• Title/Summary/Keyword: Catheter obstruction

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Catheter Obstruction of Intrathecal Drug Administration System -A Case Report-

  • Rhee, Seok-Myeon;Choi, Eun-Joo;Lee, Pyung-Bok;Nahm, Francis Sahn-Gun
    • The Korean Journal of Pain
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    • v.25 no.1
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    • pp.47-51
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    • 2012
  • Intrathecal drug administration system (ITDAS) can reduce the side effects while increasing the effectiveness of opioids compared to systemic opioid administration. Therefore, the use of ITDAS has increased in the management of cancer pain and chronic intractable pain. Catheter obstruction is a serious complication of ITDAS. Here, we present a case of catheter obstruction by a mass formed at the side hole and in the lumen. A 37-year-old man suffering from failed back surgery syndrome received an ITDAS implantation, and the ITDAS was refilled with morphine every 3 months. When the patient visited the hospital 18 months after ITDAS implantation for a refill, the amount of delivered morphine sulfate was much less than expected. Movement of the pump rotor was examined with fluoroscopy; however, it was normal. CSF aspiration through the catheter access port was impossible. When the intrathecal catheter was removed, we observed that the side hole and lumen of the catheter was plugged.

Predictive Factors for Symptomatic Dislodgement of Percutaneous Transhepatic Biliary Drainage Catheter in Patients with Malignant Biliary Obstruction (악성 담관 폐쇄 환자에서 경피경간 담도 배액술의 유증상 이탈 발생의 예측 인자)

  • Hee Jeong Yu;Jung Gu Park;Gyoo Sik Jung;Kwang Il Seo;Hyun Joon Park;Jong Hyouk Yun
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1350-1360
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    • 2023
  • Purpose To evaluate the factors that predict symptomatic dislodgement of a percutaneous transhepatic biliary drainage (PTBD) catheter in patients with malignant biliary obstruction. Materials and Methods This retrospective study included 572 patients with malignant biliary obstruction who underwent 733 PTBD catheter insertions between January 2010 and February 2015. The duration of catheter placement, approach site, location of the catheter tip, insertion angle, presence of a closed-loop pigtail, and tube diameter were evaluated. Results During the follow-up period, 224 PTBD catheter dislodgements (30.56%) were observed in 157 patients. Among them, 146 (19.92%) were symptomatic. The mean duration from catheter insertion until dislodgement was 32 days (range: 1-233 days). Male (odds ratio [OR]: 1.636, 95% confidence interval [CI]: 1.131-2.367, p = 0.009), right-sided approach (OR: 1.567, 95% CI: 1.080-2.274, p = 0.018), increased insertion angle (OR: 1.015, 95% CI: 1.005-1.026, p = 0.005), and incomplete closed-loop pigtail formation (OR: 1.672, 95% CI: 1.098-2.545, p = 0.016) were independent factors predictive of symptomatic dislodgement of a PTBD catheter. Conclusion Factors predictive of symptomatic catheter dislodgement included male sex, a right-sided approach, increased insertion angle, and incomplete closed-loop pigtail formation.

Development of Intravascular Micro Active Endoscope(I) -Analysis of Lubrication Characteristics of Small Arteries with Micro Catheter Insertion- (혈관 삽입형 초소형 작동형 내시경의 개발(I) - 도뇨관 삽입시 혈관 내부의 윤활 특성 분석 -)

  • 장준근;김중경
    • Tribology and Lubricants
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    • v.15 no.3
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    • pp.272-277
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    • 1999
  • The objective of this investigation is to examine the influence of the micro catheters, which mimic the intravascular micro active endoscopes, on local pressure changes and flow rate in an arterial branch model similar to the femoral artery of human. The effects of branch to main lumen flow rate ratios and the locations of a catheter tip were found to be significant on the local pressure changes. Relatively large pressure drops and an increase in shear stress due to the obstruction effects may induce an endothelial cell damage and a change in arterial wall permeability, which have been reported to be the primary cause of the initiation of the atherosclerosis and other major vascular diseases.

Comparison of the Laparoscopic and Open Peritoneal Dialysis Catheter Insertion in Children (소아 환자에서 복강경 복막 투석관 삽입술과 개복 삽입술의 비교)

  • Kim, Hyun-Soo;Jung, Soo-Min;Lee, Suk-Koo;Seo, Jeong-Meen
    • Advances in pediatric surgery
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    • v.17 no.2
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    • pp.125-132
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    • 2011
  • The aim of this study was to compare peritoneal dialysis catheter insertion by the open method to the laparoscopic method. Twenty four laparoscopic and 10 open peritoneal dialysis catheter placements were performed in children between 2001 and 2008. Patient characteristics, operation related data, procedural complications and clinical outcome were compared. Although there were no cases of catheter obstruction, exit site infection or bleeding in the laparoscopic group, compared to the open method, there was no statistically significant difference between the two groups. Catheter removal rate due to complication was high in the open group and catheter survival rate was high in the laparoscopic group. We concluded that laparoscopic peritoneal dialysis catheter placement is feasible in children of all age groups with at least equivalent functional results compared to the open method. An advantage of laparoscopic catheter insertion is removal of the great omentum and easy fixation of the catheter to the abdominal wall.

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Effect of Evidence-Based Practice Protocol for Catheter Dysfunction in Hemodialysis Patients: Focus on Patency Rates and Bleeding Complications (혈액투석 환자의 도관 기능부전 관리 프로토콜 적용이 도관개존 성공률 및 출혈 합병증에 미치는 영향)

  • Lee, Kyung Mi;Kim, Mi Yeon
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.3
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    • pp.356-362
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    • 2018
  • Purpose: This study was a retrospective cohort study to evaluate the effect of evidence-based guidelines for catheter dysfunction among hemodialysis patients, Success rate and bleeding complications in catheterization were examined. Methods: We performed a retrospective cohort study, including 94 patients with catheter dysfunction who were receiving hemodialysis at a university hospital; 55 in the control group and 39 in the protocol group. This protocol was composed of the catheter dysfunction assessment, conservative management of catheter dysfunction, drug management of catheter dysfunction, catheter function test and maintenance management. Data were analyzed with a Chi-square test and t-test using SPSS/WIN 23.0 program. Results: The patency rate of the protocol group was significantly higher than that of the control group. The rate of bleeding complications was not statistically significant for either the control group or the protocol group before or after application. Conclusion: The application of the guidelines effectively increased the patency rate of the catheter without bleeding complications. It is hoped that this guideline can be disseminated to nurses nationwide to improve the efficiency of catheter function for hemodialysis patients.

Changes of Blood Flow Characteristics due to Catheter Obstruction during the Coronary Angioplasty

  • Suh, Sang-Ho;Roh, Hyung-Woon;Kwon, Hyuck-Moon;Lee, Byoung-Kwon
    • International Journal of Vascular Biomedical Engineering
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    • v.2 no.1
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    • pp.25-30
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    • 2004
  • Catheters are used to measure translesional pressure gradients in the stenosed coronary arteries. Uses of catheters during coronary angioplasty cause flow obstructions. A narrowed flow cross section with catheter effectively introduced a tighter stenosis than the enlarged residual stenoses after balloon angiplasty. Catheters in blood vessels cause pressure gradient rise and blood flow drop during the measurements. In this study, three dimensional computer simulations are conducted to investigate the flow blockage effects due to the catheter obstructions during the coronary angioplasty. The computer simulation models are generated by the data, which are measured by coronary angiogram, and the blood is treated as non-Newtonian fluid. The velocity, pressure, and wall shear stress variations are observed for the estimate of damages of blood vessel. This study is also extended to investigate the effects of stenotic vessel size, and shape and catheter size and location.

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Deep vein thrombosis caused by malignant afferent loop obstruction

  • Kang, Eun Gyu;Kim, Chan;Lee, Jeungeun;Cha, Min-uk;Kim, Joo Hoon;Park, Seo-Hwa;Kim, Man Deuk;Lee, Do Yun;Rha, Sun Young
    • Journal of Yeungnam Medical Science
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    • v.33 no.2
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    • pp.166-169
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    • 2016
  • Afferent loop obstruction following gastrectomy is a rare but fatal complication. Clinical features of afferent loop obstruction are mainly gastrointestinal symptoms. A 56-year-old female underwent radical total gastrectomy with Roux-en-Y esophagojejunostomy for treatment of advanced gastric cancer. After fourteen months postoperatively, she showed gradual development of edema of both legs. Computed tomography (CT) scan showed disease progression at the jejunojejunostomy site and consequent dilated afferent loop, which resulted in inferior vena cava (IVC) compression. A drainage catheter was placed percutaneously into the afferent loop through the intrahepatic duct and an IVC filter was placed at the suprarenal IVC, and self-expanding metal stents were inserted into bilateral common iliac veins. With these procedures, sympotms related with afferent loop obstruction and deep vein thrombosis were improved dramatically. The follow-up abdominal CT scan was taken 3 weeks later and revealed the completely decompressed afferent loop and improved IVC patency. Surgical treatment should be considered as the first choice for afferent loop obstruction; however, because it is more immediate and less invasive, non-surgical modalities, such as percutaneous catheter drainage or stent placement, can be effective alternatives for inoperable cases or risky patients who have severe medical comorbidities.

A Case of Intracardiac Migration of Distal Ventriculo-Peritonal(V-P) Shunt Catheter - Case Report - (뇌실-복강 단락 원위도관의 심장내전위 - 증례보고 -)

  • Kim, Byung Joo;Cha, Seung Heon;Park, Dong June;Song, Geun Sung;Choi, Chang Hwa;Lee, Young Woo
    • Journal of Korean Neurosurgical Society
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    • v.29 no.2
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    • pp.270-273
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    • 2000
  • Ventriculoperitoneal(V-P) shunt has been used as a popular method for surgical treatment of hydrocephalus. But complications such as infection, mechanical obstruction and failure of flow rate sometimes make painful stress to neurosurgeons and patients. Of particular, migration of distal V-P shunt catheter to extraperitoneal space has rarely been reported. Even rarer is intracardiac migration of distal V-P shunt catheter. Authors report a such case and discuss the possible mechanism and preventive method.

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Two Cases of esophageal foreign body removal using Fogarty catheter (Fogarty 카테터를 이용한 식도 이물(바둑알) 제거 2예)

  • 박시내;박경호;박준욱;여상원;조승호
    • Korean Journal of Bronchoesophagology
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    • v.9 no.1
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    • pp.79-82
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    • 2003
  • Unintentional foreign body ingestion is common in children, and coins are the most common foreign body ingested. Foreign body remaining in the esophagus may be associated with mucosal ulceration or esophageal obstruction and can potentially lead to significant morbidity and even death. Removal of esophageal foreign body is therefore generally recommended. Several methods are utilized including esophagoscopy in operating room, flexible endoscopy in out patient setting, fluoroscopic Foley catheter technique, and advancement using bougienage. We report two cases of esophageal foreign body(paduk stone) which were hard to be removed by usual esophagoscopic removal. Successful removal was accomplished with the aid of Fogarty catheter under the general anesthesia.

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Invention of the Guide Catheter Irrigation Monitoring Device for Neuroendovascular Therapy

  • Ozkul, Ayca;Park, Jong-Hyun;Shin, Dong-Seung;Yilmaz, Ali;Kim, Bum-Tae
    • Journal of Korean Neurosurgical Society
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    • v.60 no.4
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    • pp.471-474
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    • 2017
  • Objective : The thromboembolic events during neuroendovascular therapy (NET) are the major complications of concern that can be occasionally fatal. The thrombotic occlusion of the guide catheter for NET is thought to be the risk of the thromboembolic events. We have developed an idea for inventing the monitoring system of the continuous irrigation through the guide catheter. We herein present a unique invention of the guide catheter irrigation monitoring device. Methods : We have developed ideas for preventing the thrombotic occlusion of the guide catheter. In order to design a convenient device working in the practical use, we have consulted and shared the ideas with the electrical engineers about putting the invention. Results : The guide catheter irrigation monitoring device (GCIMD) consisted of three parts of optical sensor, main body and electric adapter. In brief, the basic principles of working of the GCIMD are as follows. The optical sensor is attached to the dripping chamber of the line to irrigation solution. The main body had the small light and speaker to make an alarm sounds. The sensor monitors the dripping of flush solution. If the dripping stops more than three seconds, a warning alarm has been activated. So, the operating physicians can concentrate and check the guide catheter irrigation. After the use of the GCIMD, there was no major thromboembolic complication in conjunction with the thrombotic occlusion of the guide catheter in our institute. Conclusion : We have developed a brilliant invention of the GCIMD for NET.