Clinical predictors of successful thrombectomy with the Export(R) aspiration catheter in the acute phase of myocardial infarction. Data from the RICO survey working group.
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Use of the venture wire-control catheter for accessing side branches during provisional stenting: an option for bifurcations with an unfavorable anatomy.
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We report our experience with the Venture wire-control catheter in 20 patients with bifurcation lesions in which it was impossible to access the side branch using conventional techniques. This device was always used as a last resort and was employed during different stages in the treatment of the bifurcation lesions (i.e. initially, after stenting of the main vessel or both). In 17 patients (85%), use of the Venture catheter resulted in the success of the procedure. Only one complication associated with a monorail catheter was recorded. It was resolved successfully. One patient died from heart failure 10 days after the procedure and two patients, in whom it was impossible to access the side branch, had non-Q-wave myocardial infarctions. In conclusion, the Venture catheter was effective and safe, and enabled the side branches of complex bifurcation lesions to be accessed. (+info)
Severe aseptic orbital cellulitis with subtenon carboplatin for intraocular retinoblastoma.
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Retinoblastoma is a rare intraocular tumor of childhood. Chemoreduction followed by laser or cryotherapy is the treatment of choice. Subtenon carboplatin injection is also an accepted treatment modality for vitreous seeds, along with systemic chemotherapy. Transient periocular edema, optic neuropathy and fibrosis of orbital tissues are the known side effects of subteneon carboplatin injection. We report a case of severe aseptic orbital cellulitis with necrosis and prolapse of the conjunctiva 48 h after the injection, which resolved well on only conservative management. (+info)
The approach to the difficult urethral catheterization among urology residents in the United States.
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PURPOSE: To determine the prevalence of different approaches to the difficult urethral catheterization (DUC) among urology residents (UR) in the United States (US). MATERIALS AND METHODS: An email invitation to participate in an online survey regarding DUC was sent to 267 UR and to 22 urology program coordinators for them to forward to their residents. 142 UR completed the survey. RESULTS: After the initial unsuccessful attempt by a nurse, 92% of UR attempted a catheter prior to resorting to other modalities. The most common choice of the first catheter was a Coude (76%) size 18F (51%). For situations where multiple sizes and types of catheters (12-20F) were used without success, 3 scenarios were proposed: 1) Catheter passed the bulbomembranous urethra (BMU) and patient had previous history of transurethral resection of the prostate or radical retropubic prostatectomy, 2) Catheter passed the BMU and no urologic history, 3) Catheter did not pass the BMU and no urologic history. Flexible cystoscopy was used in 74%, 62% and 63%; blind passage of a glidewire was second with 15%, 23% and 20%; and blind use of filiforms and followers was chosen in 7%, 9% and 9% of the scenarios respectively. CONCLUSIONS: The most common approach to the DUC among UR in the US involves using an 18F Coude catheter first. After trying one or more urethral catheters, UR most commonly resort to flexible cystoscopy as opposed to the blind placement of glide wires or filiforms/followers. (+info)
Guardian ad litem, a potentially expensive invitation to either the mismanagement or management of patients with cognitive disorders.
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Novel use of the Heartrail catheter as a thrombectomy device.
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The presence of thrombus is independently associated with adverse outcomes during percutaneous coronary intervention (PCI), particularly in those cases involving a large thrombus burden such as in saphenous vein grafts (SVGs) or during primary PCI. Mechanical thrombectomy devices are used to reduce the thrombus burden in such high-risk procedures to reduce the risk of distal embolization and slow flow and no-reflow. Here we describe 3 cases of successful use of a stent delivery system with a wide-bore lumen, the "five-in-six" Heartrail catheter, as a thrombectomy device in SVG lesions and primary PCI following failure of conventional simple aspiration thrombectomy catheters. (+info)
Novel use of a local drug delivery catheter for coronary perforation.
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Coronary perforation is a complication of percutaneous coronary intervention that may be fatal. Conventionally, a perfusion balloon catheter is used for treatment, but may not always be available. We report a case in which bleeding due to coronary perforation was successfully treated without induction of ischemia using a local drug delivery catheter as a perfusion device. (+info)