共查询到20条相似文献,搜索用时 15 毫秒
1.
Pieri S Agresti P Carnabuci A Pizzarelli S Ianniello S De' Medici L 《La Radiologia medica》2005,110(4):359-369
PURPOSE: We report our experience with the percutaneous treatment of superior vena cava syndromes of benign etiology. MATERIALS AND METHODS: From August 1994 to August 2003 a total of 14 superior vena cava syndromes of benign origin were treated. Previous use of a central venous catheter pending the development of a peripheral arteriovenous fistula for dialysis was believed to be the cause of the obstruction of the superior vena cava in 11 patients. In 2 other cases the cause was attributed to post-radiation mediastinal fibrosis and, in one case, to a previously implanted pacemaker. The superior vena cava syndrome was confirmed by venography. After negotiating the obstruction, a self-expanding stent was selected based on the CT and venographic data. At the end of the procedure, technical success was confirmed by venography, and haemodynamic success by pressure measurements. The follow-up allowed the assessment of the clinical success of the procedure. RESULTS: Technical success was achieved in 13 patients (92.8%); in one case the obstruction could not be negotiated with the wire guide, so the patient was referred for surgery. One self-expanding stent proved sufficient to resolve the central venous obstruction and restore superior vena cava diameter in all cases but one. In one young woman, whose central obstruction was resolved with PTA, was unable to complete the procedure with deployment of a self-expanding stent owing to a supervening asthma attack that could not be treated with the commonly-used drugs. No complications related to the procedure were reported. The symptoms cleared up within 2 weeks, and haemodynamic improvements were already seen within minutes of stent deployment. CONCLUSIONS: Percutaneous treatment is a valuable alternative to surgery as it is able to restore haemodynamic parameters and resolve the clinical picture, ensuring longer functionality to arteriovenous fistulae and an improved quality of life. 相似文献
2.
Peter Isfort Tobias Penzkofer Fabian Goerg Andreas H. Mahnken 《Korean journal of radiology》2011,12(5):629-633
Stenting of the central veins is well established for treating localized venous stenosis. The techniques regarding catheter preservation for central venous catheters in the superior vena cava have been described. We describe here a method for stent implantation in the superior vena cava and the left brachiocephalic vein, and principally via a single jugular venous puncture, while saving a left sided jugular central venous catheter in a patient suffering from central venous stenosis of the superior vena cava and the left brachiocephalic vein. 相似文献
3.
Shuji Kariya Miyuki Nakatani Takuji Maruyama Yasuyuki Ono Yutaka Ueno Atsushi Komemushi Noboru Tanigawa 《Japanese journal of radiology》2018,36(7):450-455
Purpose
To evaluate the clinical results of central venous access port (CV port) placement by translumbar inferior vena cava cannulation using angio-CT unit for cancer patients with superior vena cava syndrome.Materials and methods
A CV port was placed by translumbar inferior vena cava cannulation using an angio-CT unit, in 14 consecutive patients. All patients had occlusion or advanced stenosis of the superior vena cava due to cancer progression.Results
The technical success rate of the percutaneous translumbar CV port placement was 100%. The only complication related to port placement was bleeding in the right iliopsoas muscle seen on CT in one patient, but it stopped with conservative treatment. The mean initial device service interval was 125 days (range 6–448 days). Complications in the chronic phase occurred in two patients, one with catheter-related infection and the other with catheter breakage, for a rate of 0.44/1000 catheter days. In the patient with the broken catheter, the port chamber placement site was cut and replaced with a new catheter by guidewire exchange.Conclusions
CV port placement with translumbar inferior vena cava cannulation using an angio-CT unit for cancer patients with superior vena cava syndrome was safe and effective.4.
Catheter-related upper extremity deep venous thrombosis in cancer patients: a prospective study based on Doppler US 总被引:4,自引:0,他引:4
Luciani A Clement O Halimi P Goudot D Portier F Bassot V Luciani JA Avan P Frija G Bonfils P 《Radiology》2001,220(3):655-660
PURPOSE: This prospective study extending for more than 3 years had two objectives: (a) to use Doppler ultrasonography (US) to estimate the incidence of asymptomatic catheter-related upper extremity deep venous thrombosis (DVT) in a large population and (b) to study the effect of the catheter position as an individual risk factor for catheter-related DVT. MATERIALS AND METHODS: Between October 1995 and June 1998, a total of 145 patients who had oropharyngeal tract cancer and who were fitted with the same totally implantable central venous catheters (CVCs) were included in the study. Follow-up included (a) estimation of the position of each catheter tip on a chest radiograph obtained immediately after surgery and (b) regular monthly Doppler US screening for catheter-related DVT. RESULTS: Seventeen patients developed catheter-related DVT; 13 of them were asymptomatic. The mean interval between CVC implantation and detection of thrombosis was 42.2 days. Correct positioning of the distal catheter tip was associated with a significantly lower rate of catheter-related DVT. Only five of 87 patients with a correctly positioned distal catheter tip (ie, either in the superior vena cava or at the junction between the right atrium and the superior vena cava) developed thrombosis, compared with 12 of 26 patients with a misplaced catheter (P <.001). The side on which the CVC was implanted did not influence the catheter-related DVT rate. CONCLUSION: The rate of asymptomatic catheter-related DVT is high and could be lowered with correct initial CVC positioning. 相似文献
5.
Luc Stockx Henricus Raat Jan Donck Guy Wilms Guy Marchal 《Cardiovascular and interventional radiology》1999,22(3):224-226
Purpose: To describe a combined procedure of repositioning and leaving in situ a central venous catheter followed by immediate percutaneous
treatment of associated superior vena cava syndrome (SVCS).
Methods: Eight patients are presented who have central venous catheter-associated SVCS (n = 6 Hickman catheters, n = 2 Port-a-cath) caused by central vein stenosis (n = 4) or concomitant thrombosis (n = 4). With the use of a vascular snare introduced via the transcubital or transjugular approach, the tip of the central venous
catheter could be engaged, and repositioned after deployment of a stent in the innominate or superior vena cava.
Results: In all patients it was technically feasible to reposition the central venous catheter and treat the SVCS at the same time.
In one patient flipping of the Hickman catheter in its original position provoked dislocation of the released Palmaz stent,
which could be positioned in the right common iliac vein.
Conclusion: Repositioning of a central venous catheter just before and after stent deployment in SVCS is technically feasible and a better
alternative than preprocedural removal of the vascular access. 相似文献
6.
Maria A. Rivero Dennis W.W. Shaw Robert T. Schaller Jr. 《Cardiovascular and interventional radiology》1999,22(1):81-83
An 18-year-old man with a gastrointestinal hypomotility syndrome required lifelong parenteral nutrition. Both the superior
and inferior vena cava were occluded. Computed tomography guidance was used to place a long-term central venous catheter via
a large tributary to the azygos vein. 相似文献
7.
Claude Haller Sébastien Déglise Francois Saucy Claudine Mathieu Erik Haesler Francesco Doenz Jean Marc Corpataux Salah Dine Qanadli 《Cardiovascular and interventional radiology》2009,32(4):695-702
A method for hemodialysis catheter placement in patients with central thoracic venous stenosis or occlusion is described and
initial results are analyzed. Twelve patients, with a mean age of 63.2 years (42–80 years), with central venous stenosis or
occlusion, and who required a hemodialysis catheter were reviewed. All lesions were confirmed by helical CT or phlebography.
Five patients had stenosis while seven patients were diagnosed with an occlusion of thoracic central veins. All patients were
asymptomatic, without sign of superior vena cava syndrome. After percutaneous transstenotic catheterization or guidewire-based
recannalization in occlusions, a balloon dilatation was performed and a stent was placed, when necessary, prior to catheter
placement. Technical success was 92%. Three patients had angioplasty alone and nine patients had angioplasty with stent placement.
Dialysis catheters were successfully inserted through all recannalized accesses. No immediate complication occurred, nor did
any patient develop superior vena cava syndrome after the procedure. The mean follow-up was 21.8 months (range, 8–48 months).
Three patients developed a catheter dysfunction with fibrin sheath formation (at 7, 11, and 12 months after catheter placement,
respectively). Two were successfully managed by percutaneous endovascular approach and one catheter was removed. In conclusion,
for patients with central venous stenosis or occlusion and those who need a hemodialysis catheter, catheter insertion can
be reliably achieved immediately after endovascular recannalization with acceptable technical and long-term success rates.
This technique should be considered as an alternative procedure for placing a new hemodialysis catheter through a patent vein. 相似文献
8.
Pietro Quaretti Franco Galli Lorenzo Paolo Moramarco Riccardo Corti Giovanni Leati Ilaria Fiorina Marcello Maestri 《Korean journal of radiology》2014,15(3):364-369
Central venous catheters are the most frequent causes of benign central vein stenosis. We report the case of a 79-year-old woman on hemodialysis through a twin catheter in the right internal jugular vein, presenting with superior vena cava (SVC) syndrome with patent SVC. The clinically driven endovascular therapy was conducted to treat the venous syndrome with a unilateral left brachiocephalic stent-graft without manipulation of the well-functioning catheter. The follow-up was uneventful until death 94 months later. 相似文献
9.
10.
Veroux P Veroux M Bonanno MG Tumminelli MG Baggio E Petrillo G 《European radiology》2002,12(Z3):S181-S184
The most likely etiology of benign obstruction of the superior vena cava (SVC) include fibrosing mediastinitis and iatrogenic etiologies such as sclerosis and obstruction caused by pacemakers and central venous catheter. Percutaneous stenting of SVC has been used with success both in malignant and benign superior vena cava syndrome; however, long-term follow-up of endovascular procedures is not well known. We present a case of a patient with complete occlusion of SVC of benign etiology, presenting dramatically with bilateral chylothorax and chylopericardium with cardiac tamponade, who underwent successful vena caval revascularization with thrombolytic therapy and placement of self-expanding metallic stent. The 42-month follow-up could encourage endovascular procedures even in SVC syndrome of benign etiology. 相似文献
11.
Primary misplaced or secondary flipped implanted catheters are located mostly in the right jugular vein. We demonstrate an
effective method to replace fix implanted catheters such as Ports, Grochomg or Hickman catheters. Using a femoral venous approach,
replacement into the superior vena cava can easily be done with a Sidewinder 1 catheter which is hooked over the misplaced
central venous approach. In all our patients the method was successful. The repositioning technique described is simple, fast
and has low costs. We can keep sterile conditions and do not need to solve the catheters' fixation.
Electronic Publication 相似文献
12.
Sauter A Triller J Schmidt F Kickuth R 《Cardiovascular and interventional radiology》2008,31(Z2):S144-S148
Thrombosis of the inferior vena cava is a life-threatening complication in cancer patients leading to pulmonary embolism. These patients can also be affected by superior vena cava syndrome causing dyspnea followed by trunk or extremity swelling. We report the case of a 61-year-old female suffering from an extended colorectal tumor who became affected by both of the mentioned complications. Due to thrombus formation within the right vena jugularis interna, thrombosis of the inferior vena cava, and superior vena cava syndrome, a combined interventional procedure via a left jugular access with stenting of the superior vena cava and filter placement into the inferior vena cava was performed As a consequence, relief of the patient's symptoms, prevention of pulmonary embolism, and paving of the way for further venous chemotherapy were achieved. 相似文献
13.
J Gagnon G Hudon M Boulanger 《Journal of the Canadian Association of Radiologists》1985,36(2):152-154
Acute onset of superior vena cava syndrome in critically ill patients, hours after cardiac surgery, needs angiographic documentation without delay in order to proceed with appropriate treatment. Bedside diagnostic venacavography was done for two patients in the surgical intensive care unit with a simple and safe method using a central venous catheter already in place. 相似文献
14.
Long-term central venous access with a peripherally placed subcutaneous infusion port: initial results 总被引:1,自引:0,他引:1
A new subcutaneous infusion port and catheter system for long-term central venous access, designed to be implanted in the interventional radiology suite, was evaluated. In 35 patients, a 5-F polyurethane catheter was placed in the superior vena cava via the axillary or brachial venous approach under fluoroscopic guidance. A 2.5 X 2.5-cm2 subcutaneous pocket was dissected for the port. The port was then connected to the catheter, and the incision was closed. Ports have been implanted for a total of 5,290 patient days (5-307 days for an individual patient). Blood transfusion, bolus drug administrations, and 5-day outpatient chemotherapy infusions were successful in all attempts. Blood sampling was successful in 98.9% of attempts. No infectious or thrombotic complications were encountered. Acceptance of this device by patients and nursing staff has been excellent. The initial results indicate that this peripherally placed port is a viable alternative for patients requiring long-term central venous access. 相似文献
15.
Digital subtraction venography of the upper extremity 总被引:1,自引:0,他引:1
Seventy four digital subtraction venograms of the upper extremity and mediastinum were performed in 69 patients. The indications included idiopathic arm and shoulder swelling, difficulties with a central venous catheter, chronic venous access device, or dialysis fistula, superior vena cava syndrome, or pre-operative anatomical mapping. Clinically useful information was obtained in all studies. The digital subtraction technique allows the simple and rapid performance of venography, especially in patients with limited venous access. 相似文献
16.
The Tempofilter II is a widely used temporary vena cava filter. Its unique design, which includes a long tethering catheter with a subcutaneous anchor, facilitates the deployment and retrieval of the device. Despite this, the Tempofilter II has been used only in the inferior vena cava of patients with lower extremity deep venous thrombosis. In this article, we present a case of superior vena cava filtering using the Tempofilter II in patients with upper extremity deep venous thrombosis. 相似文献
17.
Vena Cava 3D Contrast-Enhanced MR Venography: A Pictorial Review 总被引:2,自引:0,他引:2
Lin J Zhou KR Chen ZW Wang JH Yan ZP Wang YX 《Cardiovascular and interventional radiology》2005,28(6):795-805
Three-dimensional contrast-enhanced magnetic resonance venography (CE MRV) is a sensitive and accurate method for diagnosing
vena cava pathologies. The commonly used indirect approach involves a nondiluted gadolinium contrast agent injected into an
upper limb vein or, occasionally, a pedal vein for assessment of the superior or inferior vena cava. In our studies, a coronal
3D fast multi-planar spoiled gradient-echo acquisition was used. A pre-contrast scan was obtained to ensure correct coverage
of the region of interest. We initiated contrast-enhanced acquisition 15 sec after the start of contrast agent injection and
performed the procedure twice. The image sets were obtained during two 20–30-sec breath hold, with a breathing rest of 5–6
sec, to obtain the first-pass and delayed arteriovenous phases. For patients with Budd-Chiari syndrome, a third acquisition
coinciding with late venous phase was collected to visualize the hepatic veins, which was carried out by one additional acquisition
after a 5–6-sec breathing time. This review describes the clinical application of 3D CE MRV in vena cava congenital anomalies,
superior and inferior vena cava syndrome, Budd-Chiari syndrome, peripheral vein thrombosis extending to the vena cava, pre-operational
evaluation in portosystemic shunting and post-surgical follow-up, and road-mapping for the placement and evaluation of complications
of central venous devices. 相似文献
18.
J W Yedlicka J E Carlson D W Hunter W R Castaneda-Zuniga K Amplatz 《Journal of vascular and interventional radiology : JVIR》1991,2(3):343-347
The transluminal endarterectomy catheter (TEC) system was employed as a percutaneous rotational mechanical thrombectomy device in 1-week-old thrombi in five dogs (five thrombosed polytetrafluoroethylene grafts and four thrombosed native superficial femoral arteries). Luminal patency was restored in all vessels with no angiographic evidence of significant distal embolization. The TEC catheter was also successfully used for recanalization of the superior vena cava in a patient with superior vena cava syndrome. 相似文献
19.
Isotopic phlebography with Tc-99m-labeled microspheres was performed in 55 patients, 22 of whom presented with superior vena cava syndrome. The localization of the venous obstruction was visualized in each case, along with associated collateral views. Moreover, the transit times at different levels were markedly increased. In 11 patients, isotopic phlebography was repeated following treatment. Improvement, when it occurred, was largely due to diminished obstruction of the superior vena cava rather than to increased collateral supply. Therefore, isotopic phlebography of the upper extremities is a useful tool for the diagnosis of superior vena cava syndrome and for the evaluation of response to treatment. 相似文献
20.
Ilić R Trifunović Z Mandarić V Tisma S 《Vojnosanitetski pregled. Military-medical and pharmaceutical review》2005,62(5):409-412
AIM: A case is presented of the surgical treatment of epitheloid hemangioma as a rare cause of superior vena cava syndrome. CASE REPORT: A 53-year old woman was admitted to the clinic with the symptoms and signs of superior vena cava syndrome. After clinical evaluation and diagnostic tests, she was operated on through median stemotomy, and the desobliteration of the superior vena cava through longitudinal cavotomy was done. After the desobliteration b y the removal o f benign tumor from its cavity, vena cava was reconstructed with the continuous prolen suture. Pathohistologicaly, there was the evidence of epitheloid hemangioma that made the subtotal obliteration of the vena cava superior by its expansive growing at the entry in the right atrium. Postoperatively, there was a complete disappearance of the symptoms and signs of superior vena cava syndrome. After an uneventful recovery, the patient was discharged from the hospital. 相似文献