Journal of vascular and interventional radiology : JVIR
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J Vasc Interv Radiol · Sep 2003
ReviewSedation and analgesia in the interventional radiology department.
Administration of sedation and analgesia in the interventional radiology suite is often necessary during painful diagnostic and therapeutic procedures. Although sedative and analgesic agents are generally safe, catastrophic complications related to their use can occur, often as a result of incorrect drug administration or inadequate patient monitoring. The incidence of adverse outcomes related to provision of sedation and analgesia can be reduced with improved understanding of the pharmacology of these medications, by providing adequate monitoring to sedated patients, by recognizing patients who are at increased risk of experiencing an adverse drug reaction, and by early and appropriate management of complications.
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J Vasc Interv Radiol · Sep 2003
Histologic changes in the human vein wall adjacent to indwelling central venous catheters.
Central venous catheter dysfunction can be caused by thrombosis (of the catheter or vessel itself), fibrin sheath formation, or infection. These sequelae can lead to costly interventions, loss of the access device, or loss of access sites in as many as one-third of patients. This study examined the histologic changes in the access vein and superior vena cava wall that is adjacent to central venous catheters in humans. ⋯ After short-term catheter placement, focal areas of endothelial injury were seen in the vein wall adjacent to the catheter. Associated thrombus may or may not be present. Long-term catheters displayed vein wall thickening and bridges from the vein wall to the catheter. These observations represent a progressive reaction of the human vein wall to access devices.
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J Vasc Interv Radiol · Aug 2003
Comparative Study Clinical TrialGadolinium, carbon dioxide, and iodinated contrast material for planning inferior vena cava filter placement: a prospective trial.
To prospectively compare the diagnostic accuracy of CO(2) and gadolinium to iodinated contrast material for inferior vena cavography before inferior vena cava (IVC) filter placement. ⋯ CO(2) and gadolinium had limitations when compared with iodinated contrast material. Gadolinium provided superior consistency in identifying relevant landmarks for filter placement. CO(2) demonstrated significantly greater mean correlative error than gadolinium at initial and repeat readings.
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J Vasc Interv Radiol · Aug 2003
Image-guided percutaneous chemical and radiofrequency tumor ablation in an animal model.
To determine whether combining acetic acid instillation before radiofrequency (RF) ablation can improve local tissue electrical conductivity, RF energy deposition, intratumoral heating, and tumor necrosis in a large animal model. ⋯ Addition of acetic acid injections to RF ablation substantially increases tumor destruction compared with RF or injection therapy alone. However, lower acetic acid concentrations in saturated NaCl produced greater tumor coagulation, suggesting that, in this hypovascular tumor model, alterations in electrical conductivity play a more important role in increasing tumor ablation efficiency than do the additional ablative effects of acetic acid.