Transcatheter aortic valve implantation(TAVI) using stent-based bioprostheses has recently emerged as a promising alternative to surgical valve replacement in selected patients. The main route for TAVI is retrograde a...Transcatheter aortic valve implantation(TAVI) using stent-based bioprostheses has recently emerged as a promising alternative to surgical valve replacement in selected patients. The main route for TAVI is retrograde access from the femoral artery using large sheaths(16-24 F). Vascular access complications are a clinically relevant issue in TAVI procedures since they are reported to occur in up to one fourth of patients and are strongly associated with adverse outcomes. In the present paper, we review the different types of vascular access site complications associated with transfemoral TAVI. Moreover, we discuss the possible optimal management strategies with particular attention to the relevance of early diagnosis and prompt treatment using endovascular techniques.展开更多
Inadvertent puncture of the subclavian artery is an uncommon but potentially fatal complication of the commonly performed internal jugular vein catheterization.We report a case of accidental subclavian artery catheter...Inadvertent puncture of the subclavian artery is an uncommon but potentially fatal complication of the commonly performed internal jugular vein catheterization.We report a case of accidental subclavian artery catheterization close to the vertebral artery during internal jugular venous cannulation,which was successfully managed in the interventional suite with catheter removal and use of a vascular closure device.展开更多
Interventional therapy of coronary heart disease (CHD) includes percutaneous transluminal coronary angioplasty (PTCA), stent implantation etc. Owing to its revascularization without cardiac surgery, it has been the ma...Interventional therapy of coronary heart disease (CHD) includes percutaneous transluminal coronary angioplasty (PTCA), stent implantation etc. Owing to its revascularization without cardiac surgery, it has been the main effective method in treating CHD. But at the same time, there exists the problem of restenosis (RS). After PTCA, RS展开更多
Percutaneous microballoon compression of the trigeminal ganglion is a brand new operative technique for the treatment of trigeminal neuralgia. However, it is unclear how the procedure mediates pain relief, and there a...Percutaneous microballoon compression of the trigeminal ganglion is a brand new operative technique for the treatment of trigeminal neuralgia. However, it is unclear how the procedure mediates pain relief, and there are no standardized criteria, such as compression pressure, com- pression time or balloon shape, for the procedure. In this study, percutaneous microballoon compression was performed on the rabbit trigeminal ganglion at a mean inflation pressure of 1,005 ＋ 150 mmHg for 2 or 5 minutes. At 1, 7 and 14 days after percutaneous microballoon compression, the large-diameter myelinated nerves displayed axonal swelling, rupture and demy- elination under the electron microscope. Fragmentation of myelin and formation of digestion chambers were more evident after 5 minutes of compression. Image analyzer results showed that the diameter of trigeminal ganglion cells remained unaltered after compression. These experi- mental findings indicate that a 2-minute period of compression can suppress pain transduction. Immunohistochemical staining revealed that vascular endothelial growth factor expression in the ganglion cells and axons was significantly increased 7 days after trigeminal ganglion compression, however, the changes were similar after 2-minute compression and 5-minute compression. The upregulated expression of vascular endothelial growth factor in the ganglion cells after percu- taneous microballoon compression can promote the repair of the injured nerve. These findings suggest that long-term compression is ideal for patients with recurrent trigeminal neuralgia.展开更多
Cardiac catheterization and percutaneous coronary intervention play an important role in the management of coronary artery disease.Although the transfemoral approach has been the traditionally dominant method,there ha...Cardiac catheterization and percutaneous coronary intervention play an important role in the management of coronary artery disease.Although the transfemoral approach has been the traditionally dominant method,there has been an increased utilization of the transradial approach.Multiple observational studies and randomized clinical trials have shown fewer bleeding complications,reduced morbidity and mortality,improved quality of life,and better economic outcomes when the transradial approach is utilized when compared to the transfemoral approach.Despite its many benefits,utilization of this approach in certain countries including the United States has been less than optimal due to a lower adoption rates mostly driven by lack of training opportunities and decreased awareness of clinical benefits of the transradial approach.In this review,the history,observational trends,efficacy,and technical aspects of transradial cardiac catheterization and percutaneous coronary intervention are discussed.展开更多
BACKGROUND Percutaneous coronary intervention(PCI) is extensively used to treat acute coronary syndromes(ACS).Acute mesenteric ischemia is a life-threatening disease if untreated.CASE SUMMARY An 81-year-old female pre...BACKGROUND Percutaneous coronary intervention(PCI) is extensively used to treat acute coronary syndromes(ACS).Acute mesenteric ischemia is a life-threatening disease if untreated.CASE SUMMARY An 81-year-old female presented with 3 d of lethargy and 1 d of dyspnea.On November 16,2021,the patient developed a coma.Her oxygen saturation dropped to 70%-80%,the patient was admitted to the intensive care unit for further treatment.Chest computed tomography(CT) showed chronic bronchitis,emphysema,and multiple lung infections.Abdominal CT scan showed no obvious abnormalities,but have severely calcified abdominal vessels.The patient received assisted ventilation,and vasoactive,and anti-infection drugs.Troponin level was elevated.Since the patient was in a coma,it could not be determined whether she had chest pain.The cardiologist assumed that the patient had developed ACS;therefore,the patient underwent PCI via the left femoral artery approach,and no obvious abnormalities were found in the left and right coronary arteries.On the second postoperative day,the patient presented with abdominal distension and decreased bowel sounds;constipation was considered and a glycerin enema was administered.On day 4,the patient suddenly lost consciousness,and had decreased blood pressure,abdominal wall swelling with increased tension,and absence of bowel sounds.An urgent abdominal CT scan revealed gas in her hepatic portal system with extensive bowel wall necrosis.The patient died on day 5 due to intractable shock.CONCLUSION The potential serious complications in patients undergoing PCI,especially the patients who are hemodynamically unstable and have severely calcified abdominal vessels,should all be considered.展开更多
文摘Transcatheter aortic valve implantation(TAVI) using stent-based bioprostheses has recently emerged as a promising alternative to surgical valve replacement in selected patients. The main route for TAVI is retrograde access from the femoral artery using large sheaths(16-24 F). Vascular access complications are a clinically relevant issue in TAVI procedures since they are reported to occur in up to one fourth of patients and are strongly associated with adverse outcomes. In the present paper, we review the different types of vascular access site complications associated with transfemoral TAVI. Moreover, we discuss the possible optimal management strategies with particular attention to the relevance of early diagnosis and prompt treatment using endovascular techniques.
文摘Inadvertent puncture of the subclavian artery is an uncommon but potentially fatal complication of the commonly performed internal jugular vein catheterization.We report a case of accidental subclavian artery catheterization close to the vertebral artery during internal jugular venous cannulation,which was successfully managed in the interventional suite with catheter removal and use of a vascular closure device.
文摘Interventional therapy of coronary heart disease (CHD) includes percutaneous transluminal coronary angioplasty (PTCA), stent implantation etc. Owing to its revascularization without cardiac surgery, it has been the main effective method in treating CHD. But at the same time, there exists the problem of restenosis (RS). After PTCA, RS
基金supported by a grant from Shengjing Hospital,China Medical University,China,No.201010252
文摘Percutaneous microballoon compression of the trigeminal ganglion is a brand new operative technique for the treatment of trigeminal neuralgia. However, it is unclear how the procedure mediates pain relief, and there are no standardized criteria, such as compression pressure, com- pression time or balloon shape, for the procedure. In this study, percutaneous microballoon compression was performed on the rabbit trigeminal ganglion at a mean inflation pressure of 1,005 ＋ 150 mmHg for 2 or 5 minutes. At 1, 7 and 14 days after percutaneous microballoon compression, the large-diameter myelinated nerves displayed axonal swelling, rupture and demy- elination under the electron microscope. Fragmentation of myelin and formation of digestion chambers were more evident after 5 minutes of compression. Image analyzer results showed that the diameter of trigeminal ganglion cells remained unaltered after compression. These experi- mental findings indicate that a 2-minute period of compression can suppress pain transduction. Immunohistochemical staining revealed that vascular endothelial growth factor expression in the ganglion cells and axons was significantly increased 7 days after trigeminal ganglion compression, however, the changes were similar after 2-minute compression and 5-minute compression. The upregulated expression of vascular endothelial growth factor in the ganglion cells after percu- taneous microballoon compression can promote the repair of the injured nerve. These findings suggest that long-term compression is ideal for patients with recurrent trigeminal neuralgia.
文摘Cardiac catheterization and percutaneous coronary intervention play an important role in the management of coronary artery disease.Although the transfemoral approach has been the traditionally dominant method,there has been an increased utilization of the transradial approach.Multiple observational studies and randomized clinical trials have shown fewer bleeding complications,reduced morbidity and mortality,improved quality of life,and better economic outcomes when the transradial approach is utilized when compared to the transfemoral approach.Despite its many benefits,utilization of this approach in certain countries including the United States has been less than optimal due to a lower adoption rates mostly driven by lack of training opportunities and decreased awareness of clinical benefits of the transradial approach.In this review,the history,observational trends,efficacy,and technical aspects of transradial cardiac catheterization and percutaneous coronary intervention are discussed.
文摘BACKGROUND Percutaneous coronary intervention(PCI) is extensively used to treat acute coronary syndromes(ACS).Acute mesenteric ischemia is a life-threatening disease if untreated.CASE SUMMARY An 81-year-old female presented with 3 d of lethargy and 1 d of dyspnea.On November 16,2021,the patient developed a coma.Her oxygen saturation dropped to 70%-80%,the patient was admitted to the intensive care unit for further treatment.Chest computed tomography(CT) showed chronic bronchitis,emphysema,and multiple lung infections.Abdominal CT scan showed no obvious abnormalities,but have severely calcified abdominal vessels.The patient received assisted ventilation,and vasoactive,and anti-infection drugs.Troponin level was elevated.Since the patient was in a coma,it could not be determined whether she had chest pain.The cardiologist assumed that the patient had developed ACS;therefore,the patient underwent PCI via the left femoral artery approach,and no obvious abnormalities were found in the left and right coronary arteries.On the second postoperative day,the patient presented with abdominal distension and decreased bowel sounds;constipation was considered and a glycerin enema was administered.On day 4,the patient suddenly lost consciousness,and had decreased blood pressure,abdominal wall swelling with increased tension,and absence of bowel sounds.An urgent abdominal CT scan revealed gas in her hepatic portal system with extensive bowel wall necrosis.The patient died on day 5 due to intractable shock.CONCLUSION The potential serious complications in patients undergoing PCI,especially the patients who are hemodynamically unstable and have severely calcified abdominal vessels,should all be considered.
