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Brito ARDO, Nishinari K, Saad PF, Saad KR, Pereira MAT, Emídio SCD, Yazbek G, Bomfim GAZ, Cavalcante RN, Krutman M, Teivelis MP, Pignataro BS, Fonseca IYI, Centofanti G, Soares BLF. Comparison between Saline Solution Containing Heparin versus Saline Solution in the Lock of Totally Implantable Catheters. Ann Vasc Surg 2017; 47:85-89. [PMID: 28947219 DOI: 10.1016/j.avsg.2017.09.015] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Revised: 08/29/2017] [Accepted: 09/07/2017] [Indexed: 11/18/2022]
Abstract
BACKGROUND There are only 3 studies comparing the efficacy of 2 different types of lock used in totally implantable catheters regarding occlusion or reflux dysfunction. The present study contains the largest published casuistry (862 patients) and is the only one that analyzes 3 parameters: occlusion, reflux dysfunction, and flow dysfunction. METHODS This was a retrospective study of patients operated at a large oncology center and followed up in the outpatient clinic between 2007 and 2015. The patients were divided into 2 groups according to the type of lock: the Hep group (heparine), whose lock was composed of saline solution 0.9% with heparin (100 IU/mL) and the SS group (saline solution), whose lock was composed of saline solution 0.9%. RESULTS The Hep group was composed of 270 patients (31%) and the SS group of 592 patients (69%). Regarding occlusion, there were 8 cases in the Hep group (2.96%) and 8 in the SS group (1.35%; P = 0.11); in relation to reflux dysfunction, there were 8 cases in the Hep group (2.96%) and 8 in the SS group (1.35%; P = 0.11); in relation to flow dysfunction, there was 1 case in the Hep group (0.37%) and 4 cases in the SS group (0.68%; P = 1). CONCLUSIONS There was no statistically significant difference between the groups regarding occlusion, reflux dysfunction, and flow dysfunction.
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Affiliation(s)
| | - Kenji Nishinari
- Department of Vascular and Endovascular Surgery, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | | | | | | | | | - Guilherme Yazbek
- Department of Vascular and Endovascular Surgery, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | | | - Rafael Noronha Cavalcante
- Department of Vascular and Endovascular Surgery, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - Mariana Krutman
- Department of Vascular and Endovascular Surgery, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - Marcelo Passos Teivelis
- Department of Vascular and Endovascular Surgery, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | - Bruno Soriano Pignataro
- Department of Vascular and Endovascular Surgery, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil
| | | | - Guilherme Centofanti
- Department of Vascular and Endovascular Surgery, AC Camargo Cancer Center, São Paulo, São Paulo, Brazil
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Post-procedural Care in Interventional Radiology: What Every Interventional Radiologist Should Know-Part II: Catheter Care and Management of Common Systemic Post-procedural Complications. Cardiovasc Intervent Radiol 2017; 40:1304-1320. [PMID: 28584946 DOI: 10.1007/s00270-017-1709-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 05/23/2017] [Indexed: 01/14/2023]
Abstract
Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant comprehensive patient care responsibilities. Providing excellent and thorough clinical care is as essential to the practice of IR as achieving technical success in procedures. Basic clinical skills that every interventional radiologist should learn include routine management of percutaneously inserted drainage and vascular catheters and rapid effective management of common systemic post-procedural complications. A structured approach to post-procedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety. The aim of this second part, in conjunction with part 1, is to complete the comprehensive review of post-procedural care in patients undergoing interventional radiology procedures. We discuss common problems encountered after insertion of drainage and vascular catheters and describe effective methods of troubleshooting these problems. Commonly encountered systemic complications in IR are described, and ways for immediate identification and management of these complications are provided.
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Huang SY, Engstrom BI, Lungren MP, Kim CY. Management of dysfunctional catheters and tubes inserted by interventional radiology. Semin Intervent Radiol 2015; 32:67-77. [PMID: 26038615 DOI: 10.1055/s-0035-1549371] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Minimally invasive percutaneous interventions are often used for enteral nutrition, biliary and urinary diversion, intra-abdominal fluid collection drainage, and central venous access. In most cases, radiologic and endoscopic placement of catheters and tubes has replaced the comparable surgical alternative. As experience with catheters and tubes grows, it becomes increasingly evident that the interventional radiologist needs to be an expert not only on device placement but also on device management. Tube dysfunction represents the most common complication requiring repeat intervention, which can be distressing for patients and other health care professionals. This manuscript addresses the etiologies and solutions to leaking and obstructed feeding tubes, percutaneous biliary drains, percutaneous catheter nephrostomies, and drainage catheters, including abscess drains. In addition, we will address the obstructed central venous catheter.
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Affiliation(s)
- Steven Y Huang
- Department of Interventional Radiology, The University of Texas, MD Anderson Cancer Center, Houston, Texas
| | - Bjorn I Engstrom
- Division of Interventional Radiology, Consulting Radiologists LTD, Minneapolis, Minnesota
| | - Matthew P Lungren
- Department of Radiology, Stanford University Medical Center, Palo Alto, California
| | - Charles Y Kim
- Division of Vascular and Interventional Radiology, Duke University Medical Center, Durham, North Carolina
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