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A simple solution to deliver a second guidewire without a dual-lumen microcatheter-The sidecar technique.

ABSTRACT: The sidecar technique represents a simple and inexpensive solution to successfully deliver a second guidewire distally whenever a dual-lumen microcatheter is not available.

SUBMITTER: Leibundgut G

PROVIDER: S-EPMC8428808 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Parent Vessel Occlusion via the Balloon-Assisted, Dual Microcatheter Technique.

Project description:Endovascular parent vessel sacrifice is an established technique used to treat vascular pathology and tumor infiltration of blood vessels. In high-flow vessels, such as the carotid artery or vertebral artery, distal coil migration and embolization are concerns. A method to mitigate this risk would improve the safety profile of the procedure. Five patients undergoing parent vessel sacrifice were retrospectively identified (from June 2018 to May 2019) for the purpose of illustrating this high-flow parent vessel occlusion technique. The technique utilizes a proximal dual-lumen balloon microcatheter inflated for blood flow arrest. The balloon-assisted, dual microcatheter technique is useful for occlusion of high-flow parent arteries. Because it utilizes both flow arrest and a tethered coil backstop, precise occlusion of a vessel can be achieved.

| S-EPMC7591226 | biostudies-literature

Modified double-guidewire technique using a unique double-lumen sphincterotome for difficult biliary cannulation.

Project description: Not available

| S-EPMC7947635 | biostudies-literature

Use of a double-lumen cytology brush catheter to allow double-guidewire technique for endoscopic interventions.

Project description:Background and aimsSerial stent placement may be necessary during endoscopic interventions, but the passage of a guidewire alongside an initial stent can be challenging, time-consuming, and sometimes unsuccessful. We describe a modification of a cytology brush catheter to allow simultaneous placement of 2 guidewires to facilitate serial stent placement and demonstrate its application in different scenarios.MethodsThis is a retrospective series of 3 patients with different conditions (acute cholecystitis, pancreas pseudocyst, and severe biliary stricture) in whom placement of a second guidewire facilitated serial stent placement. A step-by-step demonstration of the technique is provided.ResultsSerial stent placement was successful in all patients without adverse events.ConclusionsA modified cytology brush catheter can be used to deliver 2 guidewires simultaneously during ERCP and EUS procedures. This technique may improve procedural efficiency, maintain a safety track, and augment therapy in certain situations.

| S-EPMC7731304 | biostudies-literature

Incidental Discovery of Retained Triple Lumen Catheter Guidewire.

Project description: Not available

| S-EPMC5330992 | biostudies-literature

Surface Alloying in Silver-Cobalt through a Second Wave Solution Combustion Synthesis Technique.

Project description:Herein, we report the synthesis of silver-cobalt nanopowders using three different modes of solution combustion synthesis, and we present the effects of the synthesis conditions on particle morphology. The synthesized nanoparticles were characterized using X-ray diffraction (XRD), Scanning electron microscopy (SEM), Fourier transform infrared spectroscopy (FTIR), UV-Visible spectrophotometer (UV-vis), Transmission electron microscopy (TEM), and X-Ray Photoelectron Spectroscopy (XPS) to understand the structural and elemental properties. When Co is synthesized over Ag in a second wave of combustion, peak shifts observed in XRD and XPS show a change in the cell parameters and prove the existence of a strong electronic interaction between Ag and Co. Better control of mixing and alloying through the second wave combustion synthesis mode (SWCS) was evident. The sequence of combustion affects the structure and composition of the material. SWCS reduces the amount of carbon content, as compared to single-stage combustion, and the combustion of carbon is followed by a rearrangement of atoms.

| S-EPMC6116214 | biostudies-literature

Cholangioscopy-guided double-guidewire technique for complex malignant hilar obstruction.

Project description:Video 1Cholangioscopy-guided double-guidewire technique for the management of complex malignant hilar obstruction.

| S-EPMC8755521 | biostudies-literature

Recanalization of chronic total occlusion using a new device: the real-time intravascular ultrasound double-lumen microcatheter.

Project description: Not available

| S-EPMC7909382 | biostudies-literature

Retrieving entrapped guidewire using rotablation technique: case series and literature review.

Project description:BackgroundThe present article summarizes three cases of retrieving entrapped guidewire using rotablation technique.Case summaryAll three cases pertained to guidewire being fractured and entrapped during percutaneous coronary interventions (PCIs) for right coronary artery (RCA) chronic total occlusion in a local hospital. In Case 1, two fractured filaments connecting to the entrapped guidewire could be clearly seen. One filament was in the right brachial artery and the other one was in the ascending aorta. In Case 2, the operator applied buddy wire technique during PCI but forgot to withdraw the second wire before stenting. As a result, the second SION wire was entrapped by the stent and was untangled and fractured when being retrieved. In Case 3, a SION guidewire was entrapped during PCI for RCA. The initial attempt to retrieve the guidewire ended in failure. Although the entrapped guidewire was still intact, it was difficult to advance the floppy rotawire into the RCA as it was still totally occluded. In those scenarios, complete retrieval of the entrapped guidewire using catheter-based technique was hardly possible. Rotablation was used to cut the entrapped guidewire, retrieve the broken end, and leave the remnants in coronary artery jailed by the stent. Clinical and angiographic follow-up observation demonstrated that the patients were free of target vessel failure.DiscussionEntrapment of guidewire is a rare complication of PCI. The management of entrapped guidewire is usually challenging. Rotablation technique is a useful and efficient strategy when conventional methods failed to retrieve the entrapped guidewire.

| S-EPMC9263157 | biostudies-literature

Cost Effective Technique of Shoulder Arthroscopy Without the Use of Epinephrine in Irrigation Solution.

Project description:Arthroscopic surgery of the shoulder joint and the subacromial space requires adequate visualization to be effectively performed. Visual clarity is essential to perform a safe and successful arthroscopic procedure. The major determinants to provide visualization in the subacromial space and the glenohumeral joint include adequate inflow (dependent on the dimension of the inflow cannula), flow rate versus pressure, pump system versus gravity, the use of electrocautery and radiofrequency devices, blood pressure control and hypotensive anesthesia, and the type of irrigation solution used with or without the use of epinephrine. In 2012, the cost of a 30-mL (30-mg) vial of epinephrine was $6 (adrenalin/epinephrine injection, USP, Par Pharmaceuticals), and approximately 3 to 4 bottles would be used on average for a single shoulder arthroscopy. In 2019, the same 30-mL bottle of epinephrine cost $237, a nearly 40-fold increase. The purpose of our study is to describe the various factors and techniques that can be used to maintain visual clarity in shoulder arthroscopy without the use of epinephrine in the irrigation solution and the cost savings associated without the use of epinephrine.

| S-EPMC7917405 | biostudies-literature

Novel dry pericardiocentesis: Transvenous puncture of the right ventricle with the back end of a 0.014-inch PTCA guidewire and a 1.8 Fr microcatheter.

Project description:BackgroundDry transthoracic pericardiocentesis is challenging and carries the risk of right ventricle (RV) or coronary artery injury. The RV can usually control bleeding automatically. For example, most perforations of the RV caused by pacemaker leads are treated without open surgery. Thus, we performed a transvenous puncture of the RV for dry pericardiocentesis with the back end of a 0.014-inch percutaneous transluminal coronary angioplasty (PTCA) guidewire and a 1.8 Fr microcatheter.MethodsThe back end of a 0.014-inch PTCA guidewire within a 1.8 Fr microcatheter was used to transvenously punctured through the middle of the acute margin of the RV into the pericardial space in 12 Yorkshire swine and 5 beagles. PTCA balloons of different diameters were used to dilate the puncture holes for 15 min under anticoagulation in all the animals to assess the ability of the RV to control the bleeding. Then, for 3 days, the puncture hole was dilated by a 6 Fr catheter in 9 swine and 5 dogs.ResultsThe puncture was successful in all the animals. After withdrawal of the 2.5-mm balloon or the 6 Fr catheter, none of the animals exhibited pericardial effusion, as observed by echocardiography. There was no sustained ventricular arrhythmia or other complications. All the animals survived.ConclusionTransvenous puncture of the right ventricle with the back end of a 0.014-inch PTCA guidewire and 1.8 Fr microcatheter may be feasible and have a good safety margin.

| S-EPMC9485541 | biostudies-literature

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