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vascular puncture site

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
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
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
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
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
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)...
September 16, 2016: Journal of Interventional Cardiology
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
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
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
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
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
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
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
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
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 Cardiol Sin
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
Xi-Le Bi, Xiang-Hua Fu, Xin-Shun Gu, Yan-Bo Wang, Wei Li, Li-Ye Wei, Yan-Ming Fan, Shi-Ru Bai
BACKGROUND: The risk of radial artery occlusion (RAO) needs particular attention in transradial intervention (TRI). Therefore, reducing vascular occlusion has an important clinical significance. The aim of this study was to determine the appropriate puncture site during TRI through comparing the occurrence of RAO between the different puncture sites to reduce the occurrence of RAO after TRI. METHODS: We prospectively assessed the occurrence of RAO in 606 consecutive patients undergoing TRI...
April 20, 2016: Chinese Medical Journal
R C Dettmers, W M P F Bosman, M A J van den Broek, H T C Veger, P Ph A Hedeman Joosten, B L S Borger van der Burg
PURPOSE: To show a complication of the use of an Angio-Seal™ closure device. CASE: We present a patient with a systolic murmur in his femoral artery after PCI. The murmur was caused by a dislocated Angio-Seal™, a vascular closure device. This was diagnosed by Doppler Ultrasound. The device was surgically removed. CONCLUSION: Vascular complications, such as lower limb ischemia, requiring surgical intervention tend to be higher after use of a vascular closure device...
2016: Open Cardiovascular Medicine Journal
Sofie Thorn, Nigopan Gopalasingam, Thomas Fichtner Bendtsen, Lars Knudsen, Erik Sloth
PURPOSE: Vein punctures are performed daily to sample blood. Ultrasound (US) offers an alternative to the blind landmark technique for difficult vascular access. A challenge for this procedure is the presence of US gel in the puncture area. We present a technique for US-guided puncture from extremity veins not palpable or visible to the human eye, while keeping the puncture area dry and gel-free. METHODS: Ten healthy volunteers underwent two US-guided vein punctures from veins that were neither palpable nor visible...
May 7, 2016: Journal of Vascular Access
Marcus R Kret, Ronald L Dalman, Jeffrey Kalish, Matthew Mell
OBJECTIVE: Factors influencing risk for brachial access site complications after peripheral vascular intervention are poorly understood. We queried the Society for Vascular Surgery Vascular Quality Initiative to identify unique demographic and technical risks for such complications. METHODS: The Vascular Quality Initiative peripheral vascular intervention data files from years 2010 to 2014 were analyzed to compare puncture site complication rates and associations encountered with either brachial or femoral arterial access for peripheral vascular intervention...
July 2016: Journal of Vascular Surgery
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