Canadian Association of Radiologists journal = Journal l'Association canadienne des radiologistes
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To examine the effect of variations in anatomic features and operator experience on the success and complication rates of sonographically monitored cannulation of the internal jugular vein. ⋯ Real-time ultrasound monitoring is superior to blind techniques in cannulation of the internal jugular vein because of its ease, accuracy and safety. Sonographic real-time monitoring minimizes the impact of anatomic factors on success and complication rates. It is a safe and efficacious approach that should be preferred in the placement of central lines.
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To determine the long-term clinical and radiographic outcome of patients who undergo insertion of a Gianturco-Roehm Bird's Nest vena caval filter (Cook Inc., Bloomington, Ind.). ⋯ In this small group of patients the Bird's Nest filter was effective in preventing recurrent pulmonary embolism and caused less caval thrombosis than has previously been suspected, although intrafilter clot was found in 25% of the patients who underwent follow-up imaging. Colour Doppler imaging is the method of choice for detecting nonocclusive thrombus with this type of filter. Perforation of the caval wall was universal but not clinically symptomatic. Finally, guidelines should be established to ensure the cost-effective use of inferior vena caval filters in ICU patients.
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The authors present a case of aortic arch interruption in an adult, an anomaly that was discovered coincidentally during angiography for ruptured cerebral aneurysm. The presentation in adulthood with rupture of the aneurysm and the successful surgical treatment of both abnormalities are unusual.
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The authors report a case of tracheobronchomegaly in a 62-year-old man with chronic expiratory cough. Computed tomography showed dilatation of the trachea on inspiration and complete collapse of the trachea and the proximal bronchi on full expiration. The authors discuss the importance of the collapse on expiration as the cause of the patient's symptoms.