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Invasive hemodynamic monitoring in obstetrics
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Luis D. Pacheco, Shannon Clark, Gary D. V. Hankins
The head of the patient is turned to the opposite side, and Trendelenburg positioning is accomplished. The entry site is usually 2 to 3 cm caudal to the midpoint of the clavicle. The 18-gauge introducer needle is advanced with the bevel up toward the sternal notch and beneath the clavicle. Care should be taken to avoid directing the needle too caudally (risk of pneumothorax) or too cephalad (risk of subclavian artery puncture). Once blood flow is obtained, the bevel should be rotated 90’ clockwise so that the wire, when advanced, will follow the direction toward the superior vena cava. The Seldinger technique is then followed to advance the catheter.
The Mitral Valve
Published in Theo Kofidis, Minimally Invasive Cardiac Surgery, 2021
All “rules” about femoral cannulation from the past have to be forgotten. The rules should be: never tape the artery, and do not clamp or incise it, as this may lead to the introduction of a false lumen with disastrous consequences as a result! The “Seldinger” technique is imperative. It can be done through a 2.5-cm cutdown but also completely percutaneously in thin patients with the aid of an appropriate “closure” device. Prostar or ProGlide can be used safely up to 21 French cannulas.
Vascular Access and Sheaths
Published in Vikram S. Kashyap, Matthew Janko, Justin A. Smith, Endovascular Tools & Techniques Made Easy, 2020
In the most common technique (known as the modified Seldinger technique), the blood vessel is accessed with a hollow needle. After ensuring adequate position and blood return, a wire is thread into the vessel lumen, with care taken not to dissect the arterial walls (Figure 5.1). The original Seldinger technique was “modified” to avoid posterior wall penetration to prevent bleeding from the additional back wall through-and-through puncture (4). The course of the wire is confirmed using fluoroscopy, and subsequently a sheath or a catheter is advanced over the wire into the vessel. In our practice, we typically obtain access with a 21-gauge micropuncture kit and 0.018″ access wire, with subsequent escalation to a larger sheath. This minimizes needle trauma and provides the opportunity to abort with less consequences should the access site be unfavorable.
Assessment of complications and short-term outcomes of percutaneous peritoneal dialysis catheter insertion by conventional or modified Seldinger technique
Published in Renal Failure, 2021
Yun Zou, Yibo Ma, Wenying Chao, Hua Zhou, Yin Zong, Min Yang
The Seldinger technique is a blind penetration method with inherent complications, such as bowel perforation and bleeding. Bowel perforation is a serious early complication after PD catheter insertion with an incidence of about 1% [3]. Adhesion of the intestine to the abdominal wall, especially with repeated needle punctures could significantly increase the risk of bowel perforation and bleeding. The risk of adhesions in patients with previous abdominal surgery is reportedly as high as 70–90%, especially in patients with multiple prior laparotomies [20–22]. About 5% of patients even without a previous history of abdominal surgery can also have adhesions [23]. If there is relatively free movement of the small bowel by transabdominal ultrasound, the probability of significant adhesions is low, thereby reducing the risk of intraoperative bowel injury [24,25].
Adjuvant transcatheter arterial chemoembolization after radical resection of hepatocellular carcinoma patients with tumor size less than 5 cm: a retrospective study
Published in Scandinavian Journal of Gastroenterology, 2019
Freliska Lazuardi, Jacqueline Valencia, Shusen Zheng
After administration of local anesthesia, Seldinger technique was used to introduce the catheter through femoral artery up to hepatic artery. Hepatic angiography was performed to clarify tumor vascularity, tumor nodules and distribution of the hepatic arteries. Thereafter, emulsions of Epirubicin, Oxaliplatin and Lipiodol were injected through microcatheters to the selected hepatic artery. TACE is performed 1 to 2 months after hepatic resection. Most patients only receive 1 cycle of TACE, 31 patients receive 2–3 cycles, with interval time of 1–3 months after each cycle. A follow-up CT scan is performed 1 month after the procedure to evaluate the effectiveness of the procedure.
The relationship between the carotid and coronary artery stenosis: a study based on angiography
Published in Neurological Research, 2019
Seldinger technique was used to access the puncture of femoral or radial artery. After the successful puncture, 5/6/8F arterial sheath was selected according to the situation and 2000IU heparin was administered. DSA and CAG were performed by neurologist and intracardiac interventionist, respectively.