• Title/Summary/Keyword: Catheter Insertion

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Surgical Venous Thrombectomy for Chronic May-Thurner Sysndrome - 2 cases report - (만성 메이-터너 증후군에서 시행한 외과적 혈전 제거술 - 2예 보고 -)

  • Yie, Kil-Soo;Kim, Yong-Hoon;Min, Sun-Kyung;Kim, Hyoung-Rae;Lee, Bong-Ki;Kang, Seong-Sik
    • Journal of Chest Surgery
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    • v.42 no.5
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    • pp.677-683
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    • 2009
  • May-Thurner syndrome is a deep vein thrombosis of the ilio-femoral vein due to compression of the left common iliac vein by the overlying right common iliac artery. Although, catheter directed thrombectomy (CDT) and thrombolysis with stent insertion has become the standard treatment method for acute or subacute May-Thurner syndrome, because of technical feasibility and lower recurrence rate, however, sometimes this methods make fatal complications. Furthermore, there are few reports on optimal treatment strategies for patients in a chronic state of May-Thurner syndrome. We now present two cases of chronic (> 1 month since onset of symptoms) May-Thurner syndrome treated by surgical thrombectomy and femoral arteriovenous shunt with simultaneous stent insertion after failed endovascular treatment. This technique may provide a significant benefit for patients who are not suitable for conventional endovascular treatment.

A Case of Bronchobiliary Fistula as a Complication of Radiofrequency Ablation (간암환자에서 고주파 열치료 후 발생한 기관지담관루 1예)

  • Lee, Ji-Hyun;Kim, Min-Su;Lee, Jae-Gon;Kim, Dae-Sik;Yang, Hae-Jin;Cho, Dae-Hyeon;Kang, Kyung-Woo
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.2
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    • pp.228-231
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    • 2012
  • Bronchobiliary fistula (BBF), defined as an abnormal communication between the biliary duct and bronchial trees, is a very rare condition. Bilioptysis is a pathognomonic finding for BBF. We studied a 58-year-old man, who had a BBF complicated by liver biloma that occurred after radiofrequency ablation. The diagnosis was confirmed by the presence of bile-stained sputum and an Endoscopic Retrograde Cholangio-Pancreatography. BBF was treated successfully by endoscopic sphincterotomy and biliary drainage with insertion of a double pig-tail plastic stent into the biloma. We suggest that the optimal choice of treatment modality for BBF depends on the natural course of the underlying disease, and the status of the biliary stricture.

May-Thurner Syndrome Treated with Endovascular Wall Stent - Report of two cases - (May-Thurner 증후군의 혈관 내 스텐트를 이용한 치료 - 치험 2예 -)

  • Yoon, You-Sang;Won, Je-Hwan;Choi, Ho;Soh, Dong-Mun;Lee, Cheol-Joo;Kim, Hyung-Tae
    • Journal of Chest Surgery
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    • v.36 no.3
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    • pp.202-205
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    • 2003
  • Deep vein thrombosis (DVT) is a common disease. However, May-Thurner syndrome, which is the cause of DVT, is an uncommon processes in which there is an impaired venous return due to compression of the left iliac vein by the overlying right common artery. This condition results in a left iliofemoral deep thrombosis and severe leg edema. It is, therefore, called iliac compression syndrome. Catheter-directed thrombolytic therapy of acute extensive iliofemoral DVT and balloon angioplasty with venous stenting are recommended. Two cases with history of left leg swelling are diagnosed as May-Thurner syndrome, which was demonstrated by venography. We successfully treated the patients with thrombolysis, balloon angioplasty, and stent insertion at the site of common iliac vein compression. Therefore, we report the cases with overall review of the literature.

Intervention with Balloon Valvuloplasty followed by Patent Ductus Arteriosus Stent in a Patient with Pulmonary Atresia with Intact Ventricular Septum (풍선판막성형술과 동맥관 스텐트를 이용하여 치료한 심실중격결손을 동반하지 않은 폐동맥 폐쇄 1례)

  • Lim, Han Hyuk;Kim, Young Deuk;Lee, Jae Hwan;Chang, Mea Young;Kil, Hong Ryang
    • Clinical and Experimental Pediatrics
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    • v.48 no.11
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    • pp.1256-1256
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    • 2005
  • Pulmonary atresia with intact ventricular septum (PAIVS) is rare, less than 1% of congenital heart disease. It needs a therapeutic approach according to its individual morphologic feature. Surgical treatment of valvotomy and modified Blalock-Taussig shunt or non-surgical interventional catheter balloon valvuloplasty can be used for mild to moderate hypoplasia of right ventricle. Fontan operation can be considered for less optimum morphological substrate of two ventricular repair. A 3-day-old male neonate was admitted with cyanosis and cardiac murmur. On echocardiogram, he had membranous pulmonary atresia with intact ventricular septum, normal sized tripartite right ventricle, large atrial septal defect with right-to-left shunt, small sized patent ductus arteriosus, and moderate tricuspid regurgitation. He was treated with intravenous continuous infusion of prostaglandin $E_1$ ($PGE_1$) at once. On the third day of hospitalization, Balloon valvuloplasty was performed. After insertion of patent ductus arteriosus stent on the tenth day, $PGE_1$ infusion was discontinued. On the fifteenth day, he was discharged. Now, he is 9 months old and has nearly normal cardiac structure and function with 97% of percutaneous oxygen saturation.

Analysis of Characteristics of Peripheral Arterial Ischemia in Premature Babies and Effects of Nitroglycerin Patch Application

  • Kim, Jeongeun;Lee, Jin Won;Kim, Dong Yeon
    • Child Health Nursing Research
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    • v.26 no.4
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    • pp.434-444
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    • 2020
  • Purpose: The aim of this retrospective study was to analyze the characteristics of peripheral arterial ischemia and tissue necrosis in premature babies, as well as the effects of nitroglycerin. Methods: In total, 513 newborns were enrolled who were admitted to the neonatal intensive care unit with a gestational age of 34 weeks or younger. Data were collected on general personal and clinical information, peripheral arterial ischemia, and nitroglycerin patch application in the premature infants. The collected data were analyzed using the χ2 test, t-test, Mann-Whitney U test, logistic regression. Results: Thirty-six (7.0%) infants had peripheral arterial ischemia, while 477 (93.0%) infants did not. Lower gestational age (χ2=35.97, p<.001), lower birth weight (χ2=29.40, p<.001), lower blood pressure (χ2=23.10, p<.001), and insertion of an umbilical artery catheter (p<.001) were significantly associated with the occurrence of peripheral arterial ischemia. Among the preterm infants in whom nitroglycerin patches were applied, 30 (83.3%) premature infants without necrosis improved without complications, 4 (11.1%) showed hypotension, and 2 (5.6%) showed skin damage. Conclusion: Based on a review of our experiences with nitroglycerin patches, we recommend closely observing skin color and using nitroglycerin patches on the skin to help improve flow in premature infants with peripheral arterial ischemia.

Characteristics and Nursing Activities of Severe Trauma Patients Regarding the Main Damaged Body Parts (중증외상환자의 주 손상 부위별 특성과 간호활동)

  • Kim, Myung Hee;Kim, Myung Hee;Park, Jung Ha
    • Journal of Korean Biological Nursing Science
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    • v.15 no.4
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    • pp.210-218
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    • 2013
  • Purpose: The purpose of this study was to identify the characteristics and nursing activities of severe trauma patients regarding damaged body parts in Busan Regional Emergency Medical Center. Methods: A survey using a 'trauma patient information questionnaire and a list of nurse activities' was conducted with 133 patients over 15 points ISS on EMR from June 1, 2011 to May 31, 2012. The collected data were analyzed by the SPSS/WIN 12.0 program. Results: Almost all of the subjects were men, and the mean age was 48.8. The amount of road traffic accidents was 60.4%, and the mean RTS and ISS were 6.08, and 23.14 points. Nursing activities in common were airway management, assessment of LOC & GCS, and EKG monitoring. Most of head and neck trauma patients were cared for manasing using intracranial pressure: each patience had the following assessed: pupil size and light reflex, they were checked the leak of CSF, kept $30^{\circ}$ head elevation, and administered medications. Some of chest trauma patients were treated for chest tube and central venous catheter insertion. Partial abdominal trauma patients were administered analgesic and cared for using arterial pressure measurement. Part of the limbs and pelvis trauma patients were given a blood transfusion. Conclusion: Based on the results, the characteristics and nursing activities were specific according to the specific damaged body parts.

A Case of Late Onset Group B Streptoccocal Sepsis with the Complication of Subclavian Vein Catheterization (쇄골하 정책 도관법 합병증이 발생한 후기 발병형 B군 연쇄상 구균 패혈증 1례)

  • Kim, Woo Kyung;Kim, Mi Ran;Kim, Duk Ha;Lee, Hae Ran;Park, Chong Young;Hwang, Dae Haen
    • Pediatric Infection and Vaccine
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    • v.5 no.2
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    • pp.289-295
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    • 1998
  • Group B Streptococcal sepsis and/or meningitis is one of the most serious and common diseases in the neonatal period with high mortality and frequent complications. We have experienced a case of late onset type group B streptococcal sepsis and meningitis with a complication of subclavian vein catheterization catheterization. This 29-day-old male neonate was admitted to intensive care unit with the presentation of fever and septic shock. He was born with Cesarean delivery at 36 weeks and 3 days of gestational age. He showed multiple episodes of seizure after admission and group B streptococcus was isolated from blood. CSF profiles 10 days after admission showed the features of bacterial meningitis without organism isolated. Diffuse cerebral infarction was detected on brain CT 24 days after admission. In the 13th hospital day, the complication of subclavian vein catheterization occurred; Guide wire was cut during insertion and the distal portion of it(2.5cm) was retained in the left subclavian vein. We removed the retained guide wire with goose-neck snare catheter via right femoral vein. This case was presented with a brief review of the literatures.

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Availability of peripheral inserted central catheters in severe hemophilia patients with inhibitors (중증 혈우병 항체 환자에서 시행한 말초삽입 중심혈관 카테터의 유용성)

  • Park, Youngshil
    • Clinical and Experimental Pediatrics
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    • v.51 no.12
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    • pp.1359-1362
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    • 2008
  • The most effective treatment strategy for patients with hemophilia is replacement therapy with FVIII or FIX concentrates, which usually requires long-term, uncomplicated venous access. However, central venous access device (CVADs, ports) insertion requires inpatient admission and general anesthesia, and presents some problems regarding health insurance coverage. Peripherally inserted central catheters (PICCs) were inserted in two severe hemophilia patients aged 7 and 11 years with high titers of inhibitors. They experienced frequent bleeding episodes and required replacement therapy, which eventually resulted in difficulty in acquiring venous line access. Factor VIII activity was below 1%, and inhibitor titers were 160 and 26.3 BU/ml. In an outpatient setting, PICC lines are easily placed by radiological guidance and require local anesthesia alone. PICC has been feasible, in particular, for hemophilia patients with frequent bleeding episodes.

Smart Glasses Cannula Guide System Development for Interventional Cardiology Procedures (중재적 심장 질환 시술을 위한 스마트 글래스 삽입관 가이드 시스템 개발)

  • Jang, Ik Gyu;Heo, Yeong Jun;Jeon, Geum Sang;Choi, Jaesoon
    • Journal of Biomedical Engineering Research
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    • v.41 no.5
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    • pp.173-178
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    • 2020
  • Remote control intervention surgery robotic system improves treatment effect on cardiovascular patients and reduces X-ray exposure. However, at the time of the first procedure, CT (computerized tomography) and other ultrasound diagnostic equipment should be used because the operator must insert the cannula directly into the patient's leg. Improvements to this have been un-met-needs of hospitals. In this paper, we developed a system that can insert the cannula intuitively and quickly by displaying blood vessels at a glance through the system using smart wearable glasses. The core development method is as follows. In order to project augmented reality onto the surgical image, CT scan angiography image is extracted and processed. In the process, three CT-Markers are used to create a coordinate system of blood vessel images. Additionally, a reference marker is photographed on a single camera to obtain a camera coordinate system. Since the CT marker and the reference marker are in the same position, 3D registration is performed. In the text, a detailed explanation will be given.

Reduction of the Isolated Anterior Wall of the Maxillary Sinus Fracture with Double Urinary Balloon Catheters and Fibrin Glue

  • Kim, Jaehee;Yang, Ho Jik;Kim, Jong Hwan;Kim, Su Jin
    • Archives of Craniofacial Surgery
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    • v.18 no.4
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    • pp.238-242
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    • 2017
  • Background: Conservative treatment is performed for isolated anterior wall of the maxillary sinus fractures, in many cases when the fracture is clinically not severe and asymptomatic. Despite the absence of symptoms, complications such as sinusitis, rhinitis, and chronic purulent secretion may develop; therefore, successful reduction is required. We attempted to reduce the risk of complications using an alternative technique: reduction of the fracture with two urinary balloon catheters inserted through the maxillary ostium and fixation using fibrin glue, which minimizes the damage to the bony fragments and sinus mucosa. Methods: In this study, 38 patients who were diagnosed with an isolated anterior wall of the maxillary sinus fracture at our hospital between January 2014 and January 2017 were enrolled. The fracture site was exposed via the Caldwell-Luc approach followed by reduction through the insertion of two urinary balloon catheters using a nasal endoscope and fixation with fibrin glue. The sex, cause of fracture, physical examination, and presence of complications were examined and patient's medical records and facial bone computed tomography scans were analyzed. Results: Radiological evaluation showed that there was no evidence of collapsed reduction fragments. Although some patients had remaining symptoms of hypoesthesia (15%; 3 patients), there were no complications such as infection, rhinitis, sinusitis, and chronic purulent secretion at the surgical site. Conclusion: In this study, we present an alternative surgical technique using two urinary balloon catheters and fibrin glue for the successful reconstruction of an isolated anterior wall of the maxillary sinus fracture. This technique enables precise restoration with a reduced risk of complications.