Journal of vascular and interventional radiology : JVIR
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J Vasc Interv Radiol · Sep 2001
Vacuum-assisted resection of malignant tumors with and without subsequent radiofrequency ablation: feasibility of complete tumor treatment tested in an animal model.
To evaluate the feasibility of vacuum-assisted tumor excision with and without RF ablation for the minimally invasive treatment of small tumors. ⋯ Local tumor resection with use of vacuum-assisted biopsy is feasible and promising as a minimally invasive therapy for the treatment of small focal breast neoplasms. Combined excision and RF ablation techniques may reduce the rate of local recurrence considerably.
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J Vasc Interv Radiol · Aug 2001
Randomized Controlled Trial Multicenter Study Clinical TrialRecombinant tissue plasminogen activator (alteplase) for restoration of flow in occluded central venous access devices: a double-blind placebo-controlled trial--the Cardiovascular Thrombolytic to Open Occluded Lines (COOL) efficacy trial.
Central venous access devices (CVADs) are a mainstay of current medical therapy but often become occluded by thrombus. Tissue plasminogen activator (alteplase), at a dose of 2 mg per 2 mL, has been shown to be effective in restoring flow to catheters proven by radiographic contrast injection to be occluded by thrombus. The purpose of this double-blind placebo-controlled multicenter trial was to determine the efficacy of alteplase in occluded catheters without earlier contrast injections or radiographic examinations. ⋯ Infusion of alteplase appeared to be safe and effective in restoring flow to occluded catheters without need for pretreatment radiographic evaluation.
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J Vasc Interv Radiol · Jun 2001
Comparative StudyPeripherally inserted central catheters: outcome as a function of the operator.
To determine the natural history of and outcome involved with peripherally inserted central catheters (PICCs) placed at a single institution and examine potential differences in the natural history of PICCs placed by interventional radiologists (IRs) versus registered nurses (RNs). ⋯ It is reasonable and cost-effective for trained RNs to place PICCs whenever feasible and refer complicated placements to IRS:
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J Vasc Interv Radiol · Jun 2001
Evaluation of various maneuvers for prevention of air embolism during central venous catheter placement.
This study is designed to evaluate the various physiologic maneuvers (Valsalva, humming, breath-hold) for the potential prevention of air embolism during central venous catheter placement. Central venous pressure measurements were prospectively obtained in 40 patients undergoing central venous catheter placement. The average central venous pressure at baseline was 3.275 mm Hg (range = -4 to 16, SD = 5.99). ⋯ The average increases in central venous pressure during breath hold, humming, and Valsalva were 2.85, 1.82, and 15.2 mm Hg, respectively. The difference between pressures during Valsalva and other maneuvers was statistically significant (P <.05). The conclusion is that the Valsalva maneuver is superior to breath-hold and humming for increasing central venous pressure during central venous catheter placement and, therefore, it is more likely to prevent air embolism in cooperative patients.
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J Vasc Interv Radiol · May 2001
US-guided needle aspiration and catheter drainage as an alternative to open surgical drainage for uniloculated neck abscesses.
To prospectively evaluate the effectiveness of ultrasound (US)-guided needle aspiration and catheter drainage as an alternative to open surgical drainage of uniloculated neck abscesses. ⋯ In a selected group of patients without imminent airway obstruction, most uniloculated neck abscesses may be managed initially by US-guided needle aspiration and catheter drainage before resorting to open surgical drainage.