial femoral artery (SFA) as the arterial site of puncture with surgical cut-down. It may be a reasonable access alternative to the other classical routes, especially in the setting of either obese patients with elevated body mass index or in the presence of high femoral artery bifurcation. This route seems to be feasible with a low-profile risk.
September 22, 2016: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/27634206/transradial-versus-transfemoral-carotid-artery-stenting-a-16-year-single-center-experience
#10
Oscar A Mendiz, Carlos Fava, Gustavo Lev, Gaspar Caponi, León Valdivieso
AIMS: Limited data exist on radial access in carotid artery stenting (CAS). This single-center study was performed to compare the outcome and complication rates of transradial (TR) and transfemoral (TF) CAS. METHODS AND RESULTS: The clinical and angiographic data of 775 consecutive patients with high risk for carotid endarterectomy, treated between 1999 and 2016 by CAS with cerebral protection, were evaluated. Patients were divided into 2 groups according to vascular access: TR (n = 101; 13%) and TF (n = 674)...
December 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27514319/comparison-of-a-vascular-closure-device-versus-the-radial-approach-to-reduce-access-site-complications-in-non-st-segment-elevation-acute-coronary-syndrome-patients-the-angio-seal-versus-the-radial-approach-in-acute-coronary-syndrome-trial
#11
Pedro B Andrade, Luiz A Mattos, Fábio S Rinaldi, Igor C Bienert, Robson A Barbosa, André Labrunie, Marden Tebet, Vinícius Esteves, Alexandre Abizaid, Amanda R Sousa
OBJECTIVES: To compare the radial versus femoral approach using Angio-Seal for the incidence of access site complications among non-ST-segment elevation acute coronary syndrome patients undergoing invasive strategy. BACKGROUND: Arterial access is a major site of complications after invasive coronary procedures. Vascular closure devices provide more comfort to patients decreasing time to hemostasis and need for bed rest. However, the inconsistency of data proving their safety limits their routine adoption as a strategy to prevent vascular complications...
August 12, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27501604/comparing-the-success-rate-of-radial-artery-cannulation-under-ultrasound-guidance-and-palpation-technique-in-adults
#12
RANDOMIZED CONTROLLED TRIAL
Suwimon Tangwiwat, Walaiporn Pankla, Pranee Rushatamukayanunt, Pichaya Waitayawinyu, Trisana Soontrakom, Anchala Jirakulsawat
BACKGROUND: Previous studies have shown ultrasound guidance (USG)for arterial cannulation being advantageous compared to palpation technique, but little is known about its performance by novices. OBJECTIVE: This study was to compare the utility of USG radial artery cannulation with palpation technique in terms of success rate, real-time to placement, number of attempts and complications. MATERIAL AND METHOD: After IRB approval, a randomized prospective study was performed November 2009-October 2010...
May 2016: Journal of the Medical Association of Thailand, Chotmaihet Thangphaet
https://www.readbyqxmd.com/read/27430637/appropriate-hemostasis-by-routine-use-of-ultrasound-echo-guided-transfemoral-access-and-vascular-closure-devices-after-lower-extremity-percutaneous-revascularization
#13
Masahiko Fujihara, Yuichi Haramitsu, Kenji Ohshimo, Yuko Yazu, Eri Izumi, Akihiro Higashimori, Yoshiaki Yokoi
To assess the safety and efficacy of routine use of ultrasound-guided puncture and the use of vascular closure device (VCD) in patients undergoing endovascular therapy (EVT) through femoral access. This was a single-center, non-randomized clinical study that enrolled 513 patients undergoing EVT via femoral artery access in which hemostasis was achieved using VCDs (406-patient EXOSEAL arm and 107-patient PROGLIDE arm). All cases were performed by routine use of ultrasound-guided access. The primary endpoint was the achievement of hemostasis without periprocedural and 30-day incidence of major or minor access site-related complications...
July 18, 2016: Cardiovascular Intervention and Therapeutics
https://www.readbyqxmd.com/read/27356488/comparison-of-tr-band%C3%A2-and-vasostat%C3%A2-hemostasis-devices-following-transpedal-catheterization-for-lower-extremity-revascularization-for-peripheral-arterial-disease
#14
Tak W Kwan, Apurva Patel, Roosha Parikh, Uschi Auguste, Hugo Rosero, Yili Huang, Michael Liou, Justin Ratcliffe, Joseph Puma
BACKGROUND: Transpedal access is increasingly utilized for peripheral vascular catheterization. There is a paucity of data on the use of radial hemostasis devices as an alternative to manual compression for achievement of hemostasis after this approach. OBJECTIVE: To compare safety and efficacy of two hemostasis devices following transpedal catheterization for lower extremity revascularization for peripheral arterial disease. METHODS: A consecutive cohort of patients with bilateral Rutherford 2-5 disease who underwent transpedal catheterization for peripheral vascular interventions were retrospectively analyzed...
August 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27351417/vascular-puncture-site-complications-diagnosis-therapy-and-prognosis
#15
Wolfgang Mlekusch, Irene Mlekusch, Schila Sabeti-Sandor
The numbers of endovascular procedures have been noted to substantially increase over the past two decades. Besides all the technical advances and the increasing skills of more and more trained interventionists, the vascular access site still offers the possibilities and carries the risk of access site complications, which have not been changed dramatically over the past years. Guidelines on the vascular puncture procedure itself are lacking. Complications at different vascular access sites presentclinically different, require different diagnostic work up and therapy...
June 28, 2016: VASA. Zeitschrift Für Gefässkrankheiten
https://www.readbyqxmd.com/read/27333262/endovascular-placement-of-an-extraluminal-arterial-bypass-graft-in-vitro-feasibility-study
#16
Markus Zimmermann, Jochen Pfeffer, Hong-Sik Na, Martin Liebl, Maximilian Schulze-Hagen, Christiane K Kuhl, Peter Isfort, Philipp Bruners
PURPOSE: A novel approach for arterial bypass grafting using exclusively endovascular techniques was established in-vitro in a phantom model. MATERIAL AND METHODS: The experimental setting consisted of a gel-wax phantom with two embedded parallel fluid-filled silicon tubes simulating the superficial femoral vessels. Through an 8-French sheath, a re-entry catheter (OUTBACK(®), Cordis) was placed in the simulated artery and used to puncture the vascular wall. Then a 0...
June 22, 2016: Minimally Invasive Therapy & Allied Technologies: MITAT
https://www.readbyqxmd.com/read/27265645/routine-use-of-fluoroscopic-guided-femoral-arterial-puncture-to-minimise-vascular-complication-rates-in-cto-intervention-multi-centre-uk-experience
#17
Sarah L Fairley, Andrew J Lucking, Margaret McEntegart, Aadil Shaukat, David Smith, Alexander Chase, Colm G Hanratty, James C Spratt, Simon J Walsh
BACKGROUND: Chronic total occlusion (CTO) revascularisation has a crucial role in contemporary percutaneous coronary intervention (PCI). Procedural success is influenced by disease complexity, calcific burden and patient characteristics but has substantially improved with the implementation of novel hybrid strategies. However, vascular-access related complications remain a cause of morbidity and mortality. This study aimed to assess the effectiveness of fluoroscopic-guided femoral arterial puncture to minimise this risk during CTO PCI...
May 7, 2016: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/27218309/the-wise-radialist-s-guide-to-optimal-transfemoral-access-selection-performance-and-troubleshooting
#18
Lorenzo Azzalini, E Marc Jolicœur
Transradial access (TRA) has reduced vascular access-site complication (VASC) and bleeding rates in patients undergoing coronary angiography and intervention. A "radial-first" approach should be adopted and indications of TRA extended in order to maximize its beneficial effect. However, in certain clinical scenarios, transfemoral access (TFA) is a preferable or a mandatory route to successfully perform the procedure. Since the widespread adoption of TRA, a paradoxical increase in VASC rates has been observed in patients undergoing TFA, which might be attributed to a combination of increased risk profile of both the procedures and the patients, and a loss of skills in securing TFA by those who are now default radial operators...
May 24, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27122921/feasibility-and-safety-of-coronary-procedures-via-an-arteriovenous-graft-approach-in-patients-on-maintenance-hemodialysis
#19
Rye-Cheng Ko, Min-Tsun Liao, Lin Lin, Mu-Yang Hsieh, Pei-Shan Lin, Kuei-Chin Tsai, Chia-Lun Chao, Chih-Cheng Wu
BACKGROUND: Traditionally, a radial or brachial arterial approach is unadvisable in hemodialysis patients. Consequently, coronary angiography or angioplasty is usually performed via a femoral artery approach in these patients, who carry a higher risk of vascular access complications. In hemodialysis patients, arteriovenous grafts (AVG) are created for repeated punctures; however, the feasibility and safety of a trans-AVG approach for coronary angiography or angioplasty remains unclear...
November 2015: Acta Cardiologica Sinica
https://www.readbyqxmd.com/read/27076781/clinical-and-subclinical-femoral-vascular-complications-after-deployment-of-two-different-vascular-closure-devices-or-manual-compression-in-the-setting-of-coronary-intervention
#20
Hakan Yeni, Meissner Axel, Ahmet Örnek, Thomas Butz, Petra Maagh, Gunnar Plehn
BACKGROUND: In the past two decades vascular closure devices (VCD) have been increasingly utilized as an alternative to manual compression after percutaneous femoral artery access. However, there is a lack of data confirming a significant reduction of vascular complication in a routine interventional setting. Systematic assessment of puncture sites with ultrasound was hardly performed. METHODS: 620 consecutive patients undergoing elective or urgent percutaneous coronary intervention were randomly allocated to either Angioseal (AS; n = 210), or Starclose (SC; n = 196) or manual compression (MC; n = 214)...
2016: International Journal of Medical Sciences
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