scholarly journals Managing Arrow-Trerotola Percutaneous Thrombolytic Device Complications

2019 ◽  
Vol 36 (02) ◽  
pp. 091-096
Author(s):  
Russell O. Simpson ◽  
Ron C. Gaba ◽  
Andrew J. Lipnik
Keyword(s):  
Interventional Radiology ◽  
Foreign Body ◽  
Stent Placement ◽  
Management Strategies ◽  
Dialysis Access ◽  
Balloon Tamponade ◽  
Track Record ◽  
Arteriovenous Access ◽  
Effective Use ◽  
Device Complications

AbstractDialysis access interventions are frequently performed by interventional radiologists. Several commercially available percutaneous thrombolytic devices can help restore patency to thrombosed arteriovenous access circuits. The Arrow-Trerotola Percutaneous Thrombolytic Device is one such device, and has a long track record of safe and effective use. However, like any medical device, complications can occur during its use. This article describes three complications and associated management strategies utilizing fundamental interventional radiology techniques of balloon tamponade, stent placement, and snare mediated foreign body retrieval.

scholarly journals Drug-Coated Balloon for Arteriovenous Access Stenosis in Hemodialysis Patients

2021 ◽  
Vol 1 (1) ◽  
pp. 20-28
Author(s):  
Hyangkyoung Kim
Keyword(s):  
Neointimal Hyperplasia ◽  
Transluminal Angioplasty ◽  
Current Evidence ◽  
Dialysis Access ◽  
Muscle Injuries ◽  
Arteriovenous Access ◽  
Effective Use ◽  
Flow Circuit ◽  
Drug Coated Balloon

Hemodialysis access stenosis is a pervasive problem that occurs due to the physiology of the high-flow circuit. Stenosis occurs due to endothelial and smooth muscle injuries that result in neointimal hyperplasia. Percutaneous transluminal angioplasty is the standard treatment for dialysis access-induced stenosis. Unfortunately, it is also associated with vessel wall trauma, which causes further intimal hyperplasia and restenosis. Data from randomized controlled trials (RCTs) and systematic reviews of the use of drug-coated balloons (DCBs) for dialysis access stenosis have been controversial. While several single-center trials or RCTs have reported safe and effective use of DCBs, conflicting results still exist. Furthermore, paclitaxel is known to be associated with an increased mortality risk. Herein, we review the current evidence on the role of DCBs in the treatment of dialysis access stenosis.

Chronic Ischemic Monomelic Neuropathy after Arteriovenous Fistula Creation: A Unique Presentation of Vascular Steal

2020 ◽  
Vol 3 (2) ◽  
pp. 147-150
Author(s):  
Kaczynski RE ◽  
Asaad Y ◽  
Valentin-Capeles N ◽  
Battista J
Keyword(s):  
Arteriovenous Fistula ◽  
Complete Loss ◽  
Dialysis Access ◽  
Loss Of Function ◽  
Access Site ◽  
Surgical Ligation ◽  
Arteriovenous Access ◽  
Vascular Steal ◽  
Steal Syndrome

We discuss a case of a 58 year old male who presented for left upper extremity steal syndrome including ischemic monomelic neuropathy (IMN) 1.5 months after arteriovenous fistula creation. He presented after three surgical attempts to salvage his fistula with rest pain, complete loss of function with contracture of the 4th and 5th digits, and loss of sensation in the ulnar distribution for more than three weeks. At our institution, he underwent surgical ligation of the distal fistula and creation of a new fistula proximally, resulting in complete resolution of his vascular steal symptoms almost immediately despite the chronicity prior to surgical presentation. Our patient provides a unique perspective regarding dialysis access salvage versus patient quality of life. The patients’ functional status and pain levels should take precedence over salvage of an arteriovenous access site, and early ligation of the access should be completed prior to chronic IMN development. However, if a patient presents late along the IMN course, we recommend strong consideration of access ligation in order to attempt to regain the full neurovascular function of the extremity as we experienced in our patient.

Foreign Body Ingestion

2015 ◽  
Author(s):  
Kunal Jajoo ◽  
Allison R Schulman
Keyword(s):  
Foreign Body ◽  
Foreign Bodies ◽  
Management Strategies ◽  
The United States ◽  
Foreign Body Ingestion ◽  
Gi Tract ◽  
Food Bolus ◽  
Therapeutic Decisions ◽  
Food Bolus Impaction ◽  
Bolus Impaction

Foreign-body ingestion and food bolus impaction are common causes of esophageal obstruction, with an annual incidence of 13 cases per 100,000, and represent approximately 4% of all emergency endoscopies. Although the majority of foreign bodies that travel to the gastrointestinal (GI) tract will pass spontaneously, 10 to 20% must be removed endoscopically, and 1 to 5% will require surgery. Key diagnostic and therapeutic decisions are based on common factors, including the type of ingested object, number of objects, timing between ingestion and presentation, anatomic location of the object, and presence or absence of symptoms. Complications relating to foreign-body ingestion are typically uncommon; however, the associated morbidity may be severe and occasionally life threatening, and despite the fact that overall mortality has been extremely low, it has been estimated that up to 1,500 deaths occur annually in the United States as a result of foreign-body ingestion. The initial and follow-up management strategies are crucial to preventing morbidity. This review details the epidemiology, etiology and pathophysiology, diagnosis, management, and complications of foreign-body ingestion. Figures show examples of foreign bodies in the esophagus and stomach, three esophageal areas where a foreign body is likely to be impacted, examples of a meat bolus in the esophagus, radiograph of a patient who swallowed one nail and three batteries, and examples of linear erosions of the esophagus and stomach. Tables list the most common GI pathology predisposing individuals to esophageal foreign-body impaction, timing and management of food bolus impaction and foreign-body ingestion, endoscopic management strategies for food bolus impaction and ingested foreign bodies, and radiographic and surgical management strategies for monitoring progress of foreign-body passage through the GI tract. This review contains 5 highly rendered figures, 4 tables, and 78 references.

scholarly journals Best Vascular Access in the Elderly: Time for Innovation?

2018 ◽  
Vol 47 (1-3) ◽  
pp. 236-239 ◽  
Author(s):  
Arif Asif ◽  
Mohamed M. Bakr ◽  
Michael Levitt ◽  
Tushar Vachharajani
Keyword(s):  
Arteriovenous Fistula ◽  
Ulnar Artery ◽  
The Elderly ◽  
Dialysis Access ◽  
Failure Rates ◽  
Early Failure ◽  
Upper Arm ◽  
Arteriovenous Access ◽  
Surgical Manipulation ◽  
Innovative Techniques

Background: Conflicting data continue to surround the optimal dialysis access for the elderly. Many propose that catheters are the best option for this population; others emphasize the creation of an arteriovenous fistula. Summary: While an arteriovenous access is the best available access, it has a high early failure rate, particularly in the elderly. However, significant differences exist in forearm (men ≥65 years ~70%; women ≥65 years ~80%) versus upper arm (men ≥65 years ~40%; women ≥65 years ~38%) fistula failure rates in the elderly, with upper arm having much lower failure rates. Two percutaneous innovative techniques that successfully establish fistulas at the upper arm using proximal radial/ulnar ­artery as the inflow have been recently introduced. These procedures have been successfully performed in the elderly. Importantly, these techniques bypass the open surgical exploration and as such avoid the surgical manipulation of the juxta-anastomotic region (a common cause for the development of juxta-anastomotic stenosis and early fistula failure). Key Message: This article discusses the arteriovenous fistula creation in the elderly, highlights the factors necessary for successful fistula creation, and describes the 2 innovative techniques that can be used to provide a robust platform for successful fistula creation in this population.

scholarly journals Percutaneous Interventional Radiology-Operated Endoscopy for Foreign Body Removal

2019 ◽  
Vol 22 (3) ◽  
pp. 149-153 ◽  
Author(s):  
Mamdouh Khayat ◽  
Adam Khayat ◽  
Jeffrey Forris Beecham Chick ◽  
Travis L. Healey ◽  
Ravi N. Srinivasa
Keyword(s):  
Interventional Radiology ◽  
Foreign Body ◽  
Foreign Body Removal

scholarly journals Root samples provide early and improved detection of Candidatus Liberibacter asiaticus in Citrus

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
W. Evan Braswell ◽  
Jong-Won Park ◽  
Philip A. Stansly ◽  
Barry Craig Kostyk ◽  
Eliezer S. Louzada ◽  
...  
Keyword(s):  
Control Strategies ◽  
Relative Effectiveness ◽  
Management Strategies ◽  
Probability Of Detection ◽  
Economic Consequences ◽  
Fibrous Root ◽  
Accurate Identification ◽  
Liberibacter Asiaticus ◽  
Effective Use ◽  
Detection Strategies

Abstract Huanglongbing (HLB), or Citrus Greening, is one of the most devastating diseases affecting agriculture today. Widespread throughout Citrus growing regions of the world, it has had severe economic consequences in all areas it has invaded. With no treatment available, management strategies focus on suppression and containment. Effective use of these costly control strategies relies on rapid and accurate identification of infected plants. Unfortunately, symptoms of the disease are slow to develop and indistinct from symptoms of other biotic/abiotic stressors. As a result, diagnosticians have focused on detecting the pathogen, Candidatus Liberibacter asiaticus, by DNA-based detection strategies utilizing leaf midribs for sampling. Recent work has shown that fibrous root decline occurs in HLB-affected trees before symptom development among leaves. Moreover, the pathogen, Ca. Liberibacter asiaticus, has been shown to be more evenly distributed within roots than within the canopy. Motivated by these observations, a longitudinal study of young asymptomatic trees was established to observe the spread of disease through time and test the relative effectiveness of leaf- and root-based detection strategies. Detection of the pathogen occurred earlier, more consistently, and more often in root samples than in leaf samples. Moreover, little influence of geography or host variety was found on the probability of detection.

scholarly journals Biological control of fruit flies in Brazil

2019 ◽  
Vol 54 ◽  
Author(s):  
Beatriz Jordão Paranhos ◽  
Dori Edson Nava ◽  
Aldo Malavasi
Keyword(s):  
Biological Control ◽  
Review Paper ◽  
Current Knowledge ◽  
Management Strategies ◽  
Classical Biological Control ◽  
Fruit Flies ◽  
Control Programs ◽  
Bactrocera Carambolae ◽  
Fruit Growing ◽  
Effective Use

Abstract: Fruit flies are the main pests of fruit growing in Brazil. They have been managed predominantly with the use of insecticides applied as cover spray and or/as toxic baits. Currently, the trend of management strategies is toward the adoption of methods that cause the lowest environmental impact in large areas. In this context, biological control is an excellent option to be used together with other management strategies, such as sterile insects, because it leaves no residues, does not disturb nontarget pests, and can be permanent if the natural enemy establishes itself in the field. This review paper addresses the current knowledge on the biological control of fruit flies in Brazil, highlighting the great biodiversity of its natural enemies, especially parasitoids, its biology and ecology. The classical biological control programs in Brazil are also reported, from the introduction of Tetrastichus giffardianus (Hymenoptera: Eulophidae), in 1937, to control Ceratitis capitata (Diptera: Tephritidae), to that of Fopius arisanus (Hymenoptera: Braconidae), in 2012, to control Bactrocera carambolae (Diptera: Tephritidae). Finally, the obtained advances are pointed out, as well as the main bottlenecks and perspectives for the effective use of biological control programs against fruit flies.

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