Abstract TP20: Longer Procedural Times Are Independently Associated with Symptomatic Intracranial Hemorrhage in Large Vessels Occlusion Stroke Patients Undergoing Thrombectomy

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Omar Kass-Hout ◽  
Tareq Kass-Hout ◽  
Michael R. Frankel ◽  
Fadi Nahab ◽  
Samir R. Belagaje ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Infarct Volume ◽  
P Value ◽  
Procedure Time ◽  
Entire Cohort ◽  
Radiographic Outcomes ◽  
Academic Center ◽  
Procedural Time ◽  
Symptomatic Intracranial Hemorrhage

Background and Purpose: Time to reperfusion is an essential factor in determination of outcomes in (AIS). We sought to establish the effect of the procedural time on the clinical and radiographic outcomes of AIS patients undergoing intra-arterial therapy. Methods: Retrospective review of a prospectively collected database of endovascularly treated large vessel AIS in a large academic center. Data from all consecutive patients who underwent mechanical thrombectomy from September 2010 to July 2012 were analyzed. The variable of interest was procedural time (defined as time from groin puncture to end of procedure). Outcome measures included the rates of symptomatic intracebral hemorrhage (sICH, defined as any parenchymal hematoma e.g. PH-1/PH-2), final infarct volume, 90-day mortality, and independent functional outcomes (modified Rankin Scale, mRS 0-2) at 90 days. Results: The entire cohort included 242 patients with a mean age of 65.5+/- 14.2 and median baseline NIHSS 20. Of the patients 49.38% were females. The median ASPECTS score was 8. The mean procedure time was significantly shorter in patients with good outcome (86.73 vs. 73.13 respectively, P-value: 0.0228). However, after controlling for ASPECTS score, type of retrieval device, TICI score, volume of infarct, interval from symptoms onset to puncture, and co-morbidities, this association did not prove to be significant (P-value = 0.7101). Patients with SICH had significantly higher mean procedure time than patients without SICH (79.65 vs. 104.5 respectively; P-value: 0.0319) which remained significant when controlling to the previous factors (OR = 0.974 with a 95 % CI of (0.957, 0.991). There was no correlation between the volume of infarction and the procedure time (r = 0.10996, P-value: 0.0984). There was no association between procedure time and 90-day mortality (77.8 vs. 88.2 minutes in survivals vs. deaths respectively; P-value: 0.0958). Conclusion: Our data support an association between the risk of SICH and a longer procedure time while no definite association between procedural times and the final infarction volume or long-term functional outcomes was found after adjustment for multiple imbalances.

Longer procedural times are independently associated with symptomatic intracranial hemorrhage in patients with large vessel occlusion stroke undergoing thrombectomy

2016 ◽  
Vol 8 (12) ◽  
pp. 1217-1220 ◽  
Author(s):  
Tareq Kass-Hout ◽  
Omar Kass-Hout ◽  
Chung-Huan Johnny Sun ◽  
Taha A Kass-Hout ◽  
Raul Nogueira ◽  
...  
Keyword(s):  
Intracranial Hemorrhage ◽  
Functional Outcomes ◽  
Infarct Volume ◽  
National Institutes Of Health ◽  
Procedure Time ◽  
Vessel Occlusion ◽  
Procedural Time ◽  
Symptomatic Intracranial Hemorrhage

BackgroundTime to reperfusion is an essential factor in determination of outcomes in acute ischemic stroke (AIS).ObjectiveTo establish the effect of the procedural time on the clinical outcomes of patients with AIS.MethodsData from all consecutive patients who underwent mechanical thrombectomy between September 2010 and July 2012 were analysed retrospectively. The variable of interest was procedural time (defined as time from groin puncture to final recanalization time). Outcome measures included the rates of symptomatic intracranial hemorrhage (sICH, defined as any parenchymal hematoma—eg, PH-1/PH-2), final infarct volume, 90-day mortality, and independent functional outcomes (modified Rankin Scale 0–2) at 90 days.ResultsThe cohort included 242 patients with a mean age of 65.5±14.2 and median baseline National Institutes of Health Stroke Scale score 20. 51% of the patients were female. The mean procedure time was significantly shorter in patients with a good outcome (86.7 vs 73.1 min, respectively, p=0.0228). Patients with SICH had significantly higher mean procedure time than patients without SICH (79.67 vs 104.5 min, respectively; p=0.0319), which remained significant when controlling for the previous factors (OR=0.974, 95% CI 0.957 to 0.991). No correlation was found between the volume of infarction and the procedure time (r=0.10996, p=0.0984). No association was seen between procedure time and 90-day mortality (77.8 vs 88.2 min in survivals vs deaths, respectively; p=0.0958).ConclusionsOur data support an association between the risk of SICH and a longer procedure time, but no association between procedural times and the final infarction volume or long-term functional outcomes was found.

Determination of factors involved in the rejection of bananas (Musa acuminata) intended for international commercialization

2020 ◽  
Keyword(s):  
Management Practices ◽  
Abiotic Factors ◽  
Quality Standards ◽  
Musa Acuminata ◽  
P Value ◽  
Biotic Factors ◽  
Significance Level ◽  
Export Sector ◽  
Export System

The banana agro-export sector in Ecuador provides millions of dollars in income for this concept, but with this development, a series of quality standards have been established that must be met to enter the export system. This has contributed to establishing good post-harvest production and management practices that guarantee the optimal production of bananas and plantains. The objective of this study was to determine the factors involved in the rejection of bananas (Musa acuminata) destined for international commercialization. The methodology considered the design modality of non-experimental transactional research, with a quantitative approach. The methodological design was developed in three phases at Finca 6 Hermanas located in the Barraganete sector of the San Juan parish in the Puebloviejo canton of the Los Ríos Province, Ecuador. The results highlight that the main causes for which banana rejection is generated are due to abiotic factors (damage, dry latex, scar, insect damage, broken neck, overgrowth) in a higher percentage of 79.55 % and biotic factors ( twins, diseases, short finger) by 20.45 %. The average rejection was 6 361 fingers and1 269 Kilograms (K) over the 6-week study duration. The analysis of variance turned out to be significant for variable 1 (biotic and abiotic). Ho is rejected; with the criterion of p-value < 0.0001 and F (9; 45) = 2.10., F = 13.17> F critic. In the case of variable (2) “work weeks”, Ho is accepted with the criteria obtained of p-value of 0.7694 and F (5; 45) = 2.4., As F = 0.51 < F critic, it is concludes, that with a significance level of 5% the null hypothesis is accepted. It is concluded that these figures lead to the elaboration of strategies that systemically mitigate the damages, by correcting each one of the causes that cause the deterioration of the banana and increasing the economic gains of the commercialization process.

Effect of Proximal Dome and Distal Chevron Osteotomies on Plantar Pressures and Radiographic and Functional Outcomes in Hallux Valgus Surgery: A Retrospective Analysis

2021 ◽  
Vol 111 (3) ◽  
Author(s):  
Kadir Ilker Yildiz ◽  
Abdulhamit Misir ◽  
Turan Bilge Kizkapan ◽  
Mustafa Cukurlu ◽  
Canan Gonen Aydin
Keyword(s):  
Hallux Valgus ◽  
Inclination Angle ◽  
Plantar Pressure ◽  
Functional Outcomes ◽  
First Metatarsal ◽  
Pressure Point ◽  
Radiographic Outcomes ◽  
Metatarsal Angle ◽  
Dome Osteotomy ◽  
Pressure Changes

Background No detailed comparative studies have been performed regarding plantar pressure changes between proximal dome and distal chevron osteotomies. This study aimed to compare radiographic and plantar pressure changes after distal chevron and proximal dome osteotomies and to investigate the effect of radiographic and plantar pressure changes on clinical outcomes. Methods This study included 26 and 22 patients who underwent distal chevron and proximal dome osteotomies, respectively. Visual analog scale (VAS) and American Orthopaedic Foot & Ankle Society (AOFAS) forefoot scores were used to evaluate pain and functional outcomes. Hallux valgus angle, intermetatarsal angle, talar–first metatarsal angle, and calcaneal inclination angle were measured in the evaluation of radiographic outcomes. Preoperative and postoperative plantar pressure changes were evaluated. Results There were no statistically significant differences between the two groups in age, body mass index, or AOFAS forefoot and VAS scores. In the proximal dome group, the pressure measurement showed significant lateralization of the maximal anterior pressure point in the forefoot (P &lt; .001). In addition, the postoperative calcaneal inclination angle was significantly lower (P = .004) and the talar–first metatarsal angle was significantly higher (P &lt; .001) in the proximal dome group. Postoperative transfer metatarsalgia was observed in one patient (3.8%) in the distal chevron group and five (22.7%) in the proximal dome group (P &lt; .05). Conclusions Proximal dome osteotomy led to more lateralization of the maximum anterior pressure point, decreased calcaneal inclination angle and first metatarsal elevation, and related higher transfer metatarsalgia.

Comparison of Outcome of Lateral Pinning Versus Medial and Lateral Cross Pinning in Childhood Supracondylar Fractures of Humerus

2021 ◽  
Vol 15 (9) ◽  
pp. 2873-2875
Author(s):  
Mudassar Nazzar ◽  
Muhammad Adeel-Ur- Rehman ◽  
Rizwan Anwar ◽  
Omer Farooq Tanveer ◽  
Muhammad Abdul Hanan ◽  
...  
Keyword(s):  
Nerve Injury ◽  
Ulnar Nerve ◽  
Functional Outcomes ◽  
P Value ◽  
Supracondylar Fractures ◽  
Group I ◽  
Pin Fixation ◽  
Group Ii ◽  
Carrying Angle ◽  
Ulnar Nerve Injury

Objectives: To compare the complications and outcomes of lateral entry pin fixation with medial and lateral pin fixation for Gartland type III supracondylar fractures of humerus. Methodology: This prospective comparative study involving 190 patients of Gartland type III close supracondylar fractures were included. from March-2019 to Dec-2020. In all patients, initially the elbow was mobilized using the splint placed above the elbow joint at 30 to 45 degrees’ flexion. After closed reduction, lateral pinning was applied in group I and in group II lateral and medial cross pinning was applied using the standard protocol. Patients were followed for iatrogenic ulnar nerve injury, radiologic and function outcomes in-terms of loss of reduction, elbow range of motion, loss in carrying angle and functional outcomes. Results: The two groups were comparable for loss of elbow range of motion, loss of carrying angle and loss of Bauman's angle. On clinical examination, immediate post-operative ulnar nerve injury was diagnosed in 4 (4.2%) cases in group II and in no patient in group I (p-value 0.12). Satisfactory functional outcomes were achieved in 85 (89.5%) patients in group I and in 88 (92.6%) patients in group II (p-value 0.44). Conclusion: Lateral pinning provided stable fixation clinically and radiologically as compared to lateral and medial cross pinning. Keywords: Supracondylar fracture of Humerus, Iatrogenic ulnar nerve injury, Lateral pin entry, lateral and medial cross pin entry.

Abstract P381: Pre-Treatment Perfusion Mismatch Volumes in Ischemic Stroke Patients Treated With Tenecteplase or Alteplase

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Adrienne N Dula ◽  
Ian M Alrahwan ◽  
Steven J Warach
Keyword(s):  
Imaging Modality ◽  
Infarct Volume ◽  
Volume Growth ◽  
Logistic Models ◽  
P Value ◽  
Full Cohort ◽  
Stroke Registry ◽  
Discharge Disposition ◽  
Chi Squared ◽  
Pre Treatment

Introduction: The overall goal of this study is to evaluate the relationship of pretreatment perfusion mismatch volumes to outcomes in patients receiving alteplase (ALT) to those receiving tenecteplase (TNK). Methods: This study included patients receiving treatment with ALT (0.9 mg/kg; max, 90 mg) or TNK (0.25 mg/kg; max, 25 mg) between 09/01/2017 - 06/30/2020 identified through our local stroke registry stroke registry. Of the 505 patients meeting these criteria, 280 have been screened, including patients receiving EVT (n=94) and a sampling of n=111 from the ALT group and 75 from the TNK group. Final eligibility will be patients with a pretreatment perfusion deficit, mismatch > 15 mL, and mismatch (MM) ratio ≥ 1.2. Volumes are based on RAPID software (iSchemiaView). Using univariate (chi-squared with continuity correction or Mann-Whitney U) and adjusted logistic models, the effect of lysis type and pre-treatment imaging were assessed on the primary outcome of discharge disposition. Results: A total of 93 patients were included in our analysis, 40 receiving ALT and 53 patients receiving TNK, demographics found in Table 1. Discharge to home occurred in 48.8% (20/40) of patients treated with ALT and 30.7% (16/53) treated with TNK, odds ratio (OR), 0.47; 95% CI [0.20, 1.09], (P-value for OR=0.0766). Upon adjustment for EVT, age, sex, NIHSS on admission, imaging modality, cohort imbalances (marked by *), and MM, the relation of lysis type to discharge to home gave an OR of 0.25; 95% CI [0.06, 0.90], P= 0.0383) with age (P<0.0001) and imaging modality (P=0.0020) significantly contributing to the model. Lysis type did not significantly influence discharge to hospice or death (OR, 0.62; 95% CI [0.05, 6.86], P=0.6945) upon adjustment for baseline factors. Conclusion: In this preliminary analysis, MM volumes did not contribute to the outcome of discharged to home. Analysis of the full cohort is ongoing and final analyses will relate lytic type to infarct volume growth and clinical outcomes.

Abstract P481: Time to Reperfusion Determines Clinical Outcomes Independent of Post Thrombectomy Infarct Volume

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Shashvat Desai ◽  
Amin N Aghaebrahim ◽  
James E Siegler ◽  
Andre Monteiro ◽  
Ashutosh P Jadhav ◽  
...  
Keyword(s):  
Multivariate Analysis ◽  
Clinical Outcomes ◽  
Clinical Improvement ◽  
Functional Outcomes ◽  
Time Window ◽  
Infarct Volume ◽  
Late Time ◽  
Inclusion Criteria ◽  
Ischemic Time ◽  
The Impact

Introduction: Late time window thrombectomy trials demonstrated that good functional outcomes can be achieved up to 24 hours from stroke onset in Slow Progressors (small infarct volume and large penumbral volume). In this study, we aim to investigate whether early (<6 hours) recanalization leads to superior functional outcomes compared to delayed recanalization (>6 hours) amongst patients with similar 24-hour infarct volumes post thrombectomy. Methods: We performed a retrospective analysis of a prospectively maintained LVO stroke thrombectomy database across 3 comprehensive stroke centers. Demographic, clinical, radiological, and outcomes data were analyzed. Inclusion criteria were witnessed onset anterior circulation LVO [internal carotid or middle cerebral artery M1] strokes with a good baseline mRS score (0-1) having achieved success recanalization [mTICI 2b-3] and 24-hour infarct volume of ≤10 ml on CT head or MRI. Univariate and multivariate analysis of the impact of time to recanalization on clinical outcomes was performed. Results: Of the 499 LVO strokes undergoing thrombectomy, 30% (148) met inclusion criteria. Mean age was 70 ±14 and median NIHSS score was 17 (14-21). Early recanalization (<6h) was achieved in 65% (96) of patients. Baseline demographic (age: 73 vs 74, p=0.80) and clinical characteristics (NIHSS:16.5 vs 17, p=0.52; 24-h infarct volume: 4.4 vs 4.2 ml, p=0.60) were comparable between early versus late recanalization patients. Rates of early clinical improvement (24-h NIHSS <6) (71% vs 39%, p=0.0007) and mRS 0-2 at 90 days (68% vs 48%, p=0.019) were higher in early recanalizers compared to late recanalizers. Multivariate analysis including age, NIHSS, time to recanalization, and 24-hour infarct volume identified early recanalization as an independent predictor of mRS 0-2 at 90 days (OR-2.41 95% CI 1.89-4.50). Every 1-hour increase in time to recanalization decreased the odds of 90-day mRS 0-2 by 2.2%. Conclusion: Among patients with similar 24-hour infarct volume post thrombectomy (≤10 ml), shorter time to successful recanalization is associated with significantly higher rates of early clinical improvement and mRS 0-2 at 90 days. Increased penumbral ischemic time may have an impact on outcomes post stroke thrombectomy.

Abstract 3681: Early Anticoagulation Is Not Associated With Hemorrhagic Transformation Of Ischemic Stroke In Patients With Atrial Fibrillation

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
H. B Brouwers ◽  
Svetlana Lorenzano ◽  
Lyndsey H Starks ◽  
David M Greer ◽  
Steven K Feske ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Clinical Data ◽  
Infarct Volume ◽  
Hemorrhagic Transformation ◽  
P Value ◽  
Long Term Outcome ◽  
Nihss Score

Purpose: Hemorrhagic transformation (HT) is a common and potentially devastating complication of ischemic stroke, however its prevalence, predictors, and outcome remain unclear. Early anticoagulation is thought to be a risk factor for HT which raises the clinical question when to (re)start anticoagulation in ischemic stroke patients who have a compelling indication, such as atrial fibrillation. We conducted a prospective cohort study to address this question and to identify association of hemorrhagic transformation with outcome measures in patients with atrial fibrillation in the setting of acute ischemic stroke. Materials and Methods: We performed a prospective study which enrolled consecutive patients admitted with acute ischemic stroke presenting to a single center over a three-year period. As part of the observational study, baseline clinical data and stroke characteristics as well as 3 month functional outcome were collected. For this sub-study, we restricted the analysis to subjects diagnosed with atrial fibrillation. CT and MRI scans were reviewed by experienced readers, blinded to clinical data, to assess for hemorrhagic transformation (using ECASS 2 criteria), microbleeds and infarct volumes in both admission and follow-up scans. Clinical and outcome data were analyzed for association with hemorrhagic transformation. Results: Of 94 patients, 63 had a history of atrial fibrillation (67.0%) and 31 had newly discovered atrial fibrillation (33.0%). We identified HT in 3 of 94 baseline scans (3.2%) and 22 of 48 follow-up scans (45.8%) obtained a median of 3 days post-stroke. In-hospital initiation of either anti-platelet (n = 36; OR 0.34 [95% CI 0.10-1.16], p-value = 0.09) or anticoagulation with unfractionated intravenous heparin or low molecular weight heparin (n = 72; OR 0.25 [95% CI 0.06-1.15], p-value = 0.08) was not associated with HT. Initial NIH Stroke Scale (NIHSS) score (median 13.0 [IQR 15.0] vs. 7.0 [IQR 10.0], p-value = 0.029) and baseline infarct volume (median 17 [IQR 42.03] vs. 5 [IQR 10.95], p-value = 0.011) were significantly higher in patients with HT compared to those without. Hemorrhagic transformation was associated with a significantly higher 48-hour median NIHSS score (20 [IQR 3.0] vs. 2 [IQR 3.25], p-value = 0.007) and larger final infarct volume (81.40 [IQR 82.75] vs. 9.95 [IQR 19.73], p-value < 0.001). Finally, we found a trend towards poorer 3-month modified Rankin Scale scores in subjects with HT (OR 11.25 [95% CI 0.97-130.22], p-value = 0.05). Conclusion: In patients with atrial fibrillation, initial NIHSS score and baseline infarct volume are associated with hemorrhagic transformation in acute ischemic stroke. Early initiation of antithrombotic therapy was not associated with hemorrhagic transformation. Patients with hemorrhagic transformation were found to have a poorer short and long term outcome and larger final infarct volumes.

scholarly journals Comparison of free radicals in blood in pre-operative and post-operative phases of breast malignancies: a clinicopathological study

2019 ◽  
Vol 7 (1) ◽  
pp. 210
Author(s):  
Abhishek Jina ◽  
U. C. Singh
Keyword(s):  
Breast Cancer ◽  
Free Radicals ◽  
Breast Carcinoma ◽  
Ductal Carcinoma ◽  
Lipid Peroxide ◽  
P Value ◽  
Breast Cancer Patients ◽  
Medical College ◽  
Surgery Department

Background: Various factors have been identified as influencing factors of breast cancer. The free radicals can cause increased oxidative stress by negatively affecting the body’s nucleic acids, lipids and proteins leading to various illnesses including cancer. Therefore, this study was aimed at discovering the progress of treatment of breast carcinoma by exploring the connections of the disease with free radical injury.Methods: The present study was conducted among 30 breast carcinoma patients received in the surgery department of BRD Medical College Gorakhpur. Determination of the levels superoxide dismutase (SOD) (the procedure of photoluminescence), catalase (method of Cavarochi) and the lipid peroxidise was done. The results were presented as mean and standard error (SE). P value of <0.05 was considered as statistically significant.Results: Among the total participants, 73% patients had infiltrating ductal carcinoma and 27% patients had intraductal carcinoma. The dismutase levels showed an increase in the post-operative patients for both the groups. The catalase levels and the lipid peroxide levels showed a reduction in the postoperative patients (p<0.05).Conclusions: The present study result showed that the low amounts of SOD and catalase may not be sufficient to detoxify high amounts of free radicals. The administration of catalase could help in reducing the symptoms. Though, low amounts of SOD and catalase may not be sufficient to detoxify high amounts of free radicals. The administration of enzymes could help in the treatment of breast cancer patients.

scholarly journals Isolation and structure elucidation of anti-malarial principles from Terminalia mantaly H. Perrier stem bark

2021 ◽  
Vol 15 (1) ◽  
pp. 282-292
Author(s):  
Babatunde Samuel ◽  
Yemi Adekola Adekunle
Keyword(s):  
Statistical Significance ◽  
Solvent System ◽  
Stem Bark ◽  
P Value ◽  
Resonance Spectroscopy ◽  
Global Public Health ◽  
1H And 13C Nmr ◽  
Malaria Therapy ◽  
Student’S T

Emergence of malaria parasite resistance to drugs has raised global public health concerns for a compelling need to develop improved malaria therapy. This study is a bio-guided isolation of triterpenoid antimalarial compounds from Terminalia mantaly. Methanol extract of the plant was subjected to column chromatography, and eluted with a ternary solvent system gradient-wise. Two compounds, 1 and 2, were isolated and characterised by spectroscopic data (IR, 1H and 13C NMR, COSY, HMQC, HMBC) and by comparison with literature. Isolated compounds were investigated for antimalarial property by spectrophotometric determination of inhibition of β-Hematin formation, absorbance taken at 405 nm. Results were analysed using Graghpad Prism® (6.0) and presented as mean IC50±SEM. Statistical significance, determined using Student’s t-test and one-way ANOVA, set at p-value of 0.05. Quantitative β-Hematin formation inhibitory activities gave IC50±SEM values of (compound 1; 4.434±0.47), (compound 2; 5.140±4.2) with (chloroquine; 0.335±0.1 mg/ml). Compound 1 was identified as 2,3,19,23-tetrahydroxyolean-12-en-28-oic acid glucopyranoside (arjunglucoside I), and compound2 as its aglycone, 2,3,19,23-tetrahydroxyolean-12-en-28-oic acid (arjungenin). This study provided credence for folkloric use of Terminalia mantaly to treat malaria, and this observed activity was probably due to these isolated triterpenoids.Keywords: β-Hematin, triterpenoids, nuclear magnetic resonance spectroscopy

scholarly journals Ultrasound-Guided Cannulation of the Great Saphenous Vein in Neonates: A Randomized Study

2021 ◽  
Author(s):  
Zhenzhen Tu ◽  
Yanzhe Tan ◽  
Lifei Liu ◽  
Jia Xie ◽  
Ying Xu ◽  
...  
Keyword(s):  
Great Saphenous Vein ◽  
Randomized Study ◽  
Controlled Study ◽  
Control Group ◽  
Success Rates ◽  
Procedure Time ◽  
Ultrasound Guided ◽  
Randomized Controlled ◽  
Key Points ◽  
Procedural Time

Objective This prospective randomized controlled study aimed to compare the ultrasound-guided (USG) technique with the standard single-wall puncture technique for epicutaneo-caval catheter (ECC) placement in neonates. Study Design A total of 100 neonates were included in this study. All enrolled neonates were randomly divided into two groups (n = 50): the USG group and the control group. The control group underwent standard single-wall puncture for ECC placement procedures, and the USG group underwent USG ECC placement procedures. Results The first attempt success rates (62 vs. 38%; p = 0.016) and the total success rates (92 vs. 74%; p = 0.017) were higher in the USG group than in the control group. The procedure time was shorter in the USG group than in the control group: 351.43 (112.95) versus 739.78 seconds (369.13), p < 0.001. The incidence of adverse events was not significantly different between the two groups. Conclusion Compared with the standard single-wall puncture method, USG cannulation is superior for neonatal ECC placement, with a higher success rate, and decreases the total procedural time. Key Points

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