Establishment and validation of a predictive model for peripherally inserted central catheter-related thrombosis in patients with liver cancer

BACKGROUND Peripherally inserted central catheters(PICCs)are commonly used in hospitalized patients with liver cancer for the administration of chemotherapy,nutrition,and other medications.However,PICC-related thrombosis is a serious complication that can lead to morbidity and mortality in this patient population.Several risk factors have been identified for the development of PICC-related thrombosis,including cancer type,stage,comorbidities,and catheter characteristics.Understanding these risk factors and developing a predictive model can help healthcare providers identify high-risk patients and implement preventive measures to reduce the incidence of thrombosis.AIM To analyze the influencing factors of PICC-related thrombosis in hospitalized patients with liver cancer,construct a predictive model,and validate it.METHODS Clinical data of hospitalized patients with liver cancer admitted from January 2020 to December 2023 were collected.Thirty-five cases of PICC-related thrombosis in hospitalized patients with liver cancer were collected,and 220 patients who underwent PICC placement during the same period but did not develop PICC-related thrombosis were randomly selected as controls.A total of 255 samples were collected and used as the training set,and 77 cases were collected as the validation set in a 7:3 ratio.General patient information,case data,catheterization data,coagulation indicators,and Autar Thrombosis Risk Assessment Scale scores were analyzed.Univariate and multivariate unconditional logistic regression analyses were performed on relevant factors,and the value of combined indicators in predicting PICC-related thrombosis in hospitalized patients with liver cancer was evaluated using receiver operating characteristic(ROC)curve analysis.RESULTS Univariate analysis showed statistically significant differences(P<0.05)in age,sex,Karnofsky performance status score(KPS),bedridden time,activities of daily living impairment,parenteral nutrition,catheter duration,distant metastasis,and bone marrow suppression between the thrombosis group and the non-thrombosis group.Other aspects had no statistically significant differences(P>0.05).Multivariate regression analysis showed that age≥60 years,KPS score≤50 points,parenteral nutrition,stage III to IV,distant metastasis,bone marrow suppression,and activities of daily living impairment were independent risk factors for PICC-related thrombosis in hospitalized patients with liver cancer(P<0.05).Catheter duration of 1-6 months and catheter duration>6 months were protective factors for PICC-related thrombosis(P<0.05).The predictive model for PICC-related thrombosis was obtained as follows:P predictive probability=[exp(Logit P)]/[1+exp(Logit P)],where Logit P=age×1.907+KPS score×2.045+parenteral nutrition×9.467+catheter duration×0.506+tumor-node-metastasis(TNM)staging×2.844+distant metastasis×2.065+bone marrow suppression×2.082+activities of daily living impairment×13.926.ROC curve analysis showed an area under the curve(AUC)of 0.827(95%CI:0.724-0.929,P<0.001),with a corresponding optimal cut-off value of 0.612,sensitivity of 0.755,and specificity of 0.857.Calibration curve analysis showed good consistency between the predicted occurrence of PICC-related thrombosis and actual occurrence(P>0.05).ROC analysis showed AUCs of 0.888 and 0.729 for the training and validation sets,respectively.CONCLUSION Age,KPS score,parenteral nutrition,TNM staging,distant metastasis,bone marrow suppression,and activities of daily living impairment are independent risk factors for PICC-related thrombosis in hospitalized patients with liver cancer,while catheter duration is a protective factor for the disease.The predictive model has an AUC of 0.827,indicating high predictive accuracy and clinical value.

Lower extremity peripherally inserted central catheter placement ectopic to the ascending lumbar vein:A case report

BACKGROUND Peripherally inserted central catheters(PICCs)are an essential infusion route for oncology patients receiving intravenous treatments,but lower extremity veni-puncture is the preferred technique for patients with superior vena cava syndrome(SVCS).We report the case of a patient with a lower extremity PICC ectopic to the ascending lumbar vein,to indicate and verify PICC catheterisation in the lower extremity is safe and feasible.And hope to provide different per-spectives for clinical PICC venipuncture to get the attention of peers.CASE SUMMARY On 24 August 2022,a 58-year-old male was admitted to our department due to an intermittent cough persisting for over a month,which worsened 10 d prior.Imaging and laboratory investigations suggested the patient with pulmonary malignancy and SVCS.Chemotherapy was not an absolute contraindication in this patient.Lower extremity venipuncture is the preferred technique because administering upper extremity venous transfusion to patients with SVCS can exacerbate oedema in the head,neck,and upper extremities.The patient and his family were informed about the procedure,and informed consent was obtained.After successful puncture and prompt treatment,the patient was discharged,experiencing some relief from symptoms.CONCLUSION Inferior vena cava catheterisation is rare and important for cancer patients with SVCS,particularly in complex situations involving ectopic placement.

Anatomical variation in the internal jugular vein:potential risk factors for central venous catheterization-a case report

Central venous catheterization(CVC)is an invasive medical procedure used to measure central venous pressure and provides a stable route for continuous drug administration.CVC is widely used in the emergency department and intensive care units.It is typically performed by inserting a catheter through the internal jugular vein(IJV)into the superior vena cava near the right atrium.[1,2]While catheterization is a fundamental skill proficiently performed by healthcare professionals,lethal complications may occasionally occur because of undesirable positioning,depth and diameter.

How to manage the malposition of deep vein catheterization into the artery?

Central venous catheterization establishes temporary,efficient,and rapid use of deep venous access in patients,which provides high flow rate fluid perfusion,enables measurement of central venous pressure,and acts as an important reference for clinical decision-making.However,various complications such as pneumothorax,hemothorax,hematoma,and puncture failure can easily occur during the puncture and catheterization process.

Clues for diagnosing misplaced central venous catheter in the right ascending lumbar vein during right femoral venous access

The right ascending lumbar vein is difficult to detect on anteroposterior abdominalradiographs because it overlaps with the inferior vena cava on anteroposteriorradiographs.Intensive observation by medical providers may be a cue fordiagnosis.However,knowledge of catheter misplacement of the right ascendinglumbar vein is also necessary,because misplacement cannot be suspected withoutthat awareness.

Unique method for removal of knotted lumbar epidural catheter: A case report

BACKGROUND Combined spinal-epidural(CSE)anesthesia is the preferred anesthesia method for cesarean delivery.The use of an epidural catheter is essential for administering additional drugs intraoperatively and managing postoperative pain.However,the insertion of epidural catheters is associated with various complications,such as total spinal anesthesia,symptoms indicative of spinal nerve root irritation,and challenges in epidural catheter removal.CASE SUMMARY We present a case report of a challenging epidural catheter removal due to knotting.The lumbar computed tomography scan results revealed that the catheter formed a tight knot in the epidural space.We used a novel extubation method and successfully removed the catheter.CONCLUSION The operator can use opposite forces to"spiral"apart the spinal joints by positioning the patient's body in a specific position.The findings indicate that,when combined with imaging examination results,this method is effective for the removal of epidural catheters.

Management of a Retained Epidural Catheter in a Pregnant Patient: A Case Report and Review of Literature

Background: Epidural anesthesia is an effective intervention to treat labor pain and provide analgesia for orthopedic procedures. A rare complication of this technique is epidural catheter retention. Case Presentation: In this case report, we present an otherwise healthy 21-year-old G2P0010 woman at 39 weeks and 3 days gestation whose anesthetic management was complicated by a symptomatic retained epidural catheter fragment. Computed tomography (CT) imaging of her spine showed the fractured catheter within her paraspinal muscles and neurosurgery recommended no surgical intervention at that time. The patient reported resolution of back pain while in the postpartum unit which she continues to endorse two weeks after discharge. Conclusion: Retained epidural catheter is a medical emergency that requires immediate imaging and neurological evaluation. While magnetic resonance imaging is typically regarded as the standard imaging modality for this complication, in epidural sets that contain metallic components, we suggest using CT to avoid the risk of thermal nerve damage. In cases where the patient does not report any acute complaints, nonsurgical management may be appropriate but close follow-up is required to monitor for catheter migration.

Spontaneous dislodgment of a peritoneal dialysis catheter inserted using the Seldinger technique:A case report

BACKGROUND Peritoneal dialysis(PD)is an important renal replacement therapy in patients with end-stage renal disease.PD catheters remain the lifeline for patients undergoing PD.The catheter technique survival rate is considered a core PD outcome domain.CASE SUMMARY The PD catheter spontaneously dislodged in a patient undergoing PD during regular fluid exchange without pain.Abdominal computed tomography showed a tunnel infection.A double-cuff straight Tenckhoff catheter had been inserted using the Seldinger technique.Before this incident,the patient had a history of tunnel infections.We speculate that recurrent tunnel infections and catheter insertion using the Seldinger technique may have led to catheter dislodgement.CONCLUSION The present case suggests that clinicians should more rigorously assess the persistence of catheter-related infections concerning the potential complications arising from catheter dislodgement associated with the Seldinger technique.

Knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter

Objectives:The objectives of this study were to assess the knowledge and practice skills on home-based urinary catheter care among parents of under-five children with urinary catheter.Materials and Methods:This cross-sectional study was conducted from June 1,2021,to September 11,2021,in a tertiary hospital in north India.Purposive sampling was used to select 50 participants.Three instruments were employed for data collection after fulfilling sample criteria;for baseline information demographic tool,knowledge questionnaires,and a practice checklist.Data were analyzed using descriptive and inferential statistics.Results:On assessment of 50 participants,the majority of parents aged above 30 years(74%).Most of the participants were male(82%),graduated(38%),and working in the private sector(58%).Similarly,two-thirds of participants were residing in a nuclear family(64%)with a single child 32(64%)and family income<5000 rupees per month(60%).The mean score of knowledge was 1.94±0.81 and that of practice skills was 1.98±0.85 on home-based care.Regression analysis showed that knowledge of parents was significantly associated with qualification(β:1.821,P=0.002).Similarly,association of practice skills of parents with gender(β:1.235,P=0.050)and qualification(β:1.889,P=0.00)was significant.Conclusion:The general findings of our study showed that parents’education and occupation played a significant role in a child’s care.Parental education and catheter care skills positively affect the child and reduce readmission rates.

New application of intestinal obstruction catheter in enterocutaneous fistula:A case report

BACKGROUND Enterocutaneous fistula(ECF)is an abnormal connection between the gastrointestinal tract and the skin.ECF can lead to massive body fluid loss,hypercatabolism,and malnutrition.Therefore,nutritional support plays a crucial role in managing ECFs and promoting the healing of fistulas.For nutritional support,enteral nutrition(EN)is the preferred method when gastrointestinal function is recovering.Currently,various EN approaches have been applied for different anatomical positions of the ECF.However,the effectiveness of administering EN support for treating lower ECFs still needs further exploration and improvement.CASE SUMMARY We present the case of a 46-year-old male who underwent gastrointestinal stromal tumour resection.Six days after the surgery,the patient presented with fever,fatigue,severe upper abdominal pain,and septic shock.Subsequently,lower ECFs were diagnosed through laboratory and imaging examinations.In addition to symptomatic treatment for homeostasis,total parenteral nutrition support was administered in the first 72 h due to dysfunction of the intestine.After that,we gradually provided EN support through the intestinal obstruction catheter in consideration of the specific anatomic position of the fistula instead of using the nasal jejunal tube.Ultimately,the patient could receive optimal EN support via the catheter,and no complications were found during the treatment.CONCLUSION Nutritional support is a crucial element in ECF management,and intestinal obstruction catheters could be used for early EN administration.

Multiple paradoxical embolisms caused by central venous catheter thrombus passing through a patent foramen ovale: A case report

BACKGROUND To date,this is the first case of a paradoxical embolism(PDE)that concurrently manifested in the coronary and lower limb arteries and was secondary to a central venous catheter(CVC)thrombus via a patent foramen ovale(PFO).CASE SUMMARY Here,we report a case of simultaneous coronary and lower limb artery embolism in a PFO patient carrier of a CVC.The patient presented to the hospital with acute chest pain and lower limb fatigue.Doppler ultrasound showed a large thrombus in the right internal jugular vein,precisely at the tip of the CVC.Transthoracic and transesophageal echocardiography confirmed the existence of a PFO,with inducible right-to-left shunting by the Valsalva maneuver.The patient was administered an extended course of anticoagulation therapy,and then the CVC was successfully removed.Percutaneous PFO closure was not undertaken.There was no recurrence during follow-up.CONCLUSION Thus,CVC-associated thrombosis is a potential source for multiple PDE in PFO patients.

Different timing for abdominal paracentesis catheter placement and drainage in severe acute pancreatitis complicated by intraabdominal fluid accumulation

BACKGROUND Non-surgical methods such as percutaneous drainage are crucial for the treatment of patients with severe acute pancreatitis(SAP).However,there is still an ongoing debate regarding the optimal timing for abdominal paracentesis catheter place-ment and drainage.AIM To explore the influence of different timing for abdominal paracentesis catheter placement and drainage in SAP complicated by intra-abdominal fluid accumu-lation.METHODS Using a retrospective approach,184 cases of SAP complicated by intra-abdominal fluid accumulation were enrolled and categorized into three groups based on the timing of catheter placement:group A(catheter placement within 2 d of symptom onset,n=89),group B(catheter placement between days 3 and 5 after symptom onset,n=55),and group C(catheter placement between days 6 and 7 after symptom onset,n=40).The differences in progression rate,mortality rate,and the number of cases with organ dysfunction were compared among the three groups.RESULTS The progression rate of group A was significantly lower than those in groups B and groups C(2.25%vs 21.82%and 32.50%,P<0.05).Further,the proportion of patients with at least one organ dysfunction in group A was significantly lower than those in groups B and groups C(41.57%vs 70.91%and 75.00%,P<0.05).The mortality rates in group A,group B,and group C were similar(P>0.05).At postoperative day 3,the levels of C-reactive protein(55.41±19.32 mg/L vs 82.25±20.41 mg/L and 88.65±19.14 mg/L,P<0.05),procalcitonin(1.36±0.51 ng/mL vs 3.20±0.97 ng/mL and 3.41±0.98 ng/mL,P<0.05),tumor necrosis factor-alpha(15.12±6.63 pg/L vs 22.26±9.96 pg/L and 23.39±9.12 pg/L,P<0.05),interleukin-6(332.14±90.16 ng/L vs 412.20±88.50 ng/L and 420.08±87.65ng/L,P<0.05),interleukin-8(415.54±68.43 ng/L vs 505.80±66.90 ng/L and 510.43±68.23ng/L,P<0.05)and serum amyloid A(270.06±78.49 mg/L vs 344.41±81.96 mg/L and 350.60±80.42 mg/L,P<0.05)were significantly lower in group A compared to those in groups B and group C.The length of hospital stay in group A was significantly lower than those in groups B and group C(24.50±4.16 d vs 35.54±6.62 d and 38.89±7.10 d,P<0.05).The hospitalization expenses in group A were also significantly lower than those in groups B and groups C[2.70(1.20,3.55)ten-thousand-yuan vs 5.50(2.98,7.12)ten-thousand-yuan and 6.00(3.10,8.05)ten-thousand-yuan,P<0.05).The incidence of complications in group A was markedly lower than that in group C(5.62%vs 25.00%,P<0.05),and similar to group B(P>0.05).CONCLUSION Percutaneous catheter drainage for the treatment of SAP complicated by intra-abdominal fluid accumulation is most effective when performed within 2 d of onset.

Computerized tomography-guided therapeutic percutaneous puncture catheter drainage-combined with somatostatin for severe acute pancreatitis: An analysis of efficacy and safety

BACKGROUND Severe acute pancreatitis(SAP),a condition with rapid onset,critical condition and unsatisfactory prognosis,poses a certain threat to human health,warranting optimization of relevant treatment plans to improve treatment efficacy.AIM To evaluate the efficacy and safety of computerized tomography-guided the-rapeutic percutaneous puncture catheter drainage(CT-TPPCD)combined with somatostatin(SS)in the treatment of SAP.METHODS Forty-two SAP patients admitted to The Second Affiliated Hospital of Fujian Medical University from June 2020 to June 2023 were selected.On the basis of routine treatment,20 patients received SS therapy(control group)and 22 patients were given CT-TPPCD plus SS intervention(research group).The efficacy,safety(pancreatic fistula,intra-abdominal hemorrhage,sepsis,and organ dysfunction syndrome),abdominal bloating and pain relief time,bowel recovery time,hospital stay,inflammatory indicators(C-reactive protein,interleukin-6,and pro-calcitonin),and Acute Physiology and Chronic Health Evaluation(APACHE)II score of both groups were evaluated for comparison.RESULTS Compared with the control group,the research group had a markedly higher total effective rate,faster abdominal bloating and pain relief and bowel recovery,INTRODUCTION Pancreatitis,an inflammatory disease occurring in the pancreatic tissue,is classified as either acute or chronic and is associated with high morbidity and mortality,imposing a socioeconomic burden[1,2].The pathogenesis of this disease involves early protease activation,activation of nuclear factor kappa-B-related inflammatory reactions,and infiltration of immune cells[3].Severe acute pancreatitis(SAP)is a serious condition involving systemic injury and subsequent possible organ failure,accounting for 20%of all acute pancreatitis cases[4].SAP is also characterized by rapid onset,critical illness and unsatisfactory prognosis and is correlated with serious adverse events such as systemic inflammatory response syn-drome and acute lung injury,threatening the health of patients[5,6].Therefore,timely and effective therapeutic inter-ventions are of great significance for improving patient prognosis and ensuring therapeutic effects.Somatostatin(SS),a peptide hormone that can be secreted by endocrine cells and the central nervous system,is in-volved in the regulatory mechanism of glucagon and insulin synthesis in the pancreas[7].It has complex and pleiotropic effects on the gastrointestinal tract,which can inhibit the release of gastrointestinal hormones and negatively modulate the exocrine function of the stomach,pancreas and bile,while exerting a certain influence on the absorption of the di-gestive system[8,9].SS has shown certain clinical effectiveness when applied to SAP patients and can regulate the severity of SAP and immune inflammatory responses,and this regulation is related to its influence on leukocyte apoptosis and adhesion[10,11].Computerized tomography-guided therapeutic percutaneous puncture catheter drainage(CT-TPPCD)is a surgical procedure to collect lesion fluid and pus samples from necrotic lesions and perform puncture and drainage by means of CT image examination and precise positioning[12].In the research of Liu et al[13],CT-TPPCD applied to pa-tients undergoing pancreatic surgery contributes to not only good curative effects but also a low surgical risk.Baudin et al[14]also reported that CT-TPPCD has a clinical success rate of 64.6%in patients with acute infectious necrotizing pan-creatitis,with nonfatal surgery-related complications found in only two cases,suggesting that this procedure is clinically effective and safe in the treatment of the disease.In light of the limited studies on the efficacy and safety of SS plus CT-TPPCD in SAP treatment,this study performed a relevant analysis to improve clinical outcomes in SAP patients.

Analysis of the Nursing Effect of Hierarchical Extended Nursing Based on The Guidance of Orem’s Theory in Patients with PICC Catheterization

Objective:To analyze the nursing effect of hierarchical extended nursing based on the guidance of Orem’s theory in patients with peripherally inserted central(PICC)catheterization.Methods:Ninety-one patients with PICC catheterization admitted to the hospital from May 2021 to May 2023 were selected and divided into a control group and an observation group,with 45 and 46 cases,respectively.The control group received routine nursing care,while the observation group received routine nursing care combined with hierarchical extended nursing based on the guidance of Orem’s theory for 3 months.Relevant indicators between the two groups were compared.Results:The improvement degree of various indicators in the observation group after nursing was better than that of the control group(P<0.05).Conclusion:Graded extended nursing based on the guidance of Orem’s theory improved the knowledge,belief,behavior,and self-efficacy of patients with PICC catheterization,and relieved their anxiety,depression,and other negative emotions.The nursing effect was deemed to be significant.

Catheter-Assisted Interlaminar Approach for Cervical Epidural Steroid Injection in Patient with Cervical Stenosis Caused by Ossification of Posterior Longitudinal Ligament: A Case Report

We present the case of a 64-year-old man with cervical ossification of the posterior longitudinal ligament (OPLL) experiencing chronic neck pain and radiculopathy for 6 months. A catheter-assisted interlaminar Cervical Epidural Steroid Injection (CESI) was performed under fluoroscopic guidance, targeting the affected C2-C6 levels. Significant improvement was observed after this procedure, with decreased pain scores (visual analogue scale (VAS) 8 to 2) and improved mobility. This technique not only enhances the effectiveness of CESI but also reduces the likelihood of complications such as stroke or epidural hematoma and thus provides an alternative treatment option for patients with multiple stenotic levels who are unsuitable for surgery or are unresponsive to conservative therapy such as medication or physical therapy.

Controllable NO Release for Catheter Antibacteria from Nitrite Electroreduction over the Cu-MOF

Implant-associated infections caused by biomedical catheters severely threaten patients'health.The use of electrochemical control on NO release from benign nitrite equipped in the catheter can potentially resolve this issue with excellent biocompatibility.Inspired by nitrite reductase,a Cu-BDC(BDC:benzene-1,4-dicarboxylic acid)catalyst with coordinated Cu(Ⅱ)sites was constructed as a heterogeneous electrocatalyst to control nitrite reduction to nitric oxide for catheter antibacteria.The combined results of in situ and ex situ tests unveil the key function of interconversion between Cu(Ⅱ)and Cu(Ⅰ)species in NO_(2)^(-)reduction to NO.After being incorporated into the actual catheter,the Cu-BDC catalyst exhibits high electrocatalytic activity toward NO_(2)^(-)reduction to NO and excellent antibacteria efficacy with a sterilizing rate of 99.9%,paving the way for the development of advanced metal-organic frameworks(MOFs)electrocatalysts for catheter antibacteria.

Double pigtail catheter reduction for seriously displaced intravenous infusion port catheter:A case report

BACKGROUND Implanted intravenous infusion port(TIAP)is mainly used for patients who need central venous infusion and poor peripheral vascular conditions.With the advantages of easy to carry,long maintenance cycle,few complications and excellent quality of life,it has been widely used in the fields of malignant tumor chemotherapy,parenteral nutrition support and repeated blood collection.Implanted intravenous infusion port(IVAP)dislocation can have significant complications if not recognised and reinstated immediately.CASE SUMMARY A 24-year-old man was treated with adjuvant chemotherapy for osteosarcoma.Severe displacement of IVAP catheter was found by chest X-ray examination.The IVAP cannot be used normally.Therefore,we conducted an emergency procedure to reset the catheter through double pigtail catheters,the operation was successful and the infusion port was restored.CONCLUSION When IVAP catheter displacement cannot be reset by conventional techniques,two pigtail catheters can be successfully used instead.

Transseptal approach for catheter ablation of left-sided accessory pathways in children with Marfan syndrome:A case report

BACKGROUND Left-sided accessory pathways(APs)can be accessed with either a transaortic(TA)or transseptal approach(TS).For children with Marfan syndrome(MFS)who have aortic disease,the use of TA can aggravate the disease,making TS the best choice for these patients.CASE SUMMARY A 10-year-old girl was hospitalized because of intermittent heart palpitations and chest tightness.She was diagnosed with MFS,supraventricular tachycardia,Wolff-Parkinson-White syndrome,and left-sided AP was detected by cardiac electrophysiological.Catheter ablation was successfully performed via TS under the guidance of the Ensite system.During the follow-up,no recurrence or complications occurred.CONCLUSION The TS for catheter ablation of left-sided APs can be considered in children with MFS.Adequate evaluation and selection of the appropriate puncture site are particularly important.

The Application of Midline Catheter in Perioperative Period of Patients with Laryngopharyngeal Cancer

Objective: To investigate the application value of midline catheters in patients with larynx cancer during the postoperative period. Methods: 150 patients with larynx cancer treated in our hospital from May 2019 to May 2022 were selected as the study objects. According to the random number method, 75 cases were divided into a control group and a study group. The study group used a midline catheter during treatment, and the control group used a Peripheral venous indwelling needle during treatment. The indwelling time, puncture times, complication rate, daily catheter maintenance cost and catheterization satisfaction rate of the two groups were compared. Result: The retention time of the study group (11.53 ± 6.91 days) was significantly higher than that of the control group (2.92 ± 1.41 days) (P . The total puncture times were significantly lower than that of the control group (P cidence of complications such as catheter blockage, catheter detachment, drug extravasation and phlebitis were lower than those of the control group. The difference was statistically significant (P < 0.05), the average daily maintenance cost of the two groups was not statistically significant (P > 0.05), and the satisfaction rate of the study group was significantly higher than that of the control group, the difference was statistically significant (P Conclusion: Compared with the Peripheral venous indwelling needle, postoperative application of a midline catheter in patients with larynx cancer can effectively reduce the number of puncture times and the incidence of catheter-related adverse reactions, and has higher economic benefits and satisfaction rate, which is worthy of clinical application.

“Guidezilla”extension catheter combined with balloon technique for treating pulmonary artery stenosis caused by Takayasu arteritis

Takayasu arteritis(TA)is a rare systemic vasculitis of the aorta and its primary branches,which usually occurs in young women.Due to its insidious onset and lack of specific symptoms,this disease can be easily misdiagnosed or missed.Approximately 50%of the patients having TA with pulmonary artery involvement develop pulmonary hypertension(PH).The 3-year survival rate among patients with TA-related PH is lower than that among patients with TA alone.Early balloon pulmonary angioplasty(BPA)can improve the clinical symptoms and survival of patients with stable TA.To the best of our knowledge,this is the first case reported in the English literature in which a“Guidezilla”catheter was used during BPA to treat stenosis and occlusion of the pulmonary artery caused by Takayasu arteritis(TA).