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Vascular Trauma
Published in James Michael Forsyth, How to Be a Safe Consultant Vascular Surgeon from Day One, 2023
The examiners asked me what the diagnosis was. I said the patient likely had a radial artery pseudoaneurysm secondary to the radial artery puncture. The examiners nodded (no brainer really), and then asked me what else I wanted to know in terms of examination findings.
Contour of Pressure and Flow Waves in Arteries
Published in Wilmer W Nichols, Michael F O'Rourke, Elazer R Edelman, Charalambos Vlachopoulos, McDonald's Blood Flow in Arteries, 2022
A new instrument, devised by the Colin Medical Technology Corporation in Japan and later available from Omron Co., uses an array of tonometers that are applied over the wrist with a force that depends on the blood pressure measured by an oscillometric technique in the brachial artery (Kemmotsu et al., 1991a, 1991b; Sato et al., 1993; Takazawa et al., 1995a; Chen et al., 1997) (see also Chapter 27). This provides a continuous record of phasic arterial pressure and is well suited to clinical situations where this information is desirable but radial artery puncture is not warranted. This technique carries great promise for continuous noninvasive blood pressure recording.
Planning and conducting the exercise test
Published in Robert B. Schoene, H. Thomas Robertson, Making Sense of Exercise Testing, 2018
Robert B. Schoene, H. Thomas Robertson
Exercise arterial blood gases are an important addition to a diagnostic CPET if the clinical history suggests either possible exercise-associated desaturation or that pulmonary vascular disease or interstitial lung disease are among the potential diagnostic considerations. While some clinicians prefer to insert a radial artery catheter for secure blood sampling throughout the test, others have been satisfied with an immediate post-exercise arterial sample by radial artery puncture. With either choice, the necessary equipment for arterial sampling needs to be assembled before the exercise portion of the test, and that part of the test needs to be explained to the patient.
Feasibility of distal transradial access for coronary angiography and percutaneous coronary intervention: an observational and prospective study in a Latin-American Centre
Published in Acta Cardiologica, 2023
Héctor Hugo Escutia-Cuevas, Marco Alcantara Melendez, Arnoldo Santos Jiménez-Valverde, Gregorio Zaragoza-Rodriguez, Antonio Vargas-Cruz, Juan Francisco Garcia-Garcia, Bayardo Antonio Ordonez-Salazar, Antonio Flores-Morgado, Guillermo Orozco Guerra, Diego Alvaro Renteria-Valencia
The success rates of CAG and PCI were 100% (123/123) and 97% (69/71), respectively (Table 3). Two cases of PCI failure were diagnosed with chronic total occlusion of the right coronary artery, and the procedure was stopped because the guidewire failed to pass into the true lumen with the previous investing procedure for a new attempt in 3 months. The success rate of distal radial artery puncture was 96% (155/162). Crossover sites in seven (4.5%) patients were in the ipsilateral radial artery, in three (1.5%) patients in the contralateral radial artery, one patient in the contralateral distal radial artery and 9 (6%) patients were in the femoral artery (Table 3). The decision of the crossover site was made by the operator depending on the type of complication, evaluating the distal radial an proximal radial pulses, the previous ultrasonographic arterial diameter measure, radial tortuosity, the size of the guide catheters needed and the complexity of the procedure. Among 155 cases of the distal radial approach, puncture time was 52 ± 119 s and haemostasis time was 135 ± 25 min for CAG and 150 ± 40 min for PCI. One patient died during hospitalisation due to myocardial infarction.
Positive correlations between plasma BPI level and MPO-DNA and S100A8/A9 in myocardial infarction
Published in Platelets, 2022
Shicheng Yu, Miaonan Li, Zheng Li, Pan Xu, Zhuoya Yao, Shaohuan Qian, Fudong Qian, Dasheng Gao, Hongju Wang
All subjects exhibited clinical indications for CAG, which was performed by experienced cardiologists according to the conventional Judkins method. Radial artery puncture and rapamycin-coated stents were used in all patients. During the procedure, 1 ml of 1% lidocaine was used for local anesthesia, and 3000 U heparin and 200 μg nitroglycerin were injected through the artery sheath after it was implanted. The results of CAG were read and reported by a group of experienced physicians according to the current guidelines [42]. The decision on the subsequent need for percutaneous coronary intervention (PCI) was also made by the group of experienced physicians according to the current PCI guidelines [42]. The study subjects were included in the control group if they did not meet the exclusion criteria and their CAG results were normal. NSTEMI/STEMI was diagnosed according to the criteria of the ACCF/ESC/AHA/WHF Fourth Universal Definition of myocardial infarction.
Optimal Dose of Dexmedetomidine for Perioperative Blood Glucose Regulation in Non-Diabetic Patients Undergoing Gastrointestinal Malignant Tumor Resection: A Randomized Double-Blinded Controlled Trial
Published in Journal of Investigative Surgery, 2021
Wei Zhou, Dongsheng Zhang, Shunping Tian, Chao Tan, Rongrong Ma, Jing Zhang, Jianhong Sun, Zhuan Zhang
None of the patients received preoperative medication. Routine monitoring including SpO2, ECG and noninvasive BP were performed once patients entered the operating room. Ultrasound-guided right internal jugular vein puncture was performed under local anesthesia, and a double-lumen catheter was inserted to a depth of 13–14 cm. After successful catheterization, Ringer's solution was infused at a rate of 1.5 ml/kg/h. Patients with a positive result on the modified Allen test were catheterized with radial artery puncture under local anesthesia to monitor invasive arterial pressure (IAP). Narcotrend (MT Monitortechnik GmbH&Co.KG, Germany) was used to monitor the depth of anesthesia. Groups D1, D2, and D3 were given an intravenous injection of dexmedetomidine (200 mcg/mL, 17223BP, 180528BP, 190118BP, Jiangsu Hengrui Pharmaceutical Co., Ltd.) at 1 mcg/kg for 10 min before general anesthesia induction, that was maintained with rates of 0.25, 0.5, and 1 mcg/kg/h, respectively, until approximately 30 min before the end of surgery. Group C was given intravenous saline at a rate of 50 mL/h for 10 min, followed by continuous infusion at a rate of 10 mL/h until about 30 min before the end of surgery. The dexmedetomidine and saline solutions used in each group were intravenously pumped through the fourth channel of a syringe pump (CP-2100, Beijing Silugao Medical Technology Co., Ltd., China), which was covered with a piece of opaque sheet.