Journal of vascular and interventional radiology : JVIR
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J Vasc Interv Radiol · Jan 2004
Do simultaneous bilateral tunneled infusion catheters in patients undergoing bone marrow transplantation increase catheter-related complications?
Secure venous access with multiple lumens is necessary for the care of allogeneic hematopoietic stem cell transplant (HSCT) recipients. The outcomes associated with simultaneous bilateral tunneled internal jugular infusion catheter placement in the HSCT recipient population were investigated in an attempt to determine whether simultaneous introduction of these catheters compounds or magnifies the risks (infection, venous thrombosis) associated with tunneled catheters. ⋯ Bilateral multilumen tunneled infusion catheter placement in a single procedure using imaging guidance is safe with acceptable outcomes and meets venous access needs for HSCT. There is a trend toward higher infection rates, with more lumens and more mechanical failure with dual-lumen catheters.
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J Vasc Interv Radiol · Dec 2003
Malignant tracheobronchial strictures: palliation with covered retrievable expandable nitinol stent.
To evaluate the safety and clinical effectiveness of a covered retrievable expandable nitinol stent for the treatment of malignant tracheobronchial stricture and/or esophagorespiratory fistula (ERF). ⋯ Use of a covered retrievable expandable nitinol stent is a safe and effective method for relieving dyspnea. This procedure contributed to improved quality of life for patients with malignant tracheobronchial stricture and/or ERF. Stent retrievability was useful in resolving stent-related complications.
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J Vasc Interv Radiol · Dec 2003
Use of rheolytic thrombectomy in treatment of acute massive pulmonary embolism.
The 6-F Xpeedior (AngioJet; Possis Medical, Minneapolis, MN) rheolytic thrombectomy catheter (RTC) uses high velocity saline jets for thrombus aspiration, maceration, and evacuation, through the Bernoulli principle. The purpose of this study was to evaluate the efficacy of thrombus removal using the RTC in patients with acute massive pulmonary embolism (PE). ⋯ Rheolytic thrombectomy can be performed effectively in patients with massive PE. However, a large portion of the patients in this study underwent adjuvant overnight thrombolytic infusion. Further evaluation in a larger cohort of patients is warranted to assess whether this treatment may offer an alternative or complement to thrombolysis or surgical thrombectomy.
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J Vasc Interv Radiol · Dec 2003
Case ReportsTranslumbar high inferior vena cava access placement in patients with thrombosed inferior vena cava filters.
Venous access is a dire necessity in some patients such as those with end-stage renal disease or short gut syndrome. The right internal jugular vein is the preferred entry site for tunneled central venous catheters. Alternatively, the left internal jugular is considered next, with the external jugular and subclavian veins being considered later. ⋯ As sites are lost, insertion of functional long-term central venous catheters becomes challenging. Translumbar inferior vena cava (IVC) access created in two patients with limited venous access sites who had thrombosed IVCs containing IVC filters is described. Because of the higher IVC punctures in these cases, procedural planning with cross-sectional imaging is crucial to avoid puncturing the right renal artery as it passes posterior to the IVC.