PubMed Health⌕ Search

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 91 records · Page 5Linked to original sources
PubMed1998

Combined cardiac catheterization for uncomplicated ischemic heart disease in a Medicare population.

PURPOSE: Experts recommend left heart catheterization alone to evaluate uncomplicated ischemic heart disease, reserving right heart catheterization for specific indications. Yet some centers routinely perform combined cardiac catheterization (left heart catheterization and right heart catheterization together). SUBJECTS AND METHODS: Using 1992-1993 Pennsylvania Medicare claims for cardiac catheterizations (n = 41,180), we examined rates of combined cardiac catheterization for patients with uncomplicated ischemic heart disease for each hospital (n = 73) that performed catheterizations. We compared combined cardiac catheterization rates among hospitals and developed a multivariable model to identify hospital characteristics associated with high combined cardiac catheterization rates. A random sample of cases from the 10 hospitals with the highest combined cardiac catheterization rates were reviewed to determine justification, complications, and results of combined cardiac catheterization. RESULTS: Of the 41,180 cardiac catheterizations, 14,177 (34%) were combined procedures. Among hospitals, combined cardiac catheterization rates varied from 2% to 98%. Hospital characteristics associated with high combined cardiac catheterization rates included having a cardiology fellowship program (relative risk [RR] 1.7, 95% confidence interval [CI] 1.1-2.7), location in eastern Pennsylvania (RR 2.5, 95% CI: 1.8-3.5), and volume of catheterizations performed (RR 0.95, 95% CI: 0.91-0.99/100 procedures). For reviewed cases, the most common justification for combined cardiac catheterization was planned revascularization (44%), which is not a specific indication. Only 49% of cases had at least one specific indication for right heart catheterization (range by hospital, 30%-74%). The abnormal findings on the right heart catheterization rarely appeared to change management. CONCLUSION: There is wide variation in the practice of combined cardiac catheterization, which appears to be related to teaching status and geographic location. The most common justification for the procedure was planned revascularization, which is not one of the specific indications supported by current literature.

Cardiac Catheterization↗
PubMed1993

Role of femoral vessel catheterization and altered hemostasis in the development of extraperitoneal hematomas: CT study in 44 patients.

OBJECTIVE: To ascertain the role of femoral vessel catheterization and altered hemostasis in the development of extraperitoneal hematomas, we evaluated CT scans to study the locations of extraperitoneal hematomas in three distinct clinical settings: (1) after femoral vessel catheterization with concurrent altered hemostasis due to anticoagulant, thrombolytic, and/or antiplatelet therapy (catheterized-altered hemostasis group); (2) after femoral vessel catheterization without altered hemostasis (catheterized group); and (3) with no history of femoral vessel catheterization, with or without altered hemostasis caused by a bleeding diathesis or pharmacotherapy (uncatheterized group). MATERIALS AND METHODS: Forty-four patients were identified who had CT evidence of extraperitoneal hematomas. Twenty-four were in the catheterized-altered hemostasis group, one was in the catheterized group, and 19 were in the uncatheterized group. CT scans were evaluated for anatomic subspace involvement by hemorrhage and for the presence or absence of contiguity between the hematoma and the femoral vessels. RESULTS: Bilateral hematomas were present in six of 24 patients in the catheterized-altered hemostasis group and in four of 19 patients in the uncatheterized group. We found no significant difference between the catheterized-altered hemostasis and the uncatheterized groups regarding the proportion of cases involved at any individual retroperitoneal site (p > .05). The mean number of hematoma sites in the catheterized-altered hemostasis group (4.3) was not significantly different from the mean number in the uncatheterized group (3.7) (p > .05). Contiguity between the sites of hematoma and the punctured femoral vessels was present in 75% of the patients in the catheterized-altered hemostasis group; contiguity between the hematoma and a groin was seen in 58% in the uncatheterized group. Twenty-two of 24 patients in the catheterized-altered hemostasis group had CT findings of subcutaneous fat infiltration in the groin; however, six of 19 patients in the uncatheterized group also had this finding, indicating that its presence does not always represent changes caused by catheterization. CONCLUSION: Retroperitoneal hematomas in patients with altered hemostasis and femoral vessel catheterization do not show a unique distribution attributable solely to contiguous spread of blood from the vessel puncture site. Many of these hematomas probably arise at sites distant from the femoral vessel puncture. When the hematoma is not contiguous with the punctured femoral vessels, altered hemostasis is most likely the cause of the hemorrhage.

Catheterization, Peripheral↗
PubMed1975

Percutaneous catheterization of the femoral vessels in children. I. Influence on arterial peak flow and venous emptying rate in the calves.

The influence of percutaneous catheterization of the femoral vessels on the arterial peak flow (APF) and the venous emptying rate (VER) of the calves was studied with strain gauge plethysmography in 112 children 2-16 years of age, who underwent arterial (49 cases) or venous catheterization, mostly because of heart disease. The conditions on the catheterized side were compared with those on the other side, and the pre-catheterization values were compared with those obtained after completed catheterization. The catheterization procedure was proved to have no general influence on APF or VER, although it may have an effect in individual patients. APF was not affected at arterial or venous catheterization in children older than 8 years of age. In the younger children, APF was slightly decreased on the catheterized side after arterial as well as venous catheterization. This was considered to be caused by arterial spasm. On the following day APF was normal. A few patients in this age group had a marked reduction in APF caused by intense spasm or thrombotic occlusion after arterial catheterization. These patients will be accounted for separately. VER on the catheterized side was not significantly influenced after venous or arterial catheterization, irrespective of the age of the patients.

Adolescent↗