Cardiovascular and interventional radiology
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Cardiovasc Intervent Radiol · Jul 2008
Case ReportsInterventional management of massive hemothorax due to inadvertent puncture of an aberrant right subclavian artery.
We report a case of massive hemothorax due to inadvertent puncture of an aberrant right subclavian artery during central venous access. Iatrogenic laceration at the origin of the right internal thoracic artery was successfully treated with coil embolization of the internal thoracic artery followed by stent-graft placement into the subclavian artery. Due to its elongated and abnormal course, an aberrant right subclavian artery may predispose to inadvertent puncture during vein catheterization and should be recognized as a potential threat for such procedures. Our case emphasizes that ultrasound guidance should be used routinely for central venous lines wherever possible.
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Cardiovasc Intervent Radiol · Jul 2008
Large-bore gastrostomy feeding tube insertion by a pull technique using a snare.
We describe a series of three patients who had fluoroscopic-guided placement of a large-bore gastrostomy tube using a pull technique and a large snare placed via a nasogastric or orogastric tube.
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Cardiovasc Intervent Radiol · Jul 2008
Case ReportsTraumatic inferior gluteal artery pseudoaneurysm and arteriovenous fistula managed with emergency transcatheter embolization.
We present a case of blunt trauma to the buttock resulting in an inferior gluteal artery pseudoaneurysm and arteriovenous fistula. The characteristic diagnostic features on CT angiography and digital subtraction angiography (DSA), along with the emergency percutaneous management of this traumatic vascular injury, are described. A review of the literature demonstrates inferior gluteal artery pseudoaneurysm is a rare condition, while successful treatment with glue embolization is previously unreported.
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Cardiovasc Intervent Radiol · May 2008
Comparative StudyComparison of ultrasonography-guided central venous catheterization between adult and pediatric populations.
The purpose of this study was to compare the technical success and complication rates of ultrasonography-guided central venous catheterization between adult and pediatric patients which have not been reported previously. In a 4-year period, 859 ultrasonography-guided central vein catheterizations in 688 adult patients and 247 catheterizations in 156 pediatric patients were retrospectively evaluated. Mean age was 56.3 years (range, 18 to 95 years) for adults and 3.3 years (range, 0.1 to 16.3 years) for children. ⋯ Major complications such as pneumothorax and hemothorax were not seen in any group. In conclusion, ultrasonography-guided central venous catheterization has a high technical success rate, lower puncture attempt rate, and higher single wall puncture rate in adults compared to children. Complication rates are comparable in the two groups.