Prospective evaluation of efficacy and safety of distal radial and radial artery access using a novel articulating-tip guidewire.

Background: Guidewire-facilitated access to peripheral vessels is commonplace in vascular access, but guidewire insertion into small vessels, such as the radial and distal radial arteries, can still be challenging. Failure to gain access on the first attempt may contribute to increased risks of procedural complications, such as vessel dissection, spasm, and occlusion. This research assessed the safety and efficacy of radial and distal radial artery access using a novel, FDA-cleared, small-core-diameter guidewire with an articulating tip, under ultrasound guidance.

Pressure-Induced Fibroid Ischemia: First-In-Human Experience with a Novel Device for Laparoscopic Treatment of Symptomatic Uterine Fibroids.

The purpose of this study was to assess the feasibility of use of a novel uterine fibroid treatment device hypothesized to cause fibroid infarction by increasing intra-tumoral pressure. Between August 2019 and January 2020, 21 uterine fibroids were treated in 16 symptomatic pre-menopausal black women. Pelvic magnetic resonance imaging was performed before the procedure, a day after the procedure and at 1, 3, 6, and 12 months.

Initial Clinical Experience with a Symmetric Tip Tunneled Hemodialysis Catheter Without Side Holes.

The purpose of this article is to assess the performance and safety of a novel, symmetric, side-hole-free tunneled cuffed catheter hypothesized to sustain adequate flow without the need for side holes. Between November 2016 and January 2019, Pristine hemodialysis catheters were placed de novo in 45 end-stage renal disease patients (27 males and 18 females) at a single investigational site. Forty-one catheters were placed in the right and four in the left internal jugular vein.

Catheter-related blood stream infection in hemodialysis patients with symmetric tunneled non-side-hole hemodialysis catheters.

Background: Tunneled hemodialysis catheter-related bloodstream infection is a major cause of morbidity and mortality in end-stage renal disease patients. Side holes positioned near the tip of catheters have been linked to formation of thrombi, which, in turn, have been implicated in predisposition to infection. In addition, side holes allow spillage of catheter locking solution, including antibiotics, thereby minimizing the lock solution's effect on the catheter tip.

accumulation at the tip of hemodialysis catheters with or without tip side holes in catheter related bloodstream infection in a large animal.

Background: Eighty percent of hemodialysis patients start their dialysis with a tunneled hemodialysis catheter. Catheter related bacteremia is the second most common cause of death in these patients. Side holes near the tips of the tunneled cuffed central venous catheters are associated with accumulation of thrombus, which can lead to catheter dysfunction and, possibly, also to catheter-related infection.

Clot accumulation at the tip of hemodialysis catheters in a large animal model.

Background: The issue of side holes in the tips of the tunneled cuffed central venous catheters is complex and has been subject to longstanding debate. This study sought to compare the clotting potential of the side-hole-free Pristine hemodialysis catheter with that of a symmetric catheter with side holes.

Methods: Both jugular veins of five goats were catheterized with the two different catheters.

A randomized comparison of a novel nitinol-frame low-dose-copper intrauterine contraceptive and a copper T380S intrauterine contraceptive.

Objective: We sought to compare VeraCept (VC175), a novel nitinol intrauterine contraceptive (IUC) with 175 square-mm of copper surface area, to a copper T380S IUC.

Study Design: We enrolled parous women into a randomized subject-blinded comparison of VC175 and a copper T380S in a 2:1 fashion at a single clinic. The primary outcomes were total adverse events and continuation at 12 months.

Histologic findings after mechanochemical ablation in a caprine model with use of ClariVein.

Objective: The use of foam and liquid sclerotherapy for the treatment of varicose veins and underlying venous reflux is widespread. A novel device, the ClariVein Occlusion Catheter (Vascular Insights LLC, Madison, Conn), has been the subject of several clinical trials in humans. We report the initial histologic results obtained with use of the device in a caprine vein model.

Power injection of iodinated intravenous contrast material through acute and chronic hemodialysis catheters.

Purpose: End-stage renal disease patients with hemodialysis catheters in need of contrast enhanced imaging studies often have limited peripheral venous access. In this study we aimed to determine pressures generated in hemodialysis catheters during power injection of computed tomography (CT) contrast media.

Methods: Three different chronic hemodialysis catheters and two acute hemodialysis catheters were included in this study.

Previous PICC placement may be associated with catheter-related infections in hemodialysis patients.

Background: Catheter-related infections (CRIs) are a significant source of morbidity and mortality in hemodialysis patients. The identification of novel, modifiable risk factors for CRIs may lead to improved outcomes in this population. Peripherally inserted central catheters (PICCs) have been hypothesized to compromise vascular access due to vascular damage and venous thrombosis, whereas venous thrombosis has been linked to the development of CRIs.

VenaTrac™ device for over-the-wire placement of chronic dialysis catheters.

Purpose: The VenaTrac™ is designed for exchange and primary placement of chronic tunneled hemodialysis catheters over a wire. It occludes both lumens of the catheter for the purpose of reducing the risk of air embolism and blood loss. The purpose of this paper is to report our experience with the use of this device.

Type 2 diabetes: Microvascular ischemia of pancreatic islets?

Hyperglycemia is a key factor in both beta cell death and dysfunction as well as in development of microvascular disease. The hypothesis described in this paper suggests that pancreatic microvascular endothelial dysfunction and subsequent microvascular disease of the pancreas causes islet ischemia. This subtle ischemia is the cause of initial dysfunction and subsequent apoptosis of B cells which is preceding development of type 2 diabetes.

Comparison of four embolic materials at uterine artery embolization by using postprocedural MR imaging enhancement.

Purpose: To test the hypothesis that not all embolic materials are equivalent by using postprocedural magnetic resonance (MR) imaging enhancement of uterine fibroids in patients treated with uterine artery embolization (UAE).

Materials And Methods: Approval and a waiver of consent from the institutional human investigations committee was received for this study. The study was HIPAA compliant.

Selecting optimal hemodialysis catheters: material, design, advanced features, and preferences.

Hemodialysis catheters are a necessary evil. They provide an immediate and effective lifeline for hemodialysis patients, and their use is steadily increasing. This increasingly important role has lead to the development of many generations of dialysis catheters.

Clinical outcome of the Tal Palindrome chronic hemodialysis catheter: single institution experience.

Purpose: To report the authors' clinical experience with the Tal Palindrome chronic dialysis catheter with a symmetric tip.

Materials And Methods: During a 39-month period, 126 Palindrome catheters were placed consecutively in 85 patients. Follow-up was available for 115 catheters.

Comparison of MRI outcomes of uterine artery embolization for uterine leiomyoma using tris-acryl gelatin microspheres, polyvinyl alcohol spheres, and polyvinyl alcohol particles.

Objective: Comparison of recurrence of magnetic resonance imaging (MRI) enhancement of uterine fibroids treated with uterine artery embolization (UAE) among embolic agents: polyvinyl alcohol (PVA), spherical PVA (SPVA), and tris-acryl gelatin microspheres (GM).

Methods: Pre/post-UAE gadolinium-enhanced MRIs were evaluated for residual enhancement of fibroids after UAE. Data were analyzed using 2-tail Fisher exact test to determine the likelihood of recurrence of enhancement post-UAE among embolic agents.

Fibroid volume, location and symptoms in women undergoing uterine artery embolization: does size or position matter?

Objective: To investigate the relationship between MRI-determined uterine fibroid size and their location, and fibroid-related symptoms, including quality of life and sexual function, in women with symptomatic fibroids before uterine artery embolization (UAE).

Materials And Methods: Forty-six women underwent pelvic MRI within four weeks prior to UAE. The MRIs were analyzed and fibroid size and fibroid location were recorded.

Fibroid-induced acute urinary retention: treatment by uterine artery embolization.

A 39-year-old gravida 2 para 2 woman presented to our Hospital's Emergency Department with complaints of difficulty voiding. She had an enlarged leiomyomatous uterus, for which she was not receiving any current treatment. A Foley catheter placed yielded 1,500 cc of clear yellow urine; however, the patient remained Foley-dependent for 2 weeks until she underwent uterine artery embolization (UAE).

Three-dimensional anatomy of the left central veins: implications for dialysis catheter placement.

Purpose: To define the three-dimensional anatomy of the left central veins and the implication for left-sided dialysis catheter placement.

Materials And Methods: Images from 30 consecutive patients undergoing computed tomography (CT) pulmonary angiography were reconstructed to depict the central venous anatomy. The reconstructed images were analyzed for parameters that could influence dialysis catheter placement.

Comparison of side hole versus non side hole high flow hemodialysis catheters.

Current literature suggests that side holes may be detrimental to dialysis catheter performance. Today, these catheters are primarily available with side holes. The purpose of this study was to compare flow rates, infection rate, and survival of side hole vs.

Comparison of recirculation percentage of the palindrome catheter and standard hemodialysis catheters in a swine model.

Purpose: The purpose of this study was to evaluate in vivo recirculation of a new bi-directional dialysis catheter with a symmetric tip design and compare it to currently marketed staggered and split tip catheters.

Materials And Methods: Twelve catheters were placed in three 70-kg male swine. The catheters were connected to a roller type peristaltic pump.

Pulmonary angiography for the diagnosis of thromboembolic events in the non-human primate.

Background: Evaluating possible thromboembolic events in the non-human primate has traditionally required euthanasia, significantly limiting the ability to conduct longitudinal studies. We hypothesized that pulmonary angiography could offer a safe, reproducible, and non-lethal means to assess for pulmonary embolus in the non-human primate.

Methods: Eleven rhesus primates were studied using standard pulmonary angiography techniques.