The Experts below are selected from a list of 318 Experts worldwide ranked by ideXlab platform
Thomas M. Vesely - One of the best experts on this subject based on the ideXlab platform.
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Bench-top evaluation of air flow through a valved peelable Introducer Sheath.
Journal of Vascular and Interventional Radiology, 2005Co-Authors: Thomas M. Vesely, Peter J. Ness, John E. HartAbstract:PURPOSE Air embolism is a rare but potentially fatal complication that may occur during the insertion of a central venous catheter. A valved peelable Introducer Sheath was developed to reduce the likelihood of an air embolus. This study was performed to determine the rate of air flow through this valved Introducer Sheath under different conditions that may be encountered in a clinical setting. MATERIALS AND METHODS A 16-F-diameter valved peelable Introducer Sheath was used for all experiments. A bench-top testing system was constructed that consisted of a vacuum source, a mass flow meter, and a digital vacuum gauge. A coupling device with a pneumatic O-ring was used to seal and connect the distal end of the Introducer Sheath to the testing system. A vacuum of −5 mm Hg was applied to the sealed distal end of the Sheath to simulate physiologic conditions. The rate of air flow through the valved Sheath was measured under three different conditions; (i) valve open, (ii) valve closed, and (iii) valve open but with the Sheath manually pinched. Thirty air flow measurements were performed for each of the three test conditions. RESULTS When the valve was in the open position, the mean rate of air flow through the Introducer Sheath was 417.2 mL/sec (range, 415.5–419.7 mL/sec). When the valve was in the closed position, the mean rate of air flow was 0.004 mL/sec (range, 0.000–0.067 mL/sec). When the valve was open but the Sheath was manually pinched, the mean rate of air flow through the Sheath was 31.7 mL/sec (range, 23.0–38.8 mL/sec). During the 90 testing procedures, the mean vacuum was −5.10 mm Hg (range, −5.00 to −5.45 mm Hg). CONCLUSIONS This bench-top study revealed that a massive amount of air flowed through the open 16-F Introducer Sheath when it was subjected to a vacuum of −5 mm Hg, a situation that may occur under normal physiologic conditions. The rate of air flow could be decreased by aggressively pinching the Sheath but the rate of air flow was still substantial. This study demonstrated that the addition of a sophisticated valve mechanism can essentially eliminate air flow through a peelable Introducer Sheath.
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American Society of Diagnostic and Interventional Nephrology Section Editor: Stephen Ash: Preliminary Evaluation of a Valved Introducer Sheath for the Insertion of Tunneled Hemodialysis Catheters
Seminars in Dialysis, 2004Co-Authors: Thomas M. Vesely, Alicia G Fazzaro, Danielle GherardiniAbstract:This brief technical report describes our initial experience using the FlowGuard valved Introducer Sheath during the insertion of tunneled hemodialysis catheters in 15 patients. The incorporation of a silicone valve into the Introducer Sheath is intended to minimize blood loss and decrease the risk of air embolism during the catheter insertion procedure. Our preliminary experience demonstrated that the FlowGuard Sheath is a substantial improvement when compared to standard Introducer Sheaths. However, an asymptomatic air embolus did occur in one patient. This article describes several caveats for the use of this new product.
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preliminary evaluation of a valved Introducer Sheath for the insertion of tunneled hemodialysis catheters
Seminars in Dialysis, 2004Co-Authors: Thomas M. Vesely, Alicia G Fazzaro, Danielle Gherardini, Interventional NephrologyAbstract:This brief technical report describes our initial experience using the FlowGuard valved Introducer Sheath during the insertion of tunneled hemodialysis catheters in 15 patients. The incorporation of a silicone valve into the Introducer Sheath is intended to minimize blood loss and decrease the risk of air embolism during the catheter insertion procedure. Our preliminary experience demonstrated that the FlowGuard Sheath is a substantial improvement when compared to standard Introducer Sheaths. However, an asymptomatic air embolus did occur in one patient. This article describes several caveats for the use of this new product.
Valerian Fernandes - One of the best experts on this subject based on the ideXlab platform.
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Transaxillary Intra-Aortic Balloon Pump Migration Minimized with a Long Introducer Sheath
Cardiovascular Revascularization Medicine, 2020Co-Authors: Andrew Dorsey, Ahmadreza Karimianpour, Valerian FernandesAbstract:Abstract Intra-aortic balloon pump (IABP) has been used more recently as a bridge to cardiac transplantation in hospitalized patients. Femoral IABP limits mobility and rehabilitation; thus, transaxillary approach has been described. However, transaxillary IABP may migrate causing significant vascular injury, and potential death or disqualification from transplantation. We describe a case of a 67-year-old male with transaxillary IABP inserted to allow for pre-transplant physical rehabilitation. Due to the unfolded nature of his aorta, the IABP coiled onto itself and migrated several times. We employed a novel technique to mitigate IABP migration using a long 25-cm Introducer Sheath.
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TRANSAXILLARY INTRA-AORTIC BALLOON PUMP MIGRATION MINIMIZED WITH A LONG Introducer Sheath
Journal of the American College of Cardiology, 2020Co-Authors: Ahmadreza Karimianpour, Valerian FernandesAbstract:Intra-aortic balloon pump (IABP) is a treatment for cardiogenic shock and bridge to advanced therapies. Femoral IABP limits mobility and results in pre-transplant debility. Due to the anatomy of aortic arch branch vessels and patient ambulation, transaxillary IABPs may migrate. This can cause
John L. Morris - One of the best experts on this subject based on the ideXlab platform.
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032 Impact of length and hydrophilic coating of the Introducer Sheath on radial artery spasm during transradial coronary intervention: a randomised study
Heart, 2010Co-Authors: Sudhir Rathore, Rod Stables, M Pauriah, Abdul Hakeem, J D Mills, Nicholas D. Palmer, Raphael A. Perry, John L. MorrisAbstract:Objective To assess the impact of length and hydrophilic coating of the Introducer Sheath on radial artery spasm, radial artery occlusion and local vascular complications in patients undergoing transradial coronary procedures. Patients and Methods Seven hundred and ninety patients scheduled for a six Fr transradial coronary procedures were randomly assigned to different length (23 cm and 13 cm) and hydrophilic coated Introducer Sheaths (coated and uncoated) for transradial procedure. The primary outcome was clinical evidence of radial artery spasm and secondary end points were patient discomfort, and local vascular complications. Results Procedural success was achieved in 96% of the cases and the radial artery spasm accounted for 17/33 failed cases. There was significantly less clinical radial artery spasm (19.0% vs 39.9%, OR 2.87; 95% CI, 2.07 to 3.97, p Conclusions Hydrophilic coating of the Introducer Sheath reduces the incidence of radial artery spasm during transradial coronary procedures. Sheath length did not influence this effect.
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Impact of length and hydrophilic coating of the Introducer Sheath on radial artery spasm during transradial coronary intervention: a randomized study.
Jacc-cardiovascular Interventions, 2010Co-Authors: Sudhir Rathore, Rod Stables, M Pauriah, Abdul Hakeem, J D Mills, Nicholas D. Palmer, Raphael A. Perry, John L. MorrisAbstract:Objectives The aim of this study was to assess the impact of length and hydrophilic coating of the Introducer Sheath on radial artery spasm, radial artery occlusion, and local vascular complications in patients undergoing transradial coronary procedures. Background Radial artery spasm is common during transradial procedures and the most common cause for procedural failure. Methods We randomly assigned, in a factorial design, 790 patients scheduled for a transradial coronary procedure to long (23-cm) or short (13-cm) and hydrophilic-coated or uncoated Introducer Sheaths. The primary outcome measure was clinical evidence of radial artery spasm, and secondary outcome measures were patient discomfort and local vascular complications. Results Procedural success was achieved in 96% of the cases, and radial artery spasm accounted for 17 of 33 failed cases. There was significantly less radial artery spasm (19.0% vs. 39.9%, odds ratio [OR]: 2.87; 95% confidence interval [CI]: 2.07 to 3.97, p Conclusions Hydrophilic Sheath coating, but not Sheath length, reduces the incidence of radial artery spasm during transradial coronary procedures.
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Impact of Introducer Sheath Coating on Endothelial Function in Humans After Transradial Coronary Procedures
Circulation-cardiovascular Interventions, 2010Co-Authors: Ellen A. Dawson, Sudhir Rathore, John L. Morris, N. Timothy Cable, D. Jay Wright, Daniel J. GreenAbstract:Background— The aim of this study was to compare the impact of transradial catheterization with hydrophilic-coated catheter Sheaths versus uncoated Sheaths on NO-mediated endothelial-dependent and -independent vasodilator function. Methods and Results— Thirty-five subjects undergoing transradial catheterization were recruited and assessed before and the day after catheterization. A subgroup was also assessed 3 to 4 months after catheterization. Subjects received hydrophilic-coated Sheaths (n=15) or uncoated Sheaths (n=20). Radial artery flow-mediated dilatation and endothelium- and NO-dependent arterial dilatation were assessed within the region of Sheath placement. Glyceryl trinitrate endothelium-independent NO-mediated function was also assessed. The noncatheterized arm provided an internal control. Flow-mediated dilatation in the catheterized arm decreased from 10.3�3.8% to 5.3�3.3% and 8.1�2.4% to 5.2�3.7% in the coated and uncoated groups, respectively (P
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impact of Introducer Sheath coating on endothelial function in humans after transradial coronary procedures
Circulation-cardiovascular Interventions, 2010Co-Authors: Ellen A. Dawson, Sudhir Rathore, John L. Morris, Timothy N Cable, Jay D Wright, Daniel J. GreenAbstract:Background— The aim of this study was to compare the impact of transradial catheterization with hydrophilic-coated catheter Sheaths versus uncoated Sheaths on NO-mediated endothelial-dependent and -independent vasodilator function. Methods and Results— Thirty-five subjects undergoing transradial catheterization were recruited and assessed before and the day after catheterization. A subgroup was also assessed 3 to 4 months after catheterization. Subjects received hydrophilic-coated Sheaths (n=15) or uncoated Sheaths (n=20). Radial artery flow-mediated dilatation and endothelium- and NO-dependent arterial dilatation were assessed within the region of Sheath placement. Glyceryl trinitrate endothelium-independent NO-mediated function was also assessed. The noncatheterized arm provided an internal control. Flow-mediated dilatation in the catheterized arm decreased from 10.3�3.8% to 5.3�3.3% and 8.1�2.4% to 5.2�3.7% in the coated and uncoated groups, respectively (P<0.01). These values returned toward baseline ...
Peter C Taylor - One of the best experts on this subject based on the ideXlab platform.
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use of a remotely steerable robotic catheter in a branched endovascular aortic graft
Journal of Vascular Surgery, 2012Co-Authors: Tom Carrell, Richard Salter, Neville Dastur, Peter C TaylorAbstract:We report the use of a remotely steerable catheter to treat kinked renal bridging stents 8 months after branched endovascular repair of a type III thoracoabdominal aortic aneurysm. Conventional techniques using single, coaxial, and manually steerable Sheaths proved too unstable to provide the support required to pass a wire against resistance through the kinked stent. A remotely steerable "robotic" catheter provided sufficient precision and stability to cross the kink and reline it with an additional stent, restoring renal perfusion. This technology can help achieve precise and stable Introducer Sheath position. Further evaluation is necessary to understand the wider applications.
Danielle Gherardini - One of the best experts on this subject based on the ideXlab platform.
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American Society of Diagnostic and Interventional Nephrology Section Editor: Stephen Ash: Preliminary Evaluation of a Valved Introducer Sheath for the Insertion of Tunneled Hemodialysis Catheters
Seminars in Dialysis, 2004Co-Authors: Thomas M. Vesely, Alicia G Fazzaro, Danielle GherardiniAbstract:This brief technical report describes our initial experience using the FlowGuard valved Introducer Sheath during the insertion of tunneled hemodialysis catheters in 15 patients. The incorporation of a silicone valve into the Introducer Sheath is intended to minimize blood loss and decrease the risk of air embolism during the catheter insertion procedure. Our preliminary experience demonstrated that the FlowGuard Sheath is a substantial improvement when compared to standard Introducer Sheaths. However, an asymptomatic air embolus did occur in one patient. This article describes several caveats for the use of this new product.
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preliminary evaluation of a valved Introducer Sheath for the insertion of tunneled hemodialysis catheters
Seminars in Dialysis, 2004Co-Authors: Thomas M. Vesely, Alicia G Fazzaro, Danielle Gherardini, Interventional NephrologyAbstract:This brief technical report describes our initial experience using the FlowGuard valved Introducer Sheath during the insertion of tunneled hemodialysis catheters in 15 patients. The incorporation of a silicone valve into the Introducer Sheath is intended to minimize blood loss and decrease the risk of air embolism during the catheter insertion procedure. Our preliminary experience demonstrated that the FlowGuard Sheath is a substantial improvement when compared to standard Introducer Sheaths. However, an asymptomatic air embolus did occur in one patient. This article describes several caveats for the use of this new product.
