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Anatomical variation in the internal jugular vein:potential risk factors for central venous catheterization-a case report

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World Journal of Emergency Medicine 2024年第4期15卷 316-318页

作者： Yidan Shan Weijia Huang Department of Oral and Maxillofacial Surgery the Second Affiliated Hospital of Zhejiang University School of MedicineHangzhou 310009China

Central venous catheterization(CVC)is an invasive medical procedure used to measure central venous pressure and provides a stable route for continuous drug administration.CVC is widely used in the emergency department and intensive care units.It is typically performed by inserting a catheter through the internal jugular vein(IJV)into the superior vena cava near the right atrium.[1,2]While catheterization is a fundamental skill proficiently performed by healthcare professionals,lethal complications may occasionally occur because of undesirable positioning,depth and diameter.

关键词： venous catheter jugular

Double pigtail catheter reduction for seriously displaced intravenous infusion port catheter:A case report

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World Journal of Clinical Cases 2023年第4期11卷 883-887页

作者： Yu Liu Duan-Ming Du Department of Interventional Therapy Shenzhen Second People’s HospitalThe First Affiliated Hospital of Shenzhen UniversityShenzhen 518035Guangdong ProvinceChina

BACKGROUND Implanted intravenous infusion port(TIAP)is mainly used for patients who need central venous infusion and poor peripheral vascular conditions.With the advantages of easy to carry,long maintenance cycle,few complications and excellent quality of life,it has been widely used in the fields of malignant tumor chemotherapy,parenteral nutrition support and repeated blood collection.Implanted intravenous infusion port(IVAP)dislocation can have significant complications if not recognised and reinstated immediately.CASE SUMMARY A 24-year-old man was treated with adjuvant chemotherapy for osteosarcoma.Severe displacement of IVAP catheter was found by chest X-ray examination.The IVAP cannot be used normally.Therefore,we conducted an emergency procedure to reset the catheter through double pigtail catheters,the operation was successful and the infusion port was restored.CONCLUSION When IVAP catheter displacement cannot be reset by conventional techniques,two pigtail catheters can be successfully used instead.

关键词： catheter Displaced catheter Implantable Implanted intravenous infusion port Pigtail catheter Case report

Structural and Interfacial Effects on Drug Release Kinetics of Liquid‑Based Fibrous catheter

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Advanced Fiber Materials 2022年第6期4卷 1645-1655页

作者： Chunyan Wang Yaqi Hou Xingyi Wang Weijun Li Yunmao Zhang Shuli Wang Jing Zheng Xu Hou College of Chemistry and Chemical Engineering State Key Laboratory of Physical Chemistry of Solid SurfacesXiamen UniversityXiamen 361005China Collaborative Innovation Center of Chemistry for Energy Materials Xiamen UniversityXiamen 361005China Department of Electronic Science Fujian Engineering Research Center for Solid‑State LightingSchool of Electronic Science and EngineeringXiamen UniversityXiamen 361005China College of Physical Science and Technology Xiamen UniversityXiamen 361005China

catheterization is indispensable in the field of modern medicine.However,catheter-related thrombosis and infections almost inevitably occur during the process,and as drugs can only be administered at the end of catheter,auxiliary strategies are required for successful implantation.Considering these intractable limitations,a type of self-adaptive,anti-coagulate liquidbased fibrous catheter has been developed.More importantly,it has positional drug release property that traditional catheters desperately need but couldn’t attain.Although enlightening,the feasibility and performance of the positional drug release have only been demonstrated by fluorescents,the specific drug release kinetics remains unknown for adaptation to application scenarios.Therefore,we systematically investigate the structural and interfacial effects of drug molecules and fibrous matrixes on drug release kinetics in a liquid-based fibrous catheter.Theoretical calculations and experiments demonstrate that oleophilic and hydrophilic molecules release slowly due to a dissolution-diffusion mechanism.Amphipathic molecules,however,will significantly affect the gating performance by affecting the interfacial stability,hence they release quickly with emulsifying the gating liquid.Besides the significant impact of molecular properties and interfacial effects,matrix pore size also has a slight influence that molecules release faster in bigger pores.Through this study,the liquid-based fibrous catheter may step further toward practical applications including chemotherapy,haemodialysis,angiography,etc.to overcome the existing catheter-related limitations.

关键词： Liquid-based materials Electrospinning fibrous materials catheter Drug release

Dual-sized hollow particle incorporated fibroin thermal insulating coatings on catheter for cerebral therapeutic hypothermia

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Bioactive Materials 2023年第8期26卷 116-127页

作者： Ming Li Yuan Gao Miaowen Jiang Hongkang Zhang Yang Zhang Yan Wu Wenhao Zhou Di Wu Chuanjie Wu Longfei Wu Luzi Bao Xiaoxiao Ge Zhengfei Qi Ming Wei Ang Li Yuchuan Ding Jicheng Zhang Guangzhen Pan Yu Wu Yan Cheng Yufeng Zheng Xunming Ji China-America Institute of Neuroscience and Beijing Institute of Geriatrics Xuanwu HospitalCapital Medical UniversityBeijing100053China School of Instrumentation and Optoelectronic Engineering Beihang UniversityBeijing100191China Beijing Institute for Brain Disorders Capital Medical UniversityBeijing100069China School of Materials Science and Engineering Peking UniversityBeijing100871China Shaanxi Key Laboratory of Biomedical Metallic Materials Northwest Institute for Nonferrous Metal ResearchXi’an710016China Department of Biomedical Engineering Columbia UniversityNew York CityNY10027USA Department of Neurosurgery Wayne State University School of MedicineDetroitMI48201USA Gong Yi Van-research Innovation Composite Material Co.Ltd Zheng Zhou451299China Department of Neurosurgery Xuanwu HospitalCapital Medical UniversityBeijing100053China

Selective endovascular hypothermia has been used to provide cooling-induced cerebral neuroprotection,but current catheters do not support thermally-insulated transfer of cold infusate,which results in an increased exit temperature,causes hemodilution,and limits its cooling efficiency.Herein,air-sprayed fibroin/silica-based coatings combined with chemical vapor deposited parylene-C capping film was prepared on catheter.This coating features in dual-sized-hollow-microparticle incorporated structures with low thermal conductivity.The infusate exit temperature is tunable by adjusting the coating thickness and infusion rate.No peeling or cracking was observed on the coatings under bending and rotational scenarios in the vascular models.Its efficiency was verified in a swine model,and the outlet temperature of coated catheter(75μm thickness)was 1.8-2.0◦C lower than that of the uncoated one.This pioneering work on catheter thermal insulation coatings may facilitate the clinical translation of selective endovascular hypothermia for neuroprotection in patients with acute ischemic stroke.

关键词： Silk fibroin Thermal insulation coating catheter Stroke Hypothermia

Inexpensive and combined technique: Use of suction tracheal catheter and hydrogen peroxide for the evacuation of intravesical clots

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Asian Journal of Urology 2022年第1期9卷 99-100页

作者： Fred Alain Montelongo-Rodriguez Carlos Daniel Guerra-Catanon Mario Vazquez-Herrera Adrian Gutierrez-Gonzalez Lauro Salvador Gomez-Guerra Urology Department Hospital Universitario“Dr.Jose Eleuterio Gonzalez”Universidad Autonoma de Nuevo LeonMonterreyMexico

Dear Editor,Persistent hematuria could trigger urinary retention,leading the patient to the emergency department for abdominal pain,decreased urinary output,anemia,and azotemia[1,2].Conventional bladder clot evacuation requires a three-way catheter with continuous irrigation and aspiration with a syringe or Ellik evacuator[3].Sometimes a large and well-organized hematoma requires an open cystostomy[1,4].We want to introduce a combined method using hydrogen peroxide as well as suction technique with an endotracheal catheter to evacuate intravesical clots.

关键词： urinary bladder catheter

catheter ablation of atrial fibrillation in elderly population

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Journal of Geriatric Cardiology 2017年第9期14卷 563-568页

作者： Josef Kautzner Petr Peichl Marek Sramko Robert Cihak Bashar Aldhoon Dan Wichterle Department of Cardiology Institute for Clinical and Experimental Medicine (IKEM) Videnska 1958/9 14021 Prague Czech Republic

Background Although elderly patients have been included in published series of catheter ablation for atrial fibrillation （AF）, clinicalbenefit and safety remain still less defined in this population. A retrospective analysis of the results of catheter ablation for AF in a large volumecenter focused on comparison of elderly patients with the rest of the patient cohort was conducted in this study. Methods Consecutive patientswho underwent catheter ablation for AF between January 2001 and December 2016 were analysed. A total population of 3197 patients wasdichotomized by the age of 70 years （394 elderly vs. 2803 younger subjects）. Patients were followed in terms of arrhythmia status and sur-vival for a median period of 18 vs. 21 and 35 vs. 57 months, respectively. Results Elderly patients were more frequently females （49% vs.29%, P 〈 0.0001）, had a history of hypertension （79% vs. 57%, P 〈 0.0001）, diabetes （16% vs. 11%, P 〈 0.01）, stroke （9% vs. 6%, P 〈 0.01）,coronary/peripheral artery disease （14% vs. 8%, P 〈 0.0001）, and CHAzDS2-VASc score （3.1 ± 1.3 vs. 1.5 ± 1.2 s, P 〈 0.0001）. Major com-plications were more frequent in elderly （5.3% vs. 3.2%, P = 0.03）; however, this difference was driven by vascular complications （3.6% vs.1.9%, P = 0.04）. There were comparable rates of cerebrovascular （0.3 vs. 0.3%） or nonvascular complications （1.8 vs. 1.2%）. Good arrhyth-mia control was inferior in elderly patients as compared with the rest of the cohort, both without and with antiarrhythmic drugs： 44.2% vs.58.2% （P 〈 0.0001） and 78.2 vs. 83.2% （P 〈 0.01）, respectively. Poor arrhythmia control was associated with relative risk of all-cause mor-tality of 2.7 （95% CI： 1.1-6.4） in elderly patients and 1.4 （95% CI： 0.9-2.0） in younger subjects. Conclusions catheter ablation for AF inelderly patients is safe although somewhat less effective. Good arrhythmia control is associated with better survival, especially in elderly patients.

关键词： Atrial fibrillation catheter ablation Complications The elderly

Value of cystatin C in predicting atrial fibrillation recurrence after radiofrequency catheter ablation

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Journal of Geriatric Cardiology 2018年第12期15卷 725-731页

作者： Li-Li JIN Ling YOU Rui-Qin XIE Department of Cardiology the Second Hospital of Hebei Medical UniversityShijiazhuangChina

Backgroud Recent studies have demonstrated that cystatin C is a valuable risk marker for cardiovascular disease morbidity and mortality.Therefore,we hypothesized that the pre-ablation cystatin C level was associated with post-ablation atrial fibrillation(AF)recurrence.Methods 207 patients were enrolled and completed in this prospective observational study.Patients with AF scheduled for receive radiofrequency catheter ablation(RFCA)therapy were screened for the study.Before ablation therapy,electrocardiogram,24 h holter monitor,transesophageal echocardiography,serum cystatin C,high-sensitivity C-reactive protein,creatinine levels,and routine blood examinations were examined.After ablation,patients were followed up every week for the first month,and then at 2,3,6,9,and 12 months.Thereafter,patients came back to out-patient clinic every six months regularly.Electrocardiogram or 24 h holter monitor were repeated if the patient experienced palpitations or every six months.AF recurrence was defined as atrial flbrillation/atrial flutter or atrial tachycardia lasting≥30 seconds within three months after therapy.Results Compared to patients with no AF recurrence,patients with recurrence had longer AF history(P=0.007),more early recurrence(P=0.000),a larger left atrium(P=0.004),and higher pre-ablation cystatin C levels(P=0.000).Multivariate regression analysis revealed that cystatin C and left atria(LA)diameter were risk factors for AF recurrence.After adjusting for LA diameter,the risk of AF recurrence increased 30%with every milligram cystatin C elevation(95%CI:1.117-1.523).Conclusions Pre-ablation cystatin C levels were associated with AF recurrence after RFCA therapy,an optimal cut-off value of 1.190 mg/L(sensitivity=0.576;specificity=0.851).

关键词： Atrial fibrillation catheter ablation Cystatin C Recurrence

Postablation neutrophil/lymphocyte ratio correlates with arrhythmiarecurrence after catheter ablation of lone atrial fibrillation

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Chinese Medical Journal 2014年第6期127卷 1033-1038页

作者： Guo Xueyuan Zhang Sen Yan Xianliang Chen Yingwei Yu Ronghui Long Deyong Sang Caihua Department of Cardiology Beijing Anzhen Hospital Capital Medical University Beijing Institute of Heart Lung and Blood Vessel Diseases Beijing 100029 China

Background Neutrophil/lymphocyte ratio(NLR) has been proposed as a novel marker of systemic inflammation and oxidative stress. The objective of this study was to ascertain the relationship between levels of NLR and recurrence of lone atrial fibrillation(AF) after catheter ablation.Methods A total of 379 lone AF patients who underwent catheter ablation were enrolled in the study. The NLR before and after catheter ablation was determined. Cox regression analyses were used to estimate the relationship between NLR and the recurrence of lone AF.Results After a mean follow-up of(30.5±5.3) months, 124(32.7%) patients had AF recurrences. The patients who developed AF recurrence had a higher postablation NLR(post-NLR) than patients with no recurrence(5.74±1.55 vs. 4.66±1.27, P <0.001). Multivariate Cox regression analysis revealed that post-NLR(hazard ratio(HR) 1.514, 95% confidence interval(CI) 1.364–1.680, P <0.001), left atrium diameter(HR 1.035, 95% CI 1.001–1.071, P=0.04) and body mass index(HR 1.028, 95% CI 1.002–1.054, P=0.03) were independent predictors of AF recurrence. Using a cut-off level of 5.15, post-NLR predicted AF recurrence with a sensitivity of 73% and specificity of 67%.Conclusions Our results indicate that an elevated post-NLR is associated with a high rate of lone AF recurrence. A simple measurement of NLR may help us to identify high-risk patients who need pharmacologic intervention to prevent recurrence.

关键词： atrial fibrillation catheter ablation neutrophil lymphocyte ratio

Clinical outcomes of radiofrequency catheter ablation of atrial fibrillation in octogenarians lO-year experience of a one high-volume center

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Journal of Geriatric Cardiology 2017年第9期14卷 575-581页

作者： Alan Bulava Jiri Hanis Ladislav Dusek Department of Cardiology Ceske Budejovice Hospital Ceske Budejovice Czech Republic Faculty of Medicine and Dentistry Palacky University Olomouc Czech Republic Faculty of Health and Social Sciences University of South Bohemia in Ceske Budejovice Czech Republic Institute of Biostatistics and Analyses Faculty of Medicine Masaryk University Brno Czech Republic

Background Prevalence of atrial fibrillation （AF） increases with age. Radiofrequency catheter ablation （RFCA） is an establishedtreatment option superior to antiarrhythmics （AAs）. In this study, we investigated safety and efficacy of RFCA of AF in octogenarians.Methods From our database, we extracted procedural and follow-up data for patients 〉 80 years with symptomatic AF undergoing RFCAand compared this population to RFCA patients 〈 50 years. All patients underwent pulmonary vein isolation （PVI） supplemented by linearlesions in PVI-nonresponders. Arrhythmia-free survival was assessed using seven day Holter every three months post procedure. All patientscompleted their 12 months follow-up. Results Fifty patients aged ≥80 years （80.5 ± 1.6 years） were compared to 259 patients aged 〈 50years （43.5±5.5 years）. The RFCA complication rate did not vary between groups. No differences in procedural characteristics were seenafter being analyzed by type of AF. Among patients with paroxysmal AF, 71.4% octogenarian vs. 84.7% young patients was free of anyarrhythmia, without AAs, after single procedure. For non-paroxysmal AF, arrhythmia-free survival without AAs, was considerably lower（58.6% octogenarians vs. 81.2% younger patients, P = 0.023）. If AAs were used, arrhythmia-free survival for paroxysmal AF increased to90.5% and 92.1% in octogenarians and younger patients, respectively; and in non-paroxysmal AF it increased to 79.3% vs. 88.4%. ConclusionsRFCA is a safe and effective strategy to achieve normal sinus rhythm in a highly selected group of octogenarians. Paroxysmal AF ablation inoctogenarians has similar clinical effectiveness as that seen in much younger patients. Non-paroxysmal AF ablation has lower, but still rea-sonable clinical effectiveness.

关键词： Atrial fibrillation catheter ablation Effectiveness Octogenarians Safety The elderly