Objectives: The Foley balloon catheter (FC) is a viable method for cervical ripening, but concerns about infection risk restrict its use in cases of prolonged prelabour rupture of membranes (PROM). This study aims to ...Objectives: The Foley balloon catheter (FC) is a viable method for cervical ripening, but concerns about infection risk restrict its use in cases of prolonged prelabour rupture of membranes (PROM). This study aims to evaluate the efficacy and safety of the FC compared to oral misoprostol for cervical ripening after PROM. Study Design: A retrospective data-analysis of 128 pregnant women was conducted. Of these, 49 underwent cervical ripening with an FC and 79 with oral misoprostol. We included all women with a vital singleton pregnancy at 37 - 42 weeks of gestation who underwent cervical ripening after ≥ 24 hours of PROM in specific time frames in two Dutchsecondary care and teaching hospitals. The primary outcome was the incidence of intrapartum infection, a composite of maternal and neonatal infection. In addition, we evaluated the mode of delivery, duration of priming and priming-to-delivery interval. Secondary endpoints included uterine hyperstimulation, umbilical cord prolapse, birth weight, Apgar scores, length of admission to the neonatal low dependency unit, admission to the (neonatal) Intensive Care Unit (ICU) and mortality. Statistical analyses included bivariate and multivariate techniques. Results: Cervical ripening with FC, compared with oral misoprostol, showed a higher incidence of intrapartum infection, respectively 32.7% (n = 16) vs. 12.7% (n = 10) (p = 0.006). However, after adjusting for epidural anaesthesia and pregestational BMI, the association was no longer significant. No difference was found in mode of delivery and total priming-to-delivery interval (median 21.3 hours vs. 22.0, p = 0.897). Furthermore, FC, compared with oral misoprostol, showed a longer duration of cervical ripening and hence a shorter duration of active labour (p 0.001). Apart from the 1-min Apgar score, secondary maternal and neonatal outcomes did not differ between the groups. Conclusion: In women who require cervical ripening after prolonged PROM at term, the FC and oral misoprostol are similar in terms of efficacy and safety. Advantages associated with the FC are its safe application in women with a history of caesarean section, although we did not study these women, and an implied shorter duration of active labour. Our study adds to the limited available data on the use of the FC after the rupture of membranes and a large randomized controlled trial is needed to strengthen our findings.展开更多
We report a new embolization method with cobra catheter and balloon catheter in TAE for aneurysms and arterioportal fistula. Embolization for one aneurysm and one arterioportal fistula was performed using a cobra cat...We report a new embolization method with cobra catheter and balloon catheter in TAE for aneurysms and arterioportal fistula. Embolization for one aneurysm and one arterioportal fistula was performed using a cobra catheter, and the target vessel was temporarily blocked using a balloon catheter during the intervention. 2 cases of aneurysms and arterioportal fistula were treated successfully without coils reflux. Application of both cobra catheter with balloon catheter in TAE is effective without complication.展开更多
Pseudoaneurysms of the femoral artery usually progress and can rupture if left untreated. Therefore,intraoperative hemostasis is of the paramount importance in the management of these emergent situations, especially f...Pseudoaneurysms of the femoral artery usually progress and can rupture if left untreated. Therefore,intraoperative hemostasis is of the paramount importance in the management of these emergent situations, especially for the patients with poor general health. We present an efficient method of stopping massive bleeding occurring in this patient by balloon catheter.展开更多
Objective:To evaluate the safety and efficacy of the SeparGateballoon-guiding catheter(BGC)for blocking flow and delivering devices in neurointerventional surgery.Method:This prospective multicenter single-arm trial e...Objective:To evaluate the safety and efficacy of the SeparGateballoon-guiding catheter(BGC)for blocking flow and delivering devices in neurointerventional surgery.Method:This prospective multicenter single-arm trial enrolled patients who received BGC adjuvant therapy to provide temporary blood flow arrest of the supra-aortic arch arteries and their branch vessels in interventional therapy.The primary endpoint was immediate procedural success rate in flow arrest,device delivery,and withdrawal.The efficacy endpoints were intraoperative product performance,including rigidity,smoothness,fracture resistance of the catheter wall,catheter push performance,compatibility and radiopaque display,integrity,adhesion thrombus after withdrawal and balloon rupture.The safety endpoints were adverse and serious adverse events associated with the test device and serious adverse events resulting in death or serious health deterioration.Result:A total of 129 patients were included;of them,128 were analyzed in the full analysis set(FAS)and per protocol set(PPS).Immediate procedural success was achieved in 97.7%of patients with FAS and PPS.The lower bound of the 95%confidence interval was 94.6%,higher than the preset efficacy margin of 94%.Device-related adverse events occurred in 2(1.6%)cases.One was mild adverse event of vasospasm,which resolved spontaneously.The other was serious adverse event of dissection aggravation,which was treated with stenting angioplasty.No device defects were observed.Conclusion:In neurointerventional surgery,the SeparGateBGC can be used to temporarily block the flow of the supra-aortic arch arteries and their branch vessels and guide the interventional device to the target vascular position.展开更多
Dear Editor: Chronic total occlusions (CTOs) of the coronary artery are commonly encountered complex lesionst11. Percutaneous coronary intervention (PCI) for CTO is technically challenging due to low procedural ...Dear Editor: Chronic total occlusions (CTOs) of the coronary artery are commonly encountered complex lesionst11. Percutaneous coronary intervention (PCI) for CTO is technically challenging due to low procedural success ratesTM. Microcatheter is one of the important devices for treatment of CTOTM. It has been widely used attributed to the excellent crossability whenever angula- tion and tortuousity of the coronary artery is encoun- tered. In the process, the microcatheter has to be withdrawn from the guide wire after the wire is proved to locate in the true lumen.展开更多
<strong>Background</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> Cervical ripening is pr...<strong>Background</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> Cervical ripening is prerequisite of successful induction of labor. Vaginal misoprostol and Foley’s catheter placement have been widely used for this purpose but the data are not always sufficient. We attempted to determine which (misoprostol versus Foley’s catheter) is more effective/safer in Nigerian setting. </span><b><span style="font-family:Verdana;">Methods</span></b><span style="font-family:Verdana;">: A randomized controlled trial was performed at Federal Teaching Hospital Abakaliki, Nigeria, involving 135 term pregnant </span><span style="font-family:Verdana;">women requiring cervical ripening and labor induction. Participants were</span><span style="font-family:Verdana;"> ran</span><span style="font-family:Verdana;">domly allocated to misoprostol versus catheter group. The following were</span><span style="font-family:Verdana;"> recorded/measured/analyzed: Bishop’s score, age, parity, body mass index, gestational age, labor duration, indication, oxytocin use, mode of delivery, and Apgar score. Chi square test and t test were used where appropriate. </span><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;">: At 24 hours, all of misoprostol group were either in labor, had ripe cervix, or had delivered, whereas 35.4% of catheter group had still unripe cervix (</span><i><span style="font-family:Verdana;">x</span></i><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> = 29.856, </span><i><span style="font-family:Verdana;">P</span></i><span style="font-family:Verdana;"> = 0.0001). Misoprostol group was less likely to require oxytocin in</span><span><span style="font-family:Verdana;">fusion (</span><i><span style="font-family:Verdana;">x</span></i><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> = 52.600,</span><i><span style="font-family:Verdana;"> P</span></i><span style="font-family:Verdana;"> = 0.0001) and less likely to require cesarean delivery</span></span> <span><span style="font-family:Verdana;">(cesarean: misoprostol versus catheter: 11% versus 34% (</span><i><span style="font-family:Verdana;">x</span></i><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> = 9.800, </span><i><span style="font-family:Verdana;">P</span></i><span style="font-family:Verdana;"> = </span></span><span style="font-family:Verdana;">0.001)). Total medical cost for misoprostol was less than that of catheter (</span><i><span style="font-family:Verdana;">x</span></i><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> = 14.703, </span><i><span style="font-family:Verdana;">P</span></i><span style="font-family:Verdana;"> = 0.0001). </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: 50</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">μg vaginal misoprostol, compared with catheter </span><span style="font-family:Verdana;">placement, was more effective, cheaper, and safe as a procedure of cervical</span><span style="font-family:Verdana;"> ripening before induction of labor.</span></span></span></span>展开更多
Non-deflated balloon of a transurethral inserted bladder catheter is a problem that could be difficult to manage, especially in males. A variety of methods have been described to puncture the balloon and remove the ca...Non-deflated balloon of a transurethral inserted bladder catheter is a problem that could be difficult to manage, especially in males. A variety of methods have been described to puncture the balloon and remove the catheter, though these can be associated with complications. We illustrate a simple and a safe method to overcome this problem using a flexible cystoscope under local anaesthesia.展开更多
文摘Objectives: The Foley balloon catheter (FC) is a viable method for cervical ripening, but concerns about infection risk restrict its use in cases of prolonged prelabour rupture of membranes (PROM). This study aims to evaluate the efficacy and safety of the FC compared to oral misoprostol for cervical ripening after PROM. Study Design: A retrospective data-analysis of 128 pregnant women was conducted. Of these, 49 underwent cervical ripening with an FC and 79 with oral misoprostol. We included all women with a vital singleton pregnancy at 37 - 42 weeks of gestation who underwent cervical ripening after ≥ 24 hours of PROM in specific time frames in two Dutchsecondary care and teaching hospitals. The primary outcome was the incidence of intrapartum infection, a composite of maternal and neonatal infection. In addition, we evaluated the mode of delivery, duration of priming and priming-to-delivery interval. Secondary endpoints included uterine hyperstimulation, umbilical cord prolapse, birth weight, Apgar scores, length of admission to the neonatal low dependency unit, admission to the (neonatal) Intensive Care Unit (ICU) and mortality. Statistical analyses included bivariate and multivariate techniques. Results: Cervical ripening with FC, compared with oral misoprostol, showed a higher incidence of intrapartum infection, respectively 32.7% (n = 16) vs. 12.7% (n = 10) (p = 0.006). However, after adjusting for epidural anaesthesia and pregestational BMI, the association was no longer significant. No difference was found in mode of delivery and total priming-to-delivery interval (median 21.3 hours vs. 22.0, p = 0.897). Furthermore, FC, compared with oral misoprostol, showed a longer duration of cervical ripening and hence a shorter duration of active labour (p 0.001). Apart from the 1-min Apgar score, secondary maternal and neonatal outcomes did not differ between the groups. Conclusion: In women who require cervical ripening after prolonged PROM at term, the FC and oral misoprostol are similar in terms of efficacy and safety. Advantages associated with the FC are its safe application in women with a history of caesarean section, although we did not study these women, and an implied shorter duration of active labour. Our study adds to the limited available data on the use of the FC after the rupture of membranes and a large randomized controlled trial is needed to strengthen our findings.
文摘We report a new embolization method with cobra catheter and balloon catheter in TAE for aneurysms and arterioportal fistula. Embolization for one aneurysm and one arterioportal fistula was performed using a cobra catheter, and the target vessel was temporarily blocked using a balloon catheter during the intervention. 2 cases of aneurysms and arterioportal fistula were treated successfully without coils reflux. Application of both cobra catheter with balloon catheter in TAE is effective without complication.
文摘Pseudoaneurysms of the femoral artery usually progress and can rupture if left untreated. Therefore,intraoperative hemostasis is of the paramount importance in the management of these emergent situations, especially for the patients with poor general health. We present an efficient method of stopping massive bleeding occurring in this patient by balloon catheter.
基金supported by the Co-construction of Provincial and Ministry Youth Project(SBGJ202003004)Scientific and Technological Project of Henan Province(202102310037)。
文摘Objective:To evaluate the safety and efficacy of the SeparGateballoon-guiding catheter(BGC)for blocking flow and delivering devices in neurointerventional surgery.Method:This prospective multicenter single-arm trial enrolled patients who received BGC adjuvant therapy to provide temporary blood flow arrest of the supra-aortic arch arteries and their branch vessels in interventional therapy.The primary endpoint was immediate procedural success rate in flow arrest,device delivery,and withdrawal.The efficacy endpoints were intraoperative product performance,including rigidity,smoothness,fracture resistance of the catheter wall,catheter push performance,compatibility and radiopaque display,integrity,adhesion thrombus after withdrawal and balloon rupture.The safety endpoints were adverse and serious adverse events associated with the test device and serious adverse events resulting in death or serious health deterioration.Result:A total of 129 patients were included;of them,128 were analyzed in the full analysis set(FAS)and per protocol set(PPS).Immediate procedural success was achieved in 97.7%of patients with FAS and PPS.The lower bound of the 95%confidence interval was 94.6%,higher than the preset efficacy margin of 94%.Device-related adverse events occurred in 2(1.6%)cases.One was mild adverse event of vasospasm,which resolved spontaneously.The other was serious adverse event of dissection aggravation,which was treated with stenting angioplasty.No device defects were observed.Conclusion:In neurointerventional surgery,the SeparGateBGC can be used to temporarily block the flow of the supra-aortic arch arteries and their branch vessels and guide the interventional device to the target vascular position.
文摘Dear Editor: Chronic total occlusions (CTOs) of the coronary artery are commonly encountered complex lesionst11. Percutaneous coronary intervention (PCI) for CTO is technically challenging due to low procedural success ratesTM. Microcatheter is one of the important devices for treatment of CTOTM. It has been widely used attributed to the excellent crossability whenever angula- tion and tortuousity of the coronary artery is encoun- tered. In the process, the microcatheter has to be withdrawn from the guide wire after the wire is proved to locate in the true lumen.
文摘<strong>Background</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"><strong>:</strong> Cervical ripening is prerequisite of successful induction of labor. Vaginal misoprostol and Foley’s catheter placement have been widely used for this purpose but the data are not always sufficient. We attempted to determine which (misoprostol versus Foley’s catheter) is more effective/safer in Nigerian setting. </span><b><span style="font-family:Verdana;">Methods</span></b><span style="font-family:Verdana;">: A randomized controlled trial was performed at Federal Teaching Hospital Abakaliki, Nigeria, involving 135 term pregnant </span><span style="font-family:Verdana;">women requiring cervical ripening and labor induction. Participants were</span><span style="font-family:Verdana;"> ran</span><span style="font-family:Verdana;">domly allocated to misoprostol versus catheter group. The following were</span><span style="font-family:Verdana;"> recorded/measured/analyzed: Bishop’s score, age, parity, body mass index, gestational age, labor duration, indication, oxytocin use, mode of delivery, and Apgar score. Chi square test and t test were used where appropriate. </span><b><span style="font-family:Verdana;">Results</span></b><span style="font-family:Verdana;">: At 24 hours, all of misoprostol group were either in labor, had ripe cervix, or had delivered, whereas 35.4% of catheter group had still unripe cervix (</span><i><span style="font-family:Verdana;">x</span></i><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> = 29.856, </span><i><span style="font-family:Verdana;">P</span></i><span style="font-family:Verdana;"> = 0.0001). Misoprostol group was less likely to require oxytocin in</span><span><span style="font-family:Verdana;">fusion (</span><i><span style="font-family:Verdana;">x</span></i><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> = 52.600,</span><i><span style="font-family:Verdana;"> P</span></i><span style="font-family:Verdana;"> = 0.0001) and less likely to require cesarean delivery</span></span> <span><span style="font-family:Verdana;">(cesarean: misoprostol versus catheter: 11% versus 34% (</span><i><span style="font-family:Verdana;">x</span></i><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> = 9.800, </span><i><span style="font-family:Verdana;">P</span></i><span style="font-family:Verdana;"> = </span></span><span style="font-family:Verdana;">0.001)). Total medical cost for misoprostol was less than that of catheter (</span><i><span style="font-family:Verdana;">x</span></i><sup><span style="font-family:Verdana;">2</span></sup><span style="font-family:Verdana;"> = 14.703, </span><i><span style="font-family:Verdana;">P</span></i><span style="font-family:Verdana;"> = 0.0001). </span><b><span style="font-family:Verdana;">Conclusion</span></b><span style="font-family:Verdana;">: 50</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">μg vaginal misoprostol, compared with catheter </span><span style="font-family:Verdana;">placement, was more effective, cheaper, and safe as a procedure of cervical</span><span style="font-family:Verdana;"> ripening before induction of labor.</span></span></span></span>
文摘Non-deflated balloon of a transurethral inserted bladder catheter is a problem that could be difficult to manage, especially in males. A variety of methods have been described to puncture the balloon and remove the catheter, though these can be associated with complications. We illustrate a simple and a safe method to overcome this problem using a flexible cystoscope under local anaesthesia.