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Radial access

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https://www.readbyqxmd.com/read/29455879/transient-and-regional-ischemia-related-to-continuous-saline-solution-infusion-during-radial-artery-access
#1
Nicholas Xiao, Jonathan Lindquist, Robert L Vogelzang
This case series illustrates a radial access complication seen in 7 of 9 consecutive patients (age range, 44-53 y) undergoing uterine artery embolization in May and June 2017. Demonstrative images and videos identify a transient and clinically consequential skin ischemia caused by intraprocedural saline solution infusion through the occlusive radial artery sheath. All complications documented were classified as mild adverse events (class A) according to Society of Interventional Radiology criteria. Complication severity ranged from transient blanching to ischemic necrosis of the skin...
March 2018: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29452835/a-comparison-of-preoperative-and-intraoperative-vein-mapping-sizes-for-arteriovenous-fistula-creation
#2
Samuel H Hui, Ryan Folsom, Lois A Killewich, Joel E Michalek, Mark G Davies, Lori L Pounds
BACKGROUND: Duplex ultrasound (DUS) mapping of the veins and arteries of the upper extremity is a well-established practice in arteriovenous fistula creation for long-term hemodialysis access. Previous publications have shown that vein diameters varying from 2 to 3 mm are predictive of success. Regional anesthesia is known to result in vasodilation and thus to increase the diameter of upper extremity veins. This study compares the sizes of veins measured by preoperative DUS mapping with those obtained after regional anesthesia to determine whether intraoperative DUS results in increased vein diameters and thus changes in the operative plan...
February 13, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29451949/impact-of-sheath-size-and-hemostasis-time-on-radial-artery-patency-after-transradial-coronary-angiography-and-intervention-in-japanese-and-non-japanese-patients-a-substudy-from-rap-and-beat-radial-artery-patency-and-bleeding-efficacy-adverse-event-randomized
#3
Adel Aminian, Shigeru Saito, Akihiko Takahashi, Ivo Bernat, Robert Lee Jobe, Takashi Kajiya, Ian C Gilchrist, Yves Louvard, Ferdinand Kiemeneij, Niels van Royen, Maarten van Leeuwen, Seiji Yamazaki, Takashi Matsukage, Juan F Iglesias, Sunil V Rao
BACKGROUND: During transradial (TR) access, it remains unclear whether differences in baseline patients characteristics and hemostasis care impact the rate of radial artery occlusion (RAO). We sought to compare the rate of RAO after TR access with the 6 French(Fr) Glidesheath Slender (GSS6Fr, Terumo, Japan) or a standard 5 Fr sheath in Japanese and non-Japanese patients. METHODS AND RESULTS: The Radial Artery Patency and Bleeding, Efficacy, Adverse evenT (RAP and BEAT) trial randomized 1,836 patients undergoing TR coronary angiography and/or interventions to receive the GSS6Fr or the standard 5 Fr Glidesheath (GS5Fr, Terumo, Japan)...
February 16, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29449273/novel-patient-centered-approach-to-facilitate-same-day-discharge-in-patients-undergoing-elective-percutaneous-coronary-intervention
#4
Amit P Amin, Patricia Crimmins-Reda, Samantha Miller, Brandon Rahn, Mary Caruso, Andrew Pierce, Brandy Dennis, Marissa Pendegraft, Katrine Sorensen, Howard I Kurz, John M Lasala, Alan Zajarias, Richard G Bach, Hemant Kulkarni, Jasvindar Singh
BACKGROUND: Same-day discharge (SDD) after elective percutaneous coronary intervention is safe, less costly, and preferred by patients, but it is usually performed in low-risk patients, if at all. To increase the appropriate use of SDD in more complex patients, we implemented a "patient-centered" protocol based on risk of complications at Barnes-Jewish Hospital. METHODS AND RESULTS: Our objectives were as follows: (1) to evaluate time trends in SDD; (2) to compare (a) mortality, bleeding, and acute kidney injury, (b) patient satisfaction, and (c) hospital costs by SDD versus no SDD (NSDD); and (3) to compare SDD eligibility by our patient-centered approach versus Society for Cardiovascular Angiography and Interventions guidelines...
February 15, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29435640/feasibility-and-safety-of-outpatient-cardiac-catheterization-with-intracoronary-acetylcholine-provocation-test
#5
Yuichi Saito, Hideki Kitahara, Toshihiro Shoji, Satoshi Tokimasa, Takashi Nakayama, Kazumasa Sugimoto, Yoshihide Fujimoto, Yoshio Kobayashi
Intracoronary acetylcholine (ACh) provocation test is useful to diagnose vasospastic angina. Although outpatient coronary angiography has been widely performed in current clinical settings, the feasibility and safety of ACh provocation test in outpatient services are unclear. A total of 323 patients, who electively underwent ACh provocation test in hospitalization and outpatient services, were included. Coronary angiography was performed after insertion of a temporary pacing electrode in the right ventricle...
February 12, 2018: Heart and Vessels
https://www.readbyqxmd.com/read/29424185/predictors-of-early-failure-and-secondary-patency-in-native-arteriovenous-fistulas-for-hemodialysis
#6
Rui Abreu, Sara Rioja, Joaquin Vallespin, Xavier Vinuesa, Ruben Iglesias, Jose Ibeas
BACKGROUND: Native arteriovenous fistula (AVF) is considered the gold standard of vascular access for hemodialysis due to its longer survival, fewer complications, lower mortality and costs. Patency is important for effective dialysis treatment and this remains a challenge in nephrology. There are no well-defined prognostic factors for early and long-term AVF survival. The aim of this study was to evaluate comorbidity, analytical and ultrasound (US) variables as prognostic factors for early failure and AVF patency...
February 8, 2018: International Angiology: a Journal of the International Union of Angiology
https://www.readbyqxmd.com/read/29421003/determinants-of-radiation-dose-during-right-transradial-access-insights-from-the-rad-matrix-study
#7
Alessandro Sciahbasi, Enrico Frigoli, Alessandro Sarandrea, Paolo Calabrò, Paolo Rubartelli, Bernardo Cortese, Francesco Tomassini, Dennis Zavalloni, Matteo Tebaldi, Paolo Calabria, Stefano Rigattieri, Antonio Zingarelli, Gennaro Sardella, Alessandro Lupi, Martina Rothenbühler, Dik Heg, Marco Valgimigli
BACKGROUND: The RAD-MATRIX trial reported a large operator radiation exposure variability in right radial percutaneous coronary procedures. The reasons of these differences are not well understood. Our aim was to appraise the determinants of operator radiation exposure during coronary right transradial procedures. METHODS: Patient arrangement during transradial intervention was investigated across operators involved in the RAD-MATRIX trial. Operator radiation exposure was analyzed according to the position of the patient right arm (close or far from the body) and in relation to the size of the upper leaded glass...
February 2018: American Heart Journal
https://www.readbyqxmd.com/read/29412084/fiber-reinforced-origamic-robotic-actuator
#8
Juan Yi, Xiaojiao Chen, Chaoyang Song, Zheng Wang
A novel pneumatic soft linear actuator Fiber-reinforced Origamic Robotic Actuator (FORA) is proposed with significant improvements on the popular McKibben-type actuators, offering nearly doubled motion range, substantially improved force profile, and significantly lower actuation pressure. The desirable feature set is made possible by a novel soft origamic chamber that expands radially while contracts axially when pressurized. Combining this new origamic chamber with a reinforcing fiber mesh, FORA generates very high traction force (over 150N) and very large contractile motion (over 50%) at very low input pressure (100 kPa)...
February 2018: Soft Robotics
https://www.readbyqxmd.com/read/29397275/rotation-covariant-tissue-analysis-for-interstitial-lung-diseases-using-learned-steerable-filters-performance-evaluation-and-relevance-for-diagnostic-aid
#9
Ranveer Joyseeree, Henning Müller, Adrien Depeursinge
A novel method to detect and classify several classes of diseased and healthy lung tissue of interstitial lung diseases is presented, as these diseases are hard to diagnose and differentiate. Local organizations of image directions at several scales drive the process of creating discriminative lung tissue texture signatures using spatial and Fourier domain information extracted from the images. The signatures are generated for four diseased tissue classes and healthy tissue, all of which appear in the Interstitial Lung Disease (ILD) database, using a novel one-versus-one approach for learning discriminative filter signatures...
January 11, 2018: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
https://www.readbyqxmd.com/read/29393606/choice-of-vascular-access-in-primary-pci
#10
Francesco Tomassini, Fabio Tarantino, Enrico Cerrato, Giorgio Quadri, Cristina Rolfo, Ferdinando Varbella
Primary angioplasty (PPCI), introduced in the early '90s, has now become the preferred reperfusion strategy in ST-segment elevation myocardial infarction (STEMI). PPCI has traditionally been performed through transfemoral artery access (TFA) for about two decades. Such an access, however, has been associated to a not negligible rate of vascular complications and bleedings that, in turn, may significantly affect the overall prognosis. For this reason, transradial artery access (TRA), introduced by Campeau and coll...
February 1, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29388387/safety-and-efficacy-of-ulnar-artery-approach-for-percutaneous-cardiac-catheterization-systematic-review-and-meta-analysis
#11
Ritin Fernandez, Fady Zaky, Avedis Ekmejian, Elizabeth Curtis, Astin Lee
BACKGROUND: Trans-radial access has rapidly become the standard for percutaneous coronary procedures in the last decade. As proceduralists overcome the learning curve and become more competent in trans-radial access, alternative safe access sites such as the ulnar artery have been increasingly used for emergent and elective procedures. The aim of this study was to synthesize the best available evidence of the impact on major adverse cardiac events (MACE) of ulnar artery compared to radial artery cardiac catheterization...
February 1, 2018: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/29354461/endoscopic-ganglionectomy-of-the-volar-radial-wrist-ganglion
#12
Tun Hing Lui
Volar ganglion cyst of the wrist is a common hand problem faced by orthopaedic surgeons. Excision is indicated if it is painful. Arthroscopic ganglionectomy of the wrist ganglion has been reported with the advantage of minimally invasive surgery. Most of them involve elimination of the valvular mechanism and internal drainage of the ganglion fluid to the wrist joint. The access of the ganglion sac is limited especially for a multiloculated cyst. The purpose of this Technical Note is to report the technique of endoscopic resection of the volar radial wrist ganglion...
October 2017: Arthroscopy Techniques
https://www.readbyqxmd.com/read/29343617/methods-to-determine-the-silicone-oil-layer-thickness-in-sprayed-on-siliconized-syringes
#13
Viviane Loosli, Oliver Germershaus, Henrik Steinberg, Sascha Dreher, Ulla Grauschopf, Stefanie Funke
The silicone lubricant layer in prefilled syringes (PFS) has been investigated with regards to siliconization process performance, PFS functionality and drug product attributes such as subvisible particle levels in several studies in the past. However, adequate methods to characterize the silicone oil layer thickness and -distribution are limited and systematic evaluation is missing. In this study, white light interferometry (WLI) was evaluated to close this gap in method understanding. WLI demonstrated a good accuracy of 93-99 % for MgF2 coated, curved standards covering a thickness range of 115-473 nm...
January 17, 2018: PDA Journal of Pharmaceutical Science and Technology
https://www.readbyqxmd.com/read/29340223/yabby3-orthologous-genes-in-wild-tomato-species-structure-variability-and-expression
#14
M A Filyushin, M A Slugina, A V Shchennikova, E Z Kochieva
Evolution of the genes encoding YABBY transcription factors is believed to be one of the key reasons for flat leaf emergence from the radially symmetrical stem and gynoecium diversity. YABBY genes determine the identity of the abaxial surface of all aboveground lateral organs in seed plants. In the present study, complete sequences of YABBY3-orthologous genes were identified and characterized in 13 accessions of cultivated and wild tomato species with diverse morphophysiology of leaves, flowers, and fruits...
October 2017: Acta Naturae
https://www.readbyqxmd.com/read/29339166/anticoagulation-in-acute-coronary-syndrome-state-of-the-art
#15
REVIEW
Michel Zeitouni, Mathieu Kerneis, Tarek Nafee, Jean-Philippe Collet, Johanne Silvain, Gilles Montalescot
Early intravenous anticoagulation is the corner stone treatment of patients admitted with an acute coronary syndrome: it antagonizes the ongoing coronary thrombosis and facilitates the percutaneous coronary intervention, hence a reduction of mortality and acute stent thrombosis. Unfractionated heparin, enoxaparin, bivalirudin and fondaparinux have been extensively studied in large randomized control trials and meta-analyses with the same objective: reducing the ischemic burden without hiking hemorrhagic events...
January 12, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29335385/a-transradial-approach-of-cardiac-catheterization-for-patients-on-dialysis
#16
Toshiki Kuno, Keita Hirano, Syohei Imaeda, Kenji Hashimoto, Toshinobu Ryuzaki, Tetsuya Saito, Hiroyuki Yamazaki, Ryota Tabei, Masaki Kodaira, Yohei Numasawa
BACKGROUND: Periprocedural bleeding is associated with increased risk of early mortality during percutaneous coronary intervention (PCI), especially in patients on dialysis. A transradial approach (TRA) should be considered for these patients; however, PCI operators avoid this approach because of the risk of radial artery occlusion (RAO). The aim of this study is to construct a TRA system and clarify its safety in patients on dialysis. METHODS: Eighty-eight consecutive patients on dialysis who underwent cardiac catheterization were prospectively included in this study and divided according to the access site into either the TRA group or the transfemoral approach (TFA) group...
January 15, 2018: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29329225/optical-fiber-demodulation-system-with-high-performance-for-assessing-fretting-damage-of-steam-generator-tubes
#17
Peijian Huang, Ning Wang, Junying Li, Yong Zhu, Jie Zhang, Zhide Xi
In order to access the fretting damage of the steam generator tube (SGT), a fast fiber Fabry-Perot (F-P) non-scanning correlation demodulation system based on a super luminescent light emitting diode (SLED) was performed. By demodulating the light signal coming out from the F-P force sensor, the radial collision force between the SGT and the tube support plate (TSP) was interrogated. For higher demodulation accuracy, the effects of the center wavelength, bandwidth, and spectrum noise of SLED were discussed in detail...
January 12, 2018: Sensors
https://www.readbyqxmd.com/read/29327566/upper-extremity-access-options-for-complex-endovascular-aortic-interventions
#18
Kedar S Lavingia, Anahita Dua, Jordan R Stern
The advancement of endovascular therapy has led to minimally invasive solutions to increasingly complex aortic pathology, including thoracoabdominal aneurysms and those involving the visceral segment. Upper extremity access is beneficial in a variety of these complex interventions, and may be absolutely required for certain procedures such as placement of parallel chimney grafts. Traditionally, the brachial artery has been the primary access site on the arm, using either a percutaneous or open approach. Brachial access is safe and effective, and remains suitable for the majority of clinical situations...
January 9, 2018: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/29315802/radial-versus-femoral-approach-for-same-day-inter-facility-transfer-for-percutaneous-coronary-intervention
#19
Zeev Israeli, Shahar Lavi, Olivier F Bertand, Mamas A Mamas, Rodrigo Bagur
BACKGROUND: The use of radial approach for coronary angiography, followed by same-day inter-facility transfer for percutaneous coronary intervention (PCI) has not yet been evaluated. OBJECTIVES: We sought to assess the safety and feasibility of using the transradial as compared to the transfemoral approach in patients undergoing diagnostic angiogram with same-day transfer to a PCI facility. METHODS: Patients that underwent diagnostic coronary angiography between January 2011 and June 2017 in a referring facility, and were transferred for same-day PCI were included...
January 8, 2018: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/29314640/patient-preference-an-important-emerging-factor-in-operator-access-site-selection
#20
EDITORIAL
Arka Chatterjee, William B Hillegass
Patient preference should emerge as a third component influencing radial versus femoral access for cardiac catheterization. Ideally dually experienced "switch-operators" will consider co-morbidities, technical procedural factors, and patient preferences to choose a tailored approach with each patient. A tailored and tempered three component approach to access selection which includes patient preferences will likely optimize patient-centered outcomes.
January 1, 2018: Catheterization and Cardiovascular Interventions
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