PubMed Health⌕ Search

Biomedical subjects

Ted Feldman

Publications and source records attributed to Ted Feldman.

42 records · Page 3Linked to original sources
PubMed2002

Percutaneous suture closure for brachial artery puncture.

Percutaneous suture closure for femoral artery hemostasis has gained broad use over the last few years since its introduction. The appeal of suture closure is the immediate and definitive hemostasis that it achieves, even in anticoagulated patients. Described is the use of the Perclose Techstar XL 6Fr suture closure device for the management of brachial artery puncture after diagnostic and therapeutic catheterization. A 6Fr Perclose Techstar device was used for hemostasis during ten procedures in eight patients. In addition, 6Fr and 7Fr sheaths were used. Hemostasis was achieved in all but one patient, in whom hemostasis was not achieved and surgical repair was necessary. The Perclose Techstar device is useful for selected patients for achieving brachial arterial puncture site hemostasis. The large excursion of the foot of the new closer device may not be as applicable in arteries as small as the brachial artery. Patients who are obese may be best suited for this approach.

Adult↗
PubMedDate not supplied

Percutaneous treatment of valvular heart disease: catheter-based aortic valve replacement and mitral valve repair therapies.

Until recently, percutaneous catheter therapy for valvular heart disease was limited to catheter balloon valvuloplasty for aortic, mitral, or pulmonic stenosis. A number of new approaches to percutaneous valve therapy are now developing rapidly, including methods for catheter-based valve replacement and repair. Stent-mounted valve prostheses have been successfully implanted in the pulmonic and aortic positions. These devices have been constructed using pericardial valve leaflets mounted inside balloon-expandable or self-expanding stents and have been used in patients who are high risk for valve replacement surgery. Percutaneous valve repair is also being developed for mitral regurgitation. Direct leaflet repair and percutaneous annuloplasty are being employed in clinical trials. All the percutaneous approaches are based on existing surgical techniques and offer less invasive alternatives. The era of percutaneous valve therapy has clearly arrived, and ongoing trials will define the clinical role for these new therapies.

Aortic Valve↗
PubMedDate not supplied

Angiographic access site complications in the era of arterial closure devices.

Coronary and peripheral angiography is associated with a low but significant risk of access site complications. While percutaneous devices have been shown to permit more rapid puncture site closure, previous reports have suggested the incidence and severity of complications associated with these devices are greater than with manual compression. This study compares access site complications with and without closure devices in the current era. The authors conducted a retrospective review of patients with access site complications after coronary or peripheral angiography between 1998 and 2000. Forty-five complications requiring vascular surgical consultation were identified in the 4,800 procedures performed during this time period. Fourteen complications occurred in 1,536 procedures (0.9%) using suture-mediated or collagen devices and 31 occurred in 3,264 procedures without devices (0.9%). The types of procedures and catheter sizes (mean 7 Fr) used were not different in the 2 groups. Other than complications involving a retained device, there was no difference between device and manual compression with respect to incidence or types of complication,requirement for operation, type of operation, or outcome. Access site complications identified included pseudoaneurysm (n = 22; 49%), bleeding or hematoma (n = 8;18%), arteriovenous fistula (n=5;11%), arterial thrombosis (n = 4;9%), infection (n = 4;9%), and retained device (n = 2;4%). Twenty-four patients (71% vs 45%; p = NS) required operative intervention including pseudoaneurysm repair, hematoma drainage, and thrombectomy. Eleven patients (26%) underwent successful ultra-sound-guided pseudoaneurysm compression and 9 patients (21%) required no intervention. These data demonstrate that closure devices facilitate arterial puncture site repair without an increase in access site complications. These devices can be safely utilized when rapid hemostasis is desired after coronary or peripheral angiography.

Aneurysm, False↗