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Adapting Injection Techniques to Different Regions
Published in Yates Yen-Yu Chao, Sebastian Cotofana, Anand V Chytra, Nicholas Moellhoff, Zeenit Sheikh, Adapting Dermal Fillers in Clinical Practice, 2022
Yates Yen-Yu Chao, Sebastian Cotofana, Nicholas Moellhoff
The cannula is adopted by some injectors on the nose via entry from the nasal tip. The rigidity of the cannula is hindered by the nasofrontal angle from the frontal approach. When an entry point is created on the nasal tip, it turns into a leaking point. Most nasal shape problems – nasal length, tip angle, tip projection, nasal height, and undesired shapes – are all closely related to the work done in the nasal tip. However, a break in the most pressure critical area would annul all the attempts to add volume in the tip (Figure 6.59). Although the cannula is blunt at the end, it could still penetrate vessels. A sensation of pain is usually a warning sign that vessels are being approached but the pain is rather prominent for the cannula insertion itself. The pain signal becomes nonspecific during the entire cannula nasal penetrating process. Aggressive cannula puncture carries greater risks of breaking a vessel but the blunt nature of the cannula when facing resistance, especially in a secondary procedure, necessitates more forceful application.
Anaesthetic Records
Published in T.M. Craft, P.M. Upton, Key Topics In Anaesthesia, 2021
Anaesthesia. Airway: airway type, size, cuff and shape used. Breathing system used. Ventilation —type and mode. Use of humidifier, filter, throat pack. Difficulties encountered. Intravenous cannula used — type, size and site. Drugs and fluids used together with doses, route of administration and time given.
Instrumentation and Operating Theater Set up in Minimally Invasive Cardiac Surgery
Published in Theo Kofidis, Minimally Invasive Cardiac Surgery, 2021
Fem-fem bypass requires both arterial and venous cannula to be placed in the proper position. Femoral arterial access may be warranted with or without a distal perfusion of the limb. There are usually single-stage venous cannulas, but a multistage cannula can also be used to drain the blood from SVC and IVC (Figure 4.11).
H3K27-altered diffuse midline glioma: a paradigm shifting opportunity in direct delivery of targeted therapeutics
Published in Expert Opinion on Therapeutic Targets, 2023
Julian S. Rechberger, Blake T. Power, Erica A. Power, Cody L. Nesvick, David J. Daniels
While traditional end-port cannulae have been most commonly used, improved infusion profiles have been observed with recessed step catheters and those with a porous tip [90–93]. In the largest clinical trial of CED for high-grade glioma, post-hoc MRI analysis revealed that only half of the catheters were adequately placed in the targeted area [54, 88]. Software algorithms to model and estimate infusion distribution based on the planned catheter trajectory, infusion parameters, and patient/tumor-specific anatomy are being developed in an effort to address this shortcoming. For example, Wembacher-Schroeder et al. compared the distribution of a radiolabeled antibody as determined by positron emission tomography (PET) to the distribution estimated by the iPlan Flow simulation algorithm, and found acceptable similarity in 8 out of 10 patients [94]. Use of robotic guidance to improve the accuracy of catheter placement was shown to be feasible to stereotactically implant a CED catheter in a 5-year-old patient with a large brainstem DMG [95].
Filler-induced non-thrombotic pulmonary embolism after genital aesthetic injection
Published in Journal of Cosmetic and Laser Therapy, 2022
Prevention measures of vascular complications could include syringe aspiration prior to each injection, and the use of blunt cannula (48), but these measures cannot guarantee the nonoccurrence of such complications. Though genital filler injection procedures are considered highly controversial without standardized recommendations reported in the medical literature, these procedures continue to be performed in increasing numbers, mostly in private settings (9). Peer-reviewed, objective, or independently monitored studies are needed to prove genital aesthetic filler injection safety and efficacy. Before that, the performance of these experimental procedures, especially vaginal filler injection, should be restricted, and false or unsubstantiated advertising should be prohibited. Complications and adverse outcomes, including pulmonary embolism, should be disclosed to the patients considering such experimental procedures.
Bi-needle technique versus transforaminal endoscopic spine system technique for percutaneous endoscopic lumbar discectomy in treating intervertebral disc calcification: a propensity score matched cohort analysis
Published in British Journal of Neurosurgery, 2021
Zeng Xu, Jian-Cheng Zheng, Bin Sun, Ke Zhang, Yun-Hao Wang, Chang-Gui Shi, Hui-Qiao Wu, Xiao-Dong Wu, Hua-Jiang Chen, Wen Yuan
The Bi-needle technique was designed to improve the efficiency and safety of IDC. It provides several significant advantages over existing method. Needle A is inserted into the disc and lies parallel with the plane of the disc space. It can be used as a reference line for placement of needle B and the subsequent working cannula.11 This not only helps to improve the accuracy of needle B but also minimizes X-ray use. After the endoscopic system reaches the herniation, the chromodiscography with 1 mL methylene blue is performed through needle A under direct visualization. The herniation stains blue while the calcification remains white (Figure 3(f,g)). This is very helpful as different instruments are used for calcified and non-calcified areas. In the Bi-needle group, after exposing the calcification, we inject 0.9% saline solution via needle A. This loosens the calcification which may even be washed away using pressure in the flushing flow. These procedures allow careful retraction of neural tissue and complete excision of calcification through the narrow operative corridor. All these steps help to save operative time and minimize the need for radiographs. In this study, the operative time for the Bi-needle group (68.91 ± 6.84min) was significantly shorter than the operative time for the TESSYS group (91.82 ± 10.31min).