SEARCH · PubMed Health

Results for “Catheterization”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 559 records · Page 31Linked to original sources

PubMed1988

Thrombolytic therapy for femoral artery thrombosis after pediatric cardiac catheterization.

Femoral artery thrombosis remains a well-known complication after cardiac catheterization. A study was undertaken to assess the efficacy of thrombolytic therapy for this complication. A total of 526 consecutive infants and children were prospectively evaluated after cardiac catheterization, and the medical charts of 42 patients who required femoral artery thrombectomy between 1975 and 1985 were reviewed. In the prospective study, patients were given a bolus injection of heparin, 150 U/kg, at the time the artery was entered. Patients with persistently absent or diminished pulse 2 hours after catheterization received a second bolus injection of 50 U/kg followed by an infusion of 20 U/kg/hr heparin for a maximum of 48 hours. If the affected leg pulse was absent or reduced and the systolic Doppler blood pressure was less than two thirds that of the unaffected leg, thrombolytic therapy was begun. In the 42 patients with surgical thrombectomy, there were no serious complications of surgery. Forty-five of the 526 patients (8.6%) had a decreased or absent pulse after catheterization. Of these 45 patients, 32 (71.1%) improved with systemic heparinization only. Thirteen patients (28.9%) had a persistently absent pedal pulse suggesting femoral artery thrombosis, despite continuous heparinization. Eleven patients were successfully treated with thrombolytic therapy and two required surgical thrombectomy. Intraarterial balloon dilatation procedures were performed in 8 of these 13 patients. Prothrombin time was prolonged (11.5 +/- 1.06 to 52.3 +/- 40.4 seconds; p less than 0.025) and fibrinogen levels were significantly reduced (2.25 +/- 0.79 to 1.52 +/- 0.52 gm/dl; p less than 0.01) during therapy. There were no serious complications, although four patients bled from the groin entry site.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1991

Risk stratification in survivors of acute myocardial infarction: routine cardiac catheterization and angiography is a reasonable approach in most patients.

Noninvasive risk assessment in survivors of AMI can effectively subdivide patients into groups with differing risk profiles after hospital discharge, but some patients at risk for late death or recurrent AMI may be incorrectly identified; data from cardiac catheterization and angiography provide complementary and generally more powerful prognostic information. Many patients may derive particular benefit from early cardiac catheterization and angiography, including: (1) patients with AMI complicated by recurrent myocardial ischemia, congestive heart failure, and/or complex ventricular arrhythmias; (2) patients with abnormal or inconclusive results of noninvasive testing or those patients unable to perform an exercise test; (3) patients with abnormal left ventricular global systolic function and those with increased left ventricular end-systolic volume; (4) "young" patients (younger than 50 years of age?); (5) older patients (older than 65 to 70 years of age?); (6) patients with non-Q wave AMI; and (7) patients who are receiving thrombolytic therapy. Performance of early cardiac catheterization and angiography in virtually all survivors of AMI, with selective use of appropriate noninvasive tests, may provide a more efficacious means of risk assessment after AMI; if all tests are performed judiciously, the cost of such an approach need not be excessive. A combination of invasive and selected noninvasive tests probably provides optimal information. The risks to the routine performance of diagnostic cardiac catheterization and angiography in all survivors of AMI are: (1) adequate care and attention may not be paid to proper performance of the procedure(s) and to detailed and proper analyses of the data; (2) the need for additional noninvasive testing in selected patients may be ignored; and most importantly, (3) premature or unnecessary revascularization procedures may be performed subsequently. For optimal patient care, the clinician must obtain all necessary data, avoid unnecessary and repetitive tests, know the accuracy of individual tests at his or her own facility, interpret all data in proper context, and then counsel patients objectively about available management strategies. With this approach, all patients who might appropriately benefit from coronary artery revascularization will be correctly identified, and patients who are truly at very low risk (minimal residual coronary artery disease and preserved left ventricular function particularly if associated with a patent infarct-related artery) may be similarly identified and managed appropriately with elimination of unnecessary additional testing and pharmacologic therapy. Finally, whatever approach to risk stratification one chooses for an individual patient, the importance of and the need to correct and/or ameliorate risk factors for coronary artery disease must be recognized and undertaken.

Age Factors↗

PubMed1992

Noninvasive evaluation of interventricular pressure gradient across ventricular septal defect: a simultaneous study of Doppler echocardiography and cardiac catheterization.

Simultaneous continuous-wave Doppler echocardiography and left- and right-sided cardiac pressure measurements were performed during cardiac catheterization in 64 patients with a congenital ventricular septal defect (VSD). The peak-to-peak pressure gradient across the VSD on cardiac catheterization ranged from 0 to 109 mm Hg (61 +/- 31.7 mm Hg). The peak shunt velocity and peak pressure gradient across the VSD on Doppler ultrasound imaging ranged from 0.96 to 5.21 m/sec (3.75 +/- 1.16 m/sec) and from 4 to 105 mm Hg (62 +/- 29.8 mm Hg), respectively. Doppler measurements of the peak interventricular pressure gradient correlated well with measurements obtained by cardiac catheterization (r = 0.98, standard error of estimate = 6.3 mm Hg, p less than 0.001). Doppler ultrasound imaging yielded information comparable to that obtained by catheterization and provided an accurate method of measuring the pressure gradient across the VSD, which is a useful parameter for the assessment of pulmonary artery systolic pressure in patients with a VSD, without a left or right ventricular outflow tract obstruction.

Adolescent↗

PubMed1979

Innominate aterial arteriovenous fistula complicating retrograde brachial arterial catheterization.

Arteriovenous fistula of the innominate artery occurred in a patient 3 weeks after retrograde brachial arterial catheterization was performed 1 day before aortocoronary bypass surgery. Intramural dissection was noted at catheterization, and a mediastinal hematoma at operation. Exploration of the hematoma in the course of catheterization might have prevented the arteriovenous fistula, which necessitated a second operation 3 weeks after the first. To our knowlege this complication of retrograde brachial catheterization has not previously been described. We recommend that known injuries to cervical or thoracic arteries occurring just before operations requiring extracorporeal circulation be explored to prevent late complications. Recent injuries to the cervical and thoracic arteries that are not acessible to external compression should be exposed and treated during sternotomy to prevent late complications if heparinization is contemplated.

Aorta, Thoracic↗

PubMed1985

Radiation exposure and protection in cardiac catheterization laboratories.

Cardiac catheterization with angiography can deliver the greatest dose of x-radiation of any diagnostic medical examination. The physicians and technologists in the angiography room receive low-level scattered radiation over a period of months to decades. Although the radiobiology is complex, the physicians who perform cardiac catheterization should be familiar with the potential genetic and somatic effects of radiation and with the methods to reduce or eliminate x-ray exposure. The aim of radiation protection criteria is to reduce the risk of cancer death to less than the fatality risk for other occupations regarded as safe. This report is a review of the literature relating to radiation exposure and protection in cardiac catheterization laboratories. Catheterization personnel have control over the time duration of exposure, placement of technologists, shielding, location of equipment and monitoring of dose received.

Adult↗

PubMed1986

Fibrinolytic therapy for femoral arterial thrombosis after cardiac catheterization in infants and children.

The charts of 79 patients who required femoral arterial (FA) thrombectomy after cardiac catheterization were reviewed. Fifteen patients (19%) had poor pulses after thrombectomy and 2 had an extremity amputated. One thousand consecutive patients undergoing cardiac catheterization were also studied to prospectively determine the safety and efficacy of systemic fibrinolytic therapy for treatment of FA thrombosis. Among these, 771 patients underwent retrograde arterial catheterization, including 31 patients with left-sided obstructive lesions who had undergone transarterial balloon dilation procedures with large catheters. All patients were given heparin at the time of arterial cannulation. Patients who had a pulseless extremity 4 hours after catheterization continued to receive heparin therapy for 24 to 48 hours. If the extremity continued to have no palpable pulse and the systolic blood pressure was less than 50% of that in the contralateral leg, intravenous streptokinase infusion was begun. The overall incidence of FA thrombosis was 3.6% (28 of 771), including 39% (12 of 31) of all patients undergoing transarterial balloon dilation procedures; 97% (27 of 28) of patients weighed less than 14 kg and the majority weighed less than 10 kg. After an average treatment period of 33 hours, 16 patients continued to have a pulseless extremity and were treated with streptokinase for an average duration of 13 hours. Normal pulses and systolic blood pressure returned in 14 (88%) and were nearly normal in 1 other patient (6%). The incidence of bleeding at the arterial puncture site was 25% and was highest in the patients who had a transarterial balloon dilation procedure. No serious complications occurred.

Adolescent↗

PubMed1989

Usefulness of the Doppler mean gradient in evaluation of children with aortic valve stenosis and comparison to gradient at catheterization.

To assess the usefulness of the Doppler mean gradient as a noninvasive indicator of the need for intervention, 33 children (ages 3 months to 20 years) with valvular aortic stenosis (AS) underwent a 2-dimensional and Doppler echocardiographic examination a median of 1 day before cardiac catheterization. The clinical decision for intervention was based on finding a catheterization peak-to-peak pressure gradient of greater than 75 mm Hg or from 50 to 75 mm Hg in the presence of symptoms or an abnormal exercise treadmill test result. Of the 33 patients, 23 required intervention. The decision for intervention was compared to the Doppler mean gradient, and the Doppler peak and mean gradients were compared to the catheterization peak-to-peak gradient. All 12 patients with a Doppler mean gradient greater than 27 mm Hg had intervention and had a catheterization peak-to-peak gradient of greater than or equal to 75 mm Hg. All 3 patients with a Doppler mean gradient less than 17 mm Hg had no intervention and had a peak-to-peak gradient less than 50 mm Hg. The remaining 18 patients with Doppler mean gradients between 17 and 27 mm Hg comprised an intermediate group in whom the Doppler mean gradient alone did not predict the need for intervention. From a chi-square table, a Doppler mean gradient greater than 27 mm Hg predicted the need for intervention with 100% specificity (no false positives) and 52% sensitivity (11 false negatives).(ABSTRACT TRUNCATED AT 250 WORDS)

Aortic Valve Stenosis↗

PubMed1991

Determination of severity of valvular aortic stenosis by Doppler echocardiography and relation of findings to clinical outcome and agreement with hemodynamic measurements determined at cardiac catheterization.

To determine the relation of Doppler findings to clinical outcome and the agreement between Doppler and cardiac catheterization in the assessment of aortic stenosis (AS) severity, 510 consecutive patients with suspected AS studied in our laboratory were analyzed. Adequate echocardiographic and Doppler examinations were obtained in 498 patients or 98% of the population. Clinical data were available for analysis in 497 patients. In 160 patients, Doppler demonstrated an aortic valve area less than or equal to 0.75 cm2 or a peak jet velocity greater than or equal to 4.5 m/s consistent with critical AS. In the subgroup with cardiac catheterization (n = 105), Doppler was 97% accurate. Aortic valve replacement or balloon valvuloplasty was performed in 109 patients, 106 of whom were symptomatic. Noncritical AS was detected by Doppler in 327 patients, with 95% accuracy in the subgroup with cardiac catheterization (n = 133). Aortic valve replacement was performed in 15 patients with symptoms of AS and with valve areas assessed by Doppler to be between 0.76 and 0.80 cm2 or with peak jet velocities greater than 3.5 m/s. In 20 patients, aortic valve replacement was performed because of moderate to severe aortic regurgitation, and in 11 elderly (greater than 70 years old) patients with valve areas between 0.80 and 1.0 cm2, valve replacement was performed at the time of coronary artery bypass surgery in an attempt to prevent the need for a repeat surgical procedure in the future. These observations allow the following conclusions. In the symptomatic patient with critical or near critical AS by Doppler, cardiac catheterization does not provide additional information beyond that provided by Doppler.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed1982

Advanced ventricular arrhythmias during bedside pulmonary artery catheterization.

To determine the incidence of advanced arrhythmias and acute right bundle branch block during beside pulmonary artery catheterization, 119 critically ill patients undergoing 150 pulmonary artery catheterizations were prospectively studied using continuous electrocardiographic monitoring with permanent recordings. Ventricular arrhythmias other than isolated premature ventricular contractions, couplets or bigeminy occurred during 80 of the 150 catheterizations (53 percent). These included ventricular salvos (three to five consecutive premature ventricular contractions) in 30 percent, nonsustained ventricular tachycardia (five to 30 premature ventricular contractions) in 20 percent and sustained ventricular tachycardia (more than 30 consecutive premature ventricular contractions) in 3 percent. In two patients, ventricular fibrillation developed; in another three patients, lidocaine or precordial thump was required to terminate the episodes of ventricular tachycardia. The incidence of advanced ventricular arrhythmias was statistically correlated with either the presence of predisposing risk factors for ventricular ectopy (p less than 0.05) or prolonged catheterization time (p less than 0.01). A new right bundle branch block developed in seven patients (5 percent) and persisted for a mean of 9.5 hours.

Adult↗

PubMed1976

Differential ovarian and adrenal vein catheterization.

Twenty-two hirsute women underwent percutaneous adrenal and ovarian vein catheterization to differentiate and localize excessive hormonal output. All studies were done under fluoroscopic control; catheter placement was verified by venography, and blood samples were withdrawn for hormonal analysis. The right ovarian vein was successfully sampled in 42 per cent of attempts; the left ovarian vein, in 75 per cent; the right adrenal vein, in 56 per cent; and the left adrenal vein, in 100 per cent. Bilateral catheterization did not prove clinically useful. First, anatomic variations in venous size and drainage made catheterization and bilateral sampling difficult. Second, adrenal secretion is both episodic and parallel, necessitating both simultaneous catheterization and serial sampling for adequate diagnosis. The stress of the procedure may provoke increased adrenal output. Third, since ovarian secretion is not parallel, and since increased hormone output has been documented in that ovary containing developing follicles or a corpus luteum, distinguishing ovarian dysfunction proved difficult. Finally, for a time-consuming procedure, patient discomfort cannot be disregarded. This technique has not proved to be a reliable means of determining the site of androgen hypersecretion and thus cannot be recommended in the routine evaluation of female hirsutism.

17-Ketosteroids↗

PubMed1985

Supraclavicular central venous catheterization.

Percutaneous central venous catheterization is a well-accepted procedure for cardiac monitoring, total parenteral nutrition, and long-term drug therapy. The supraclavicular approach was used for 90 catheterizations in 81 gynecologic patients to evaluate ease of insertion, complication rate, and patient compliance. Anatomic considerations, insertion technique, and the rationale for the supraclavicular approach are discussed in detail. A successful catheterization rate of 91% was achieved with acceptable morbidity. There were three instances each of pneumothorax, catheter malposition, and catheter infection. Advantages of the supraclavicular approach include a wider target area, a more direct route to the superior vena cava, and less pain on insertion. With reliable and constant landmarks, relative ease of and comfort on insertion, and low complication rate, the supraclavicular technique is the preferred method when percutaneous central venous catheterization is indicated.

Adult↗

PubMed1989

Accuracy of total bladder volume and residual urine measurements: comparison between real-time ultrasonography and catheterization.

The practical value of ultrasonography as a rapid means to accurately determine total bladder volumes and residual urine volume was assessed. Transverse and sagittal bladder diameters were measured with real-time ultrasonography in 50 women: (1) before uroflowmetry, (2) before supine-postvoiding catheterization, (3) before standing catheterization, and (4) after standing catheterization. Calculated bladder volumes, by use of the measured diameters, for each of eight formulas from the literature were compared with their corresponding measured total urine volume, total residual volume, and standing residual volume. The lower limit of ultrasonographic visualization of urine in the bladder was approximately 42 ml. No correlation existed between calculated ultrasound bladder volumes and measured urine volumes for any of the eight formulas. Standing residual volumes were measured in 96% of cases. Ultrasonography cannot as yet rapidly measure bladder volumes accurately. Catheterization remains the best method of assessing postvoid residuals: supine measurements, the gold standard, should be augmented by standing measurements when more accurate volumes are required.

Adult↗

PubMed1993

Treatment of infertility associated with endometriosis by selective tubal catheterization under hysteroscopy and laparoscopy.

OBJECTIVE: To evaluate the efficacy of treatment for infertility associated with endometriosis by selective tubal catheterization under hysteroscopy and laparoscopy. STUDY DESIGN: Eighty-eight infertile women who underwent selective tubal catheterization with insufflation of oil-soluble radiopaque dye were reviewed. The efficacy of treatment was analyzed with regard to conception rate. RESULTS: The conception rate after selective tubal catheterization was higher in women with endometriosis (60%) than in women without endometriosis (36.5%) (p < 0.05). Most women conceived within the first 4 months after treatment. No statistical difference in conception rate was observed among patients with stage I, II, or III disease. CONCLUSIONS: Selective tubal catheterization with insufflation of oil-soluble radiopaque dye was an effective treatment for infertility associated with endometriosis.

Catheterization↗

PubMed1980

Role of selective venous catheterization of the small thyroid veins as a diagnostic study in hypercalcemic states.

Previous studies of selective venous catheterization stress its value in localizing hyperfunctioning parathyroid tissue in patients with an established diagnosis of hyperparathyroidism. Our study presents our experience with selective venous catheterization as a diagnostic aid in differential diagnosis of hypercalcemia. In our four patients, an extensive metabolic work-up did not resolve the differential diagnosis of hypercalcemia, and selective venous catheterization provided the ultimate data that led to the correct diagnosis of hypercalcemia in each patient. Selective venous catheterization can be an important diagnostic study in carefully selected patients with hypercalcemia.

Adenoma↗

PubMed1996

Micronucleus frequencies in urothelial cells of catheterized patients with chronic bladder inflammation.

Epidemiological studies suggest an association between chronic inflammation and increased risk for cancer, although the mechanism underlying this relationship is unresolved. In the present study, we test the hypothesis that DNA damage is induced in the epithelium of tissues during such inflammation by products of activated inflammatory cells. Individuals on long-term indwelling urinary catheterization were used as a study population. These individuals have chronic bladder inflammation and, as a population, an increased risk for bladder cancer. Urine of 29 patients and 26 age-matched non-catheterized controls was collected and micronucleus (MN) frequencies were determined in exfoliated urothelial cells in the urinary sediments. The urine from the catheterized group had large numbers of white blood cells (mean count, 26.6 +/- 3.6 cells per high-power field), indicating the presence of a chronic bladder infection and an inflammatory reaction. In contrast, white blood cells were not present in urine from individuals in the control group. There was no significant difference in MN frequencies in the 2 groups (mean frequencies, controls: 0.098 +/- 0.030%; catheterized: 0.140 +/- 0.025%, p = 0.13). These data imply that chromosomal damage does not always occur during chronic inflammation. Although the reasons for this observation are yet to be determined, possible explanations include the pathophysiology of the inflammatory reaction and the influence of vitamins, non-steroidal anti-inflammatory drugs and the catheter itself in protection against inflammatory cell-mediated DNA damage.

Adult↗

PubMed1983

Results of clean intermittent catheterization for children with neurogenic bladders.

Forty-nine patients were placed on a regimen of clean intermittent catheterization one to four years prior to this review. The children were intermittently catheterized, and a silver nitrate solution 1:1000 was instilled after each catheterization. Nurse practitioners, and community and school personnel contributed to the management. Twenty-one patients were continent with anticholinergics, and 18 also required alpha-adrenergic agents. Eighty-eight per cent were essentially bacteriuria-free, 65 per cent were essentially infection-free, and forty-nine per cent were totally continent. The remaining 25 had mild incontinence. Eleven had clearances below 85 mm/min with 8 reverting to normal on therapy. Nine had reflux prior to the study and one improved. In 8 patients reflux developed during therapy; 4 had severe reflux which required ureteral reimplantation. The results demonstrated that a clean intermittent catheterization program is feasible in a rural setting and that a genitourinary irrigant does decrease bacteriuria.

Bacteriuria↗

PubMed1984

Clean intermittent self-catheterization in the elderly.

There has been some doubt as to whether or not the elderly patient can successfully master and comply with clean intermittent self-catheterization in the treatment of their bladder dysfunctions. We recently reviewed our experience with intermittent self-catheterization in patients sixty years of age and older to determine whether or not this was an acceptable alternative to other methods of urinary drainage. Our retrospective analysis of 65 patients between the ages of sixty and eighty years revealed that the elderly patient had little difficulty mastering the technique of intermittent self-catheterization. Complications were minimal and in general correctable. The catheterization program was successful in 94 per cent of the patients in our series.

Aged↗

PubMed1981

Correlation between cardiac catheterization and echocardiography in assessing the severity of mitral stenosis.

During a 12-mth period 162 consecutive patients with mitral stenosis underwent examination by M-mode as well as cross-sectional echocardiography. The mitral valve area was measured by cross-sectional echocardiography ad the severity of mitral stenosis by M-mode echocardiography. Out of the total, 69 patients underwent left and right heart catheterization and in 53 of these the mitral valve area was calculated. A correlation of r=0.92 for the mitral valve area was found between sector scan echocardiography and cardiac catheterization, whereas the correlation between M-mode echocardiography and catheterization yielded a result of only r=0.38. Thus the assessment of the severity of mitral stenosis by cross-sectional echocardiography is a reliable alternative to cardiac catheterization.

Cardiac Catheterization↗