Time to hemostasis after traction removal of tunneled cuffed central venous catheters.

Purpose: Many patients undergo placement of tunneled cuffed central venous catheters (TCCVCs) for indications including administration of medical therapy and hemodialysis. They are removed when no longer needed or if there is a device complication. There is no consensus regarding the necessity of routine preremoval coagulation studies or platelet count, so this study was performed to determine if abnormal coagulation status affects the time to hemostasis (TH) after traction removal of TCCVCs.

Renal interventions after abdominal aortic aneurysm repair using an aortic endograft with suprarenal fixation.

Background: Our aim was to determine whether suprarenal fixation in endografts compromises renal artery (RA) flow and whether subsequent RA intervention is precluded by the stent struts.

Methods: Prospectively acquired data from 104 patients with endovascular aneurysm repair (EVAR) of an abdominal aortic aneurysm using the Zenith endograft (Cook, Inc., Bloomington, IN) were analyzed.

Severe thrombocytopenia due to hypersplenism successfully treated with partial splenic embolization in preoperative management.

Hypersplenism is a known complication of portal hypertension secondary to cirrhosis of the liver. Although thrombocytopenia secondary to hypersplenism does not cause clinically significant hemostatic defect, it may need to be addressed in selective circumstances, such as preoperative preparation for a surgery. This report describes a 30-year-old male with a history of cirrhosis of the liver and hypersplenism who had a recurrence of craniopharyngioma.

Suspected acute pulmonary embolism: evaluation with multi-detector row CT versus digital subtraction pulmonary arteriography.

Purpose: To determine diagnostic accuracy of four-channel multi-detector row computed tomography (CT) in emergency room and inpatient populations suspected of having acute pulmonary embolism (PE) who prospectively underwent both CT and pulmonary arteriography (PA).

Materials And Methods: Patients referred for PA to assess suspected PE were eligible. Institutional review board approval and written informed consent were obtained.

Embolization of large gastric varices using vena cava filter and coils.

A 40-year-old male with alcoholic cirrhosis and portal hypertension presented with acute variceal hemorrhage. Abdominal CT scan and endoscopy revealed large gastric varices. The patient underwent a TIPS procedure.

Management of catheter-induced venous thrombosis.

Catheter-induced venous thrombosis remains a significant problem in current clinical practice. A high level of biocompatibility of the materials used to manufacture the existing venous access devices has not eliminated catheter-induced venous thrombosis. Similarly, catheter bonding with anticoagulants or their systemic use, while in some instances having a favorable effect on the incidence, has not eliminated this problem.

Randomized comparison of split tip versus step tip high-flow hemodialysis catheters.

Background: Our purpose was to compare the function and complications of two high-flow polyurethane hemodialysis catheters.

Methods: This prospective, randomized trial compared the Ash-Split (MedComp) and Opti-Flow (Bard Access Systems) catheters. All patients referred for tunneled hemodialysis catheter placement were offered entry in the study, provided they met inclusion criteria.

Use of balloon-expandable stents in transjugular intrahepatic portosystemic shunts in cases of Wallstent endoprosthesis technical failure and revision of shunt stenosis.

Thirteen patients underwent placement of a balloon-expandable stent either at initial transjugular intrahepatic portosystemic shunt (TIPS) creation (n = 3) because of immediate technical failure of the Wallstent or at shunt revision because of failure of the Wallstent to reduce the portosystemic gradient View Article and Find Full Text PDF

Percutaneous imaging-guided access for the treatment of calculi in continent urinary reservoirs.

Purpose: To describe our long-term experience with percutaneous access to continent urinary reservoirs for calculus removal.

Patients And Methods: A retrospective study of 13 procedures in 10 patients was performed. In 2 of the 13 procedures, access and calculus removal was performed in a single session.