Ultrasound guidance for arterial (other than femoral) catheterisation in adults.
Ontology highlight
ABSTRACT:
SUBMITTER: Flumignan RL
PROVIDER: S-EPMC8507521 | biostudies-literature | 2021 Oct
REPOSITORIES: biostudies-literature
Publications
Ultrasound guidance for arterial (other than femoral) catheterisation in adults.
Flumignan Ronald Lg RL Trevisani Virginia Fm VF Lopes Renato D RD Baptista-Silva Jose Cc JC Flumignan Carolina Dq CD Nakano Luis Cu LC
The Cochrane database of systematic reviews 20211012
<h4>Background</h4>Arterial vascular access is a frequently performed procedure, with a high possibility for adverse events (e.g. pneumothorax, haemothorax, haematoma, amputation, death), and additional techniques such as ultrasound may be useful for improving outcomes. However, ultrasound guidance for arterial access in adults is still under debate.<h4>Objectives</h4>To assess the effects of ultrasound guidance for arterial (other than femoral) catheterisation in adults.<h4>Search methods</h4>W ...[more]
Similar Datasets
Project description: Not available
| S-EPMC6299761 | biostudies-literature
Project description:BackgroundRandomised controlled trials of ultrasound (US)-guided transfemoral access (TFA) for coronary procedures have shown mixed results.AimsWe aimed to compare US-guided versus non-US-guided TFA from randomised data in an individual participant-level data (IPD) meta-analysis.MethodsWe completed a systematic review and an IPD meta-analysis of all randomised controlled trials comparing US-guided versus non-US-guided TFA for coronary procedures. We performed a one-stage mixed-model meta-analysis using the intention-to-treat population from included trials. The primary outcome was a composite of major vascular complications or major bleeding within 30 days.ResultsA total of 2,441 participants (1,208 US-guided, 1,233 non-US-guided) from 4 randomised clinical trials were included. The mean age was 65.5 years, 27.0% were female, and 34.5% underwent a percutaneous coronary intervention. The incidence of major vascular complications or major bleeding (34/1,208 [2.8%] vs 55/1,233 [4.5%]; odds ratio [OR] 0.61, 95% confidence interval [CI]: 0.39-0.94; p=0.026) was lower in the US-guided TFA group. In the prespecified subgroup of participants who received a vascular closure device, those randomised to US-guided TFA experienced a reduction in the primary outcome (2.1% vs 5.6%; OR 0.36, 95% CI: 0.19-0.69), while no benefit for US guidance was observed in the subgroup without vascular closure devices (4.1% vs 3.3%; OR 1.21, 95% CI: 0.65-2.26; interaction p=0.009).ConclusionsIn participants undergoing coronary procedures by TFA, US guidance decreased the composite outcome of major vascular complications or bleeding and may be especially helpful when using vascular closure devices.
| S-EPMC10758987 | biostudies-literature
Project description: Not available
| S-EPMC9744071 | biostudies-literature
Project description:BackgroundA better understanding of the blood supply of the femoral head is essential to guide therapeutic strategies for patients with femoral neck fractures. However, because of the limitations of conventional techniques, the precise distribution and characteristics of intraosseous arteries of the femoral head are not well displayed.Questions/purposesTo explore the characteristics and interconnections of the intraosseous vessel system between different areas of the femoral head and the possible blood supply compensatory mechanism after femoral neck fracture.MethodsThe three-dimensional (3-D) structures of the intraosseous blood supply in 30 uninjured normal human femoral heads were reconstructed using angiography methods and microCT scans. The data were imported in the AMIRA® and MIMICS® software programs to reconstruct and quantify the extra- and intraosseous arteries (diameter, length). In a separate experiment, we evaluated the residual blood supply of femoral heads in 27 patients with femoral neck fractures before surgery by analyzing digital subtraction angiography data; during the study period, this was performed on all patients in whom hip-preserving surgery was planned, rather than arthroplasty. The number of affected and unaffected subjects included in the three groups (superior, inferior, and anterior retinacular arteries) with different types of fractures (Garden Types I-IV) were recorded and analyzed (Fisher's exact test) to reflect the affected degrees of these three groups of retinacular arteries in patients after femoral neck fractures.ResultsThe main results of our cadaver study were: (1) the main blood supply sources of the femoral head were connected by three main network structures as a whole, and the epiphyseal arterial network is the most widely distributed and the primary network structure in the femoral head; (2) the main stems of the epiphyseal arteries which were located on the periphery of the intraosseous vascular system have fewer anastomoses than the network located in the central region; (3) compared with the round ligament artery and anterior retinacular artery, the inferior retinacular artery has a relatively large caliber. Digital subtraction angiography of the 27 patients with hip fractures indicated that the inferior retinacular arterial system had a high likelihood of being unaffected after femoral neck fracture (100% [14 of 14] in nondisplaced fractures and 60% [six of 10] in Garden Type III fractures).ConclusionsThe epiphyseal arterial network and inferior retinacular arterial system appear to be two important structures for maintaining the femoral head blood supply after femoral neck fracture. Increased efforts to protect these key structures during surgery, such as drilling and placing internal implants closer to the central region of the femoral head, might be helpful to reduce the effect of iatrogenic injury of the intraosseous vascular system.Clinical relevance3-D anatomic evidence of intraosseous arterial distribution of the femoral head and the high frequency with which the inferior retinacular arteries remained patent after femoral neck fracture lead us to consider the necessity of drilling and placing internal implants closer to the central region of the femoral head during surgery. Future controlled studies might evaluate this proposition.
| S-EPMC5498378 | biostudies-literature
Project description:Femoral acetabular impingement is a common hip disorder that may prove debilitating to many patients. Surgical management is indicated by way of hip arthroscopy for impinging CAM and pincer acetabular lesions. Traditionally, fluoroscopy has been used for the intraoperative assessment of bony resection; however, many disadvantages include radiation risks, equipment demands, and more. With ultrasound-guided arthroscopy, we describe the use of 1:1 3-dimensional hip printed models through various visual perspectives of impinging lesions. Given the low cost of 3-dimensional hip printing, lack of radiation exposure, and tactile multiangular views, we propose a safer and more reproducible intraoperative technique to conventional fluoroscopy to achieve better resection and outcomes after femoral acetabular impingement surgery.
| S-EPMC6926318 | biostudies-literature
Project description:BackgroundPericardial effusion is a common entity which may have important implications in patient's prognosis. In several cases, pericardiocentesis is indicated for diagnostic and/or therapeutic purposes.Case presentationA blind pericardiocentesis failed in a 95-year-old woman admitted to the emergency department with a large pericardial effusion incidentally diagnosed in the ambulatory setting. Ultrasound-guided pericardiocentesis aided in easily accessing to the pericardial cavity, without periprocedural complications.ConclusionsUltrasound-guided pericardiocentesis is simple, safe and effective, and should replace the blind technique. This procedure should be part of the armamentarium of ultrasound-guided practices of emergency or critical care physicians.
| S-EPMC8844339 | biostudies-literature
Project description: Not available
| S-EPMC6464626 | biostudies-literature
Project description:Rupture of the Achilles tendon is a common injury seen in patients of varying ages and activity levels. There are many considerations for treatment of these injuries, with both operative and nonoperative management providing satisfactory outcomes in the literature. The decision to proceed with surgical intervention should be individualized for each patient, including the patient’s age, future athletic goals, and comorbidities. Recently, a minimally invasive percutaneous approach to repair the Achilles tendon has been proposed as an equivalent alternative to the traditional open repair, while avoiding wound complications associated with larger incisions. However, many surgeons have been hesitant to adopt these approaches due to poor visualization, concern that suture capture in the tendon is not as robust, and the potential for iatrogenic sural nerve injury. The purpose of this Technical Note is to describe a technique using high-resolution ultrasound guidance intraoperatively during minimally invasive repair of the Achilles tendon. This technique minimizes the drawbacks of poor visualization associated with percutaneous repair, while providing the benefit of a minimally invasive approach. Technique Video Video 1 Detailed description of our preferred technique using ultrasound guidance during Achilles tendon repair with the Percutaneous Achilles Repair System (PARS) system. The ultrasound probe is placed over the posterior aspect of the ankle, overlying the Achilles tendon. The patient is in the prone position on the operating table. In the long axis view, the longitudinal fibers of the Achilles tendon and paratenon can be visualized. Moving distally, the Achilles tendon can be visualized as it inserts onto the calcaneus. Moving from distal to proximal, the Achilles tendon can be seen fanning out from a cord-like structure to more of a ribbon-like structure as it extends into the gastrocnemius and soleus. In the short-axis view, the “broom-end” appearance of the tendon can be appreciated. Moving lateral to the tendon, the sural vein and nerve can be visualized and avoided during the PARS repair. The sural nerve can be identified by its location and the classic honeycomb appearance, in contrast to the accompanying sural vein, which is hypoechoic in nature and compressible. While using the ultrasound intraoperatively, the surgeon can ensure the PARS needles are passed through the jig into the bulk of the Achilles tendon. This can be visualized on both the short- and long-axis views after each suture pass and can help decrease risk of suture cutout due to poor suture placement. Use of the ultrasound intraoperatively also allows the surgeon to identify the location of the sural nerve, and avoid it during the procedure and with each needle pass. After each needle pass is confirmed on ultrasound to have proper position, the remainder of the repair proceeds as normal.
| S-EPMC9984726 | biostudies-literature
Project description:PurposeIn this paper we compared two different 3D ultrasound (US) modes (3D free-hand mode and 3D wobbler mode) to see which is more suitable to perform the 3D-US/3D-US registration for clinical guidance applications. The typical errors with respect to their impact on the final localization error were evaluated step by step.MethodsMulti-point target and Hand-eye calibration methods were used for 3D US calibration together with a newly designed multi-cone phantom. Pointer based and image based methods were used for 2D US calibration. The calibration target error was computed by using a different multi-cone phantom. An egg-shaped phantom was used as ground truth to compare distortions for both 3D modes along with the measurements of the volume. Finally, we compared 3D ultrasound images acquired by 3D wobbler mode and 3D free-hand mode with respect to their 3D-US/3D-US registration accuracy using both, phantom and patient data. A theoretical step by step error analysis was performed and compared to empirical data.ResultsTarget registration errors based on the calibration with the 3D Multi-point and 2D pointer/image method have been found to be comparable (∼1mm). They both outperformed the 3D Hand-eye method (error >2mm). Volume measurements with the 3D free-hand mode were closest to the ground truth (around 6% error compared to 9% with the 3D wobbler mode). Additional scans on phantoms showed a 3D-US/3D-US registration error below 1 mm for both, the 3D free-hand mode and the 3D wobbler mode, respectively. Results with patient data showed greater error with the 3D free-hand mode (6.50mm - 13.37mm) than with the 3D wobbler mode (2.99 ± 1.54 mm). All the measured errors were found to be in accordance to their theoretical upper bounds.ConclusionWhile both 3D volume methods showed comparable results with respect to 3D-US/3D-US registration for phantom images, for patient data registrations the 3D wobbler mode is superior to the 3D free-hand mode. The effect of all error sources could be estimated by theoretical derivations.
| S-EPMC7098612 | biostudies-literature
Project description:Injections of botulinum neurotoxins (BoNTs) are prescribed by clinicians for a variety of disorders that cause over-activity of muscles; glands; pain and other structures. Accurately targeting the structure for injection is one of the principle goals when performing BoNTs procedures. Traditionally; injections have been guided by anatomic landmarks; palpation; range of motion; electromyography or electrical stimulation. Ultrasound (US) based imaging based guidance overcomes some of the limitations of traditional techniques. US and/or US combined with traditional guidance techniques is utilized and or recommended by many expert clinicians; authors and in practice guidelines by professional academies. This article reviews the advantages and disadvantages of available guidance techniques including US as well as technical aspects of US guidance and a focused literature review related to US guidance for chemodenervation procedures including BoNTs injection.
| S-EPMC5793105 | biostudies-literature