• Title/Summary/Keyword: Catheters

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The Effects of Balloon-Guide Catheters on Outcomes after Mechanical Thrombectomy in Acute Ischemic Strokes : A Meta-Analysis

  • Ahn, Jun Hyong;Cho, Steve S.;Kim, Sung-Eun;Kim, Heung Cheol;Jeon, Jin Pyeong
    • Journal of Korean Neurosurgical Society
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    • v.62 no.4
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    • pp.389-397
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    • 2019
  • Objective : Mechanical thrombectomies with balloon-guide catheters (BGC) are thought to improve successful recanalization rates and to decrease the incidence of distal emboli compared to thrombectomies without BGC. We aimed to assess the effects of BGC on the outcomes of mechanical thrombectomy in acute ischemic strokes. Methods : Studies from PubMed, EMBASE, and the Cochrane library database from January 2010 to February 2018 were reviewed. Random effect model for meta-analysis was used. Analyses such as meta-regression and the "trim-and-fill" method were additionally carried out. Results : A total of seven articles involving 2223 patients were analyzed. Mechanical thrombectomy with BGC was associated with higher rates of successful recanalization (odds ratio [OR], 1.632; 95% confidence interval [CI], 1.293-2.059). BGC did not significantly decrease distal emboli, both before (OR, 0.404; 95% CI, 0.108-1.505) and after correcting for bias (adjusted OR, 1.165; 95% CI, 0.310-4.382). Good outcomes were observed more frequently in the BGC group (OR, 1.886; 95% CI, 1.564-2.273). Symptomatic intracranial hemorrhage and mortality did not differ significantly with BGC use. Conclusion : Our meta-analysis demonstrates that BGC enhance recanalization rates. However, BGC use did not decrease distal emboli after mechanical thrombectomies. This should be interpreted with caution due to possible publication bias and heterogeneity. Additional meta-analyses based on individual patient data are needed to clarify the role of BGC in mechanical thrombectomies.

Safety and Efficacy of Peripherally Inserted Central Catheters in Terminally Ill Cancer Patients: Single Institute Experience

  • Park, Kwonoh;Lim, Hyoung Gun;Hong, Ji Yeon;Song, Hunho
    • Journal of Hospice and Palliative Care
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    • v.17 no.3
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    • pp.179-184
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    • 2014
  • Purpose: We investigated the safety and efficacy of peripherally inserted central catheters (PICCs) in terminally ill cancer patients. Methods: A retrospective review was conducted on patients who underwent PICC at the hospice-palliative division of KEPCO (Korea Electric Power Corporation) Medical Center between January 2013 and December 2013. All PICCs were inserted by an interventional radiologist. Results: A total of 30 terminally ill cancer patients received the PICC procedure during the study period. Including one patient who had had two PICC insertions during the period, we analyzed a total of 31 episodes of catheterization and 571 PICC days. The median catheter life span was 14.0 days (range, 1~90 days). In 25 cases, catheters were maintained until the intended time (discharge, transfer, or death), while they were removed prematurely in six other cases (19%; 10.5/1000 PICC days). Thus, the catheter maintenance success rate was 81%. Of those six premature PICC removal cases, self-removal due to delirium occurred in four cases (13%; 7.0/1000 PICC days), and catheter-related blood stream infection and thrombosis were reported in one case, each (3%; 1.8/1000 PICC days). Complication cases totaled eight (26%; 14.1/1000 PICC days). The time to complication development ranged from two to 14 days and the median was seven days. There was no PICC complication-related death. Conclusion: Considering characteristics of terminally ill cancer patients, such as a poor general condition, vulnerability to trivial damage, and a limited period of survival, PICC could be a safe intravenous procedure.

Clinical Use of the Pace-maker in four cases (Pace-maker 사용 4예 경험)

  • 이성구
    • Journal of Chest Surgery
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    • v.13 no.3
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    • pp.219-228
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    • 1980
  • The heart block and bradyarrhythmia with or without Stokes-Adams attacks are serious, usually terminal events and the immediate mortality is very high. Stimulation with an artificial pacemaker is now an accepted form of treatment in cases of Stokes-Adams syndrome in which medication in unable to produce any lasting improvement. Permanent pacemaker therapy is indicated in these circumstances. The purpose of this report is to describe the successful use of pacemaker in 3 cases of Stokes-Adams syndromes and a case of sinoatrial block with bradyarrhythmia at the Department of Thoracic and Cardiovascular Surgery, Kyungpook National University School of Medicine. Electrode catheter was passed through the right external jugular vein and attached to the endocardial surface of the right ventricle. In case 1, fixed type generator was used at first and for the case 2, 3, 4, and case 1 at second, demand type generators were used. The bipolar electrode catheters were used for the three cases and unipolar electrode catheter for case 4. The results of immediate and late period were satisfactory.

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Risk Factors of Delirium Among the Patients at a Surgical Intensive Care Unit (일 종합병원 외과계 중환자실 환자의 섬망 발생 요인)

  • Chun, You Kyoung;Park, Jeong Yun
    • Journal of Korean Critical Care Nursing
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    • v.10 no.3
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    • pp.31-40
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    • 2017
  • Purpose : This study examined the prevalence of delirium-related factors in a surgical intensive care unit (SICU). Methods : This retrospective study enrolled 73 patients who were admitted to an SICU from October 1, 2016 to March 20, 2017 and who had been hospitalized for more than 72 hours. Data was collected by reviewing electronic medical records. Results : Delirium occurred in 46 (63.0%) patients. Its related factors were age, education, mechanical ventilator, sleep, narcotics, physical restraint, and central line catheters. Conclusion : The results indicate that sleep and physical restraint are significant factors related to delirium occurrence. The results of this study can help in developing guidelines for the prevention of delirium.

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Development of Intravascular Micro Active Endoscope(I) -Analysis of Lubrication Characteristics of Small Arteries with Micro Catheter Insertion- (혈관 삽입형 초소형 작동형 내시경의 개발(I) - 도뇨관 삽입시 혈관 내부의 윤활 특성 분석 -)

  • 장준근;김중경
    • Tribology and Lubricants
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    • v.15 no.3
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    • pp.272-277
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    • 1999
  • The objective of this investigation is to examine the influence of the micro catheters, which mimic the intravascular micro active endoscopes, on local pressure changes and flow rate in an arterial branch model similar to the femoral artery of human. The effects of branch to main lumen flow rate ratios and the locations of a catheter tip were found to be significant on the local pressure changes. Relatively large pressure drops and an increase in shear stress due to the obstruction effects may induce an endothelial cell damage and a change in arterial wall permeability, which have been reported to be the primary cause of the initiation of the atherosclerosis and other major vascular diseases.

Molecular Imaging of Stretch-Induced Tissue Factor Expression in Carotid Arteries with Intravascular Ultrasound

  • Park Byung-Rae
    • Biomedical Science Letters
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    • v.11 no.1
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    • pp.23-29
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    • 2005
  • Molecular imaging with targeted contrast agents enables tissues to be distinguished by detecting specific cell-surface receptors. In the present study, a ligand-targeted acoustic nanoparticle system is used to identify angioplasty-induced expression of tissue factor by smooth muscle cell within carotid arteries. Pig carotid arteries were overstretched with balloon catheters, treated with tissue factor-targeted or a control nanoparticle system, and imaged with intravascular ultrasound before and after treatment. Tissue factor-targeted emulsion bound and increased the echogenicity and gray-scale levels of overstretched smooth muscle cell within the tunica media, versus no change in contralateral control arteries. Expression of stretch-induced tissue factor in carotid artery media was confirmed by immunohistochemistry. The potential for abnormal thrombogenicity of balloon-injured arteries, as reflected by smooth muscle expression of tissue factor, was imaged using a novel, targeted, nanoparticulate ultrasonic contrast agent.

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Ultrasound-guided Continuous Axillary Brachial Plexus Block Using a Nerve Stimulating Catheter: EpiStim Catheter

  • Choi, Sang Sik;Lee, Mi Kyoung;Kim, Jung Eun;Kim, Se Hee;Yeo, Gwi Eun
    • The Korean Journal of Pain
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    • v.28 no.4
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    • pp.287-289
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    • 2015
  • Brachial plexus block (BPB) under ultrasound guidance has come to be widely used. However, nerve injury has been reported following ultrasound-guided BPB. We hypothesized that BPB under ultrasound guidance in conjunction with real-time electrical nerve stimulation would help us prevent nerve injury and do more successful procedure. Here, we report the successful induction and maintenance of ultrasound-guided BPB and the achievement of good peri- and postoperative pain control using a conductive catheter, the EpiStim$^{(R)}$.

Merit of Zone III Resuscitative Endovascular Occlusion of the Aorta under Real-Time Fluoroscopy in Hybrid ER: A Case of REBOA in Traumatic Cardiac Arrest

  • Lee, Sung Do;Chung, Seungwoo;Ki, Young Jun;Seo, Sang Hyun;Park, Chan Yong
    • Journal of Trauma and Injury
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    • v.33 no.3
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    • pp.191-194
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    • 2020
  • Resuscitative endovascular balloon occlusion of the aorta (REBOA) is a novel technique to maintain proximal arterial pressure. It is important to locate the balloon catheter correctly in performing REBOA but it is inaccurate to check the catheter position by external measurement. Even if the position of the catheter is initially confirmed by X-ray, it is difficult to determine the location of the catheter that changes according to various situations. We performed REBOA under real-time fluoroscopy and could maintain the catheter in correct position under various situations.

Anorectal Malformation - Postoperative Care and Functional Results - (항문직장기형 - 수술 후 관리 및 기능적 결과 -)

  • Kim, Jae-Chun
    • Advances in pediatric surgery
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    • v.12 no.1
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    • pp.115-125
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    • 2006
  • Postoperative management of anorectal malformation consists of colostomy management and then management after definitive surgery. Colostomy management requires attention to certain details, i. e. complete decompression of the distal limb to avoid secondary megarectosigmoid and prevention and treatment of urinary tract infections in patients with rectourethral fistula. Management after definitive surgery requires the care of catheters placed in the rectourethral fistula or cloacal defect. Prevention and treatment of various complications after definitive operation, i. e. wound infection, anal stenosis or stricture, anal mucosal prolapse, and management of functional disorders, i.e. constipation, fecal incontinence and urinary incontinence are also necessary. In this review, recent trends for the prevention and treatment of the above mentioned problems after operation for anorectal malformation are presented.

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Blood Flow Characteristics due to Catheter Insertion in the Eccentric Stenosed Coronary Artery (편심협착부가 있는 관상동맥내 카테터삽입에 따른 혈액유동특성)

  • Roh Hyung-Woon;Suh Sang-Ho;Kwon Hyuk-Moon;Lee Byung-Kwon
    • Proceedings of the KSME Conference
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    • 2002.08a
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    • pp.707-708
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    • 2002
  • Catheters are used to measure translesional pressure gradients in the stenosed coronary arteries. Catheter insertions during coronary angioplasty cause flow obstructions. A narrowed flow cross section with catheter present effectively introduced a tighter stenosis than the enlarged residual stenoses after balloon angiplasty. In general, the form of stenoses are no uniform. Sometimes, these are occurred the irregularly eccentricity If the analyses are conducted for uniform stenosed artery, the results will be underestimated. Thus, in this study, three dimensional computer simulations are conducted to investigate the flow blockage effects due to the catheter insertion during the coronary angioplasty. The results for the eccentric stenosed artery are compared with those of the concentric stenosed artery.

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