scholarly journals Non-target digital ischemia in an ulnar artery distribution following transradial access: Case report and review of best practice techniques

2021 ◽  
pp. 112972982110008
Author(s):  
Patrick Kennedy ◽  
Darren Klass ◽  
John Chung
Keyword(s):  
Best Practice ◽  
Artery Aneurysm ◽  
Ulnar Artery ◽  
Complication Rates ◽  
Endovascular Interventions ◽  
Transradial Access ◽  
Digital Ischemia ◽  
Aneurysm Embolization ◽  
Lower Complication ◽  
Access Complications

Transradial access is a safe approach for visceral endovascular interventions, with lower complication rates compared to transfemoral access. This report describes an unusual case of ulnar artery thrombosis following splenic artery aneurysm embolization via left transradial approach, resulting in non-target digital ischemia and eventual amputation of the ring and little finger distal phalanges. Technical considerations to reduce the incidence of access complications are also reviewed, along with practice modifications undertaken at our institution following this case to improve outcomes.

scholarly journals Ulnar artery aneurysm with digital ischemia

1999 ◽  
Vol 4 (3) ◽  
pp. 143-145 ◽  
Author(s):  
Joanne Torre
Keyword(s):  
Artery Aneurysm ◽  
Ulnar Artery ◽  
Digital Ischemia

scholarly journals Dropping the Hammer: An Uncommon Case of Right-Hand Pain in a Professional Hockey Player

2018 ◽  
Vol 11 (3) ◽  
pp. 238-241 ◽  
Author(s):  
Donald Kasitinon ◽  
Robert J. Dimeff
Keyword(s):  
Case Reports ◽  
Artery Aneurysm ◽  
Ulnar Artery ◽  
Cold Sensitivity ◽  
Hockey Stick ◽  
Hockey Player ◽  
Doppler Ultrasound Imaging ◽  
Digital Ischemia ◽  
Professional Hockey ◽  
Repetitive Trauma

A 26-year-old, right-handed male professional hockey player presented for a second opinion with dysesthesia of the tips of his right third, fourth, and fifth fingers after 2 previous incidents of hyperextension injuries to his right wrist while holding his hockey stick. Radiographs and computed tomography scans were negative for fracture. After magnetic resonance angiography and Doppler ultrasound imaging, the athlete was diagnosed with hypothenar hammer syndrome (HHS) with ulnar artery aneurysm and thrombosis. He underwent successful surgery with ligation and excision of the aneurysmal, thrombosed ulnar artery and was able to return to hockey 4 weeks after surgery. HHS is thought to be a rare posttraumatic digital ischemia from thrombosis and/or aneurysm of the ulnar artery and was traditionally considered an occupational injury but has been reported more frequently among athletes. There have only been 2 previous case reports of hockey players diagnosed with HHS, and in the previous 2 case reports, both involved repetitive trauma from the hockey stick, which resulted in thrombotic HHS. We present a case of a professional hockey player diagnosed with HHS also due to repetitive trauma from the hockey stick, but this time resulting in aneurysmal HHS with thromboembolism. This case report highlights the importance of keeping HHS in the differential diagnosis in athletes with pain, cold sensitivity, and paresthesia in their fingers with or without a clear history of repetitive trauma to the hypothenar eminence, as HHS is a condition with good outcomes after proper treatment.

scholarly journals Transradial Access: A Comprehensive Review

2021 ◽  
Vol 4 ◽  
Author(s):  
Shawn Hobby ◽  
Maxwell Stroebel ◽  
Ricardo Yamada ◽  
Thor Johnson ◽  
Andre Uflacker ◽  
...  
Keyword(s):  
Radial Artery ◽  
Lower Cost ◽  
Artery Occlusion ◽  
Patient Comfort ◽  
Complication Rates ◽  
Femoral Access ◽  
Transradial Access ◽  
Lower Complication ◽  
Anatomic Variants ◽  
Left Radial Artery

Transradial access (TRA) via the left radial artery is an alternative to traditional transfemoral access for catheter-based procedures that is becoming increasingly more relevant in all types of arterial vascular interventions. First investigated in the realm of cardiology, TRA has been proven to provide many benefits (such as lower complication rates, lower cost, and improved patient comfort during and after the procedure) when compared with traditional femoral access while maintaining efficacy. This article provides an in-depth summary of the technical aspects of radial access while incorporating more recent data to explain patient preference for TRA, and the ways that TRA can improve peri-procedure workflow and compensation. It also describes potential complications, such as radial artery spasm, difficult anatomic variants and radial artery occlusion, and then gives techniques for mitigating and treating these complications. The article explains why TRA has become an important option for vascular and interventional radiology physicians, and why it is likely that this will continue to grow in relevance.

#49: Results of 10 Years of Peripherally Inserted Central Catheter Use and the Association with Infections in Pediatric Patients at a Tertiary Care Oncology Hospital

2021 ◽  
Vol 10 (Supplement_1) ◽  
pp. S16-S16
Author(s):  
Jennia J Acebo ◽  
María Costta ◽  
Gisella Sánchez ◽  
Erika Villanueva ◽  
Erika Montalvo E ◽  
...  
Keyword(s):  
Cancer Patients ◽  
Complication Rate ◽  
Best Practice ◽  
Infectious Complication ◽  
Pediatric Patients ◽  
Tertiary Care ◽  
Bloodstream Infections ◽  
Complication Rates ◽  
Peripheral Venous Access ◽  
Pediatric Cancer Patients

Abstract Introduction Pediatric cancer patients merit the placement of central lines for the treatments they receive. Subcutaneous central ports (SCs) and peripherally inserted central catheters (PICCs) are the most frequently used lines. PICCs have gained popularity due to the ease of insertion, which can be invaluable in the pediatric oncology setting for administration of intravenous therapy, parenteral nutrition, and/or blood products. Since central-line-associated bloodstream infections increase the morbidity and mortality of cancer patients, as well as increase the cost generated by their treatment, active surveillance of these healthcare-associated infections is warranted. Methods This is a retrospective descriptive study of pediatric patients treated via PICCs at the Hospital SOLCA Núcleo Quito between 2009 and 2019. Results During the study period, 70 PICC lines were placed in 66 patients, totaling 1862 catheter-days. The majority of patients (75.7%) were diagnosed with leukemia or lymphoma. As of 2011, all PICCs were placed in the operating room by a surgeon. Ultrasound was used 39 times for the insertion of PICCs. Inadequate peripheral venous access was the most common indication (64.2%) for placement. Twenty-nine PICCs had complications, of which 13 were infectious complications and 16 were noninfectious. The most common infectious complication was PICC-related bloodstream infection (13), and the most frequent noninfectious complication was occlusion (10). The overall complication rate was 15.5 complications per 1000 catheter-days, and the overall infectious complication rate was 6.9 complications per 1000 catheter days. Annual complication rates fluctuated over the study period. The PICC line-associated infection rate per 1000 catheter-days was 13.1‰ in 2009, 12.4‰ in 2010, 5.0‰ in 2011, 7.9‰ in 2012, 0 in 2013, 13.4‰ in 2014, 4.8‰ in 2015, 16.2‰ in 2016, 8.2‰ in 2017, and 4.3‰ in 2018. Conclusion In general, complications related to PICC in pediatric patients at a tertiary care oncology hospital have fluctuated over the years. Our findings indicate the need for further efforts in staff education and training in the insertion, care, and maintenance of PICC lines. Best practice guidelines are also critical to reducing complications, especially occlusion and infection rates, to thereby improve patient outcomes.

Integrated dual lag screws versus single lag screw cephalomedullary nail constructs: a meta-analysis and systematic review

2021 ◽  
pp. 112070002098506
Author(s):  
James R Onggo ◽  
Mithun Nambiar ◽  
Jason D Onggo ◽  
Anuruban Ambikaipalan ◽  
Parminder J Singh ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Meta Analysis ◽  
Femoral Fractures ◽  
Harris Hip Score ◽  
Complication Rates ◽  
Non Union ◽  
Lag Screw ◽  
Significant Difference ◽  
Lower Complication ◽  
Cephalomedullary Nails

Background/Aim: This study aims to determine the safety and efficacy of integrated dual lag screw (IDL) cephalomedullary nails (CMN) when compared with single lag screw (SL) constructs, in the internal fixation of intertrochanteric femoral fractures. Methods: The Smith & Nephew InterTan IDL was compared with SL CMN group consisting of the Stryker Gamma-3 (G3) and Synthes Proximal Femoral Nail Antirotation (PFNA) CMN. A multi-database search was performed according to PRISMA guidelines. Data from studies assessing the clinical and radiological outcomes, complications and perioperative parameters of InterTan versus G3 or PFNA CMN in patients with intertrochanteric femoral fractures were extracted and analysed. Results: 15 studies were included in this meta-analysis, consisting of 2643 patients. InterTan was associated with lower complication rates in terms of all-cause revisions (OR 0.34; 95% CI, 0.22–0.51; p < 0.001), cut-outs (OR 0.30; 95% CI, 0.17–0.51; p < 0.001), medial or lateral screw migration (OR 0.19; 95% CI, 0.06–0.65; p = 0.008) as well as persistent hip and thigh pain (OR 0.65; 95% CI, 0.47–0.90; p = 0.008). In terms of perioperative parameters, InterTan is associated with longer operative times (MD 5.57 minutes; 95% CI, 0.37–10.78 minutes, p = 0.04) and fluoroscopy times (MD 38.89 seconds, 95% CI, 15.88–61.91 seconds; p < 0.001). There was no statistically significant difference in terms of clinical Harris Hip Score and radiological outcomes, non-union, haematoma, femoral fractures, varus collapse, length of stay and mean intraoperative blood loss between the 2 groups. Conclusions: Integrated dual lag screw cephalomedullary nails are associated with fewer revisions and complications. However, there is insufficient data to suggest that either nail construct is associated with better functional outcomes.

Complications of neuroendoscopic septostomy

2021 ◽  
pp. 1-7
Author(s):  
Travis J. Atchley ◽  
Blake Sowers ◽  
Anastasia A. Arynchyna ◽  
Curtis J. Rozzelle ◽  
Brandon G. Rocque
Keyword(s):  
Endoscopic Third Ventriculostomy ◽  
Third Ventriculostomy ◽  
Complication Rates ◽  
Ventricular Size ◽  
Current Procedural Terminology ◽  
Operative Techniques ◽  
Chi Square ◽  
Intraoperative Complication ◽  
Significant Difference ◽  
Lower Complication

OBJECTIVE The advent of neuroendoscopy revolutionized the management of complex hydrocephalus. Fenestration of the septum pellucidum (septostomy) is often a therapeutic and/or necessary intervention in neuroendoscopy. However, these procedures are not without risk. The authors sought to record the incidence and types of complications. They attempted to discern if there was decreased likelihood of septostomy complications in patients who underwent endoscopic third ventriculostomy (ETV)/choroid plexus cauterization (CPC) as compared with those who underwent other procedures and those with larger ventricles preoperatively. The authors investigated different operative techniques and their possible relationships to septostomy complications. METHODS The authors retrospectively reviewed all neuroendoscopic procedures with Current Procedural Terminology code 62161 performed from January 2003 until June 2019 at their institution. Septostomy, either alone or in conjunction with other procedures, was performed in 118 cases. Basic demographic characteristics, clinical histories, operative details/findings, and adverse events (intraoperative and postoperative) were collected. Pearson chi-square and univariate logistic regression analyses were performed. Patients with incomplete records were excluded. RESULTS Of 118 procedures, 29 (24.5%) septostomies had either intraoperative or postoperative complications. The most common intraoperative complication was bleeding, as noted in 12 (10.2%) septostomies. Neuroendocrine dysfunction, including apnea, bradycardia, neurological deficit, seizure, etc., was the most common postoperative complication and seen after 15 (12.7%) procedures. No significant differences in complications were noted between ventricular size or morphology or between different operative techniques or ventricular approaches. There was no significant difference between the complication rate of patients who underwent ETV/CPC and that of patients who underwent septostomy as a part of other procedures. Greater length of surgery (OR 1.013) was associated with septostomy complications. CONCLUSIONS Neuroendoscopy for hydrocephalus due to varying etiologies provides significant utility but is not without risk. The authors did not find associations between larger ventricular size or posterior endoscope approach and lower complication rates, as hypothesized. No significant difference in complication rates was noted between septostomy performed during ETV/CPC and other endoscopic procedures requiring septostomy.

Sonographic diagnosis of ulnar artery aneurysm in hypothenar hammer syndrome: report of 2 cases.

2001 ◽  
Vol 20 (8) ◽  
pp. 921-924 ◽  
Author(s):  
T E Velling ◽  
F J Brennan ◽  
L D Hall ◽  
M L Puckett ◽  
T R Reeves ◽  
...  
Keyword(s):  
Artery Aneurysm ◽  
Ulnar Artery ◽  
Sonographic Diagnosis ◽  
Hypothenar Hammer Syndrome ◽  
Syndrome Report

Defining “early” cranioplasty to achieve lower complication rates of bone flap failure: resorption and infection

2018 ◽  
Vol 161 (1) ◽  
pp. 25-31 ◽  
Author(s):  
Jang Hun Kim ◽  
Soon-Young Hwang ◽  
Taek-Hyun Kwon ◽  
Kyuha Chong ◽  
Won-Ki Yoon ◽  
...  
Keyword(s):  
Bone Flap ◽  
Complication Rates ◽  
Flap Failure ◽  
Lower Complication ◽  
Early Cranioplasty

scholarly journals The comparison of laparoscopy, shock wave lithotripsy and retrograde intrarenal surgery for large proximal ureteral stones

2013 ◽  
Vol 7 (11-12) ◽  
pp. 673 ◽  
Author(s):  
Ufuk Ozturk ◽  
Nevzat Can Şener ◽  
H.N. Goksel Goktug ◽  
Adnan Gucuk ◽  
Ismail Nalbant ◽  
...  
Keyword(s):  
Shock Wave ◽  
Shock Wave Lithotripsy ◽  
Ureteral Stones ◽  
Complication Rates ◽  
Success Rates ◽  
Retrograde Intrarenal Surgery ◽  
Flexible Ureterorenoscopy ◽  
Lower Complication ◽  
Lower Complication Rate ◽  
Invasive Method

Introduction: In this study we compare the success rates and complication rates of shock wave lithotripsy (SWL), laparoscopic, and ureteroscopic approaches for large (between 1 and 2 cm) proximal ureteral stones.Methods: In total, 151 patients with ureteral stones between 1 and 2 cm in diameter were randomized into 3 groups (52 SWL, 51 laparoscopy and 48 retrograde intrarenal surgery [RIRS]). The groups were compared for stone size, success rates, and complication rates using the modified Clavien grading system.Results: Stone burden of the groups were similar (p = 0.36). The success rates were 96%, 81% and 79%, respectively in the laparoscopy, SWL, and ureteroscopy groups. The success rate in laparoscopy group was significantly higher (p < 0.05). When these groups were compared for complication rates, RIRS seemed to bethe group with the lowest complication rates (4.11%) (p < 0.05). SWL and laparoscopy seem to have similar rates of complication (7.06% and 7.86%, respectively, p = 0.12).Interpretation: To our knowledge, this is the first study to compare the results of laparoscopy, SWL and RIRS in ureteral stones. Our results showed that in management of patients with upper ureteral stones between 1 and 2 cm, laparoscopy is the most successful method based on its stone-free rates and acceptable complication rates. However, the limitations of our study are lack of hospital stay and cost-effectiveness data. Also, studies conducted on larger populations should support our findings. When a less invasive method is the only choice, SWL and flexible ureterorenoscopy methods have similar success rates. RIRS, however, has a lower complication rate than the other approaches.

Sign in / Sign up

Export Citation Format

Share Document