Relevant bibliographies by topics / Catheter positioning

Academic literature on the topic 'Catheter positioning'

Author: Grafiati
Published: 10 December 2022
Last updated: 30 January 2023

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Journal articles on the topic "Catheter positioning"

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Kamenetsky, Eric, Rahul Reddy, Mark C. Kendall, Antoun Nader, and Jessica J. Weeks. "Effect of Arm Positioning on Entrapment of Infraclavicular Nerve Block Catheter." Case Reports in Anesthesiology 2017 (2017): 1–4. http://dx.doi.org/10.1155/2017/7196340.

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Continuous brachial plexus nerve block catheters are commonly inserted for postoperative analgesia after upper extremity surgery. Modifications of the insertion technique have been described to improve the safety of placing an infraclavicular brachial plexus catheter. Rarely, these catheters may become damaged or entrapped, complicating their removal. We describe a case of infraclavicular brachial plexus catheter entrapment related to differences in arm positioning during catheter placement and removal. Written authorization to obtain, use, and disclose information and images was obtained from the patient.
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Ramirez, Chuck, Shannon Miranda, and Erica Sager. "Hemodialysis Catheter Insertion Without Chest X-Ray: Review of a 24-Month Study." Journal of the Association for Vascular Access 23, no. 4 (December 1, 2018): 216–20. http://dx.doi.org/10.1016/j.java.2018.10.001.

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Abstract Acute care hemodialysis catheters have traditionally been validated for use through chest X-ray interpretation. This study was implemented to evaluate if hemodialysis catheters can be placed safely and accurately, utilizing an electrocardiogram plus doppler or dual vector positioning system to validate for use. Over a 24-month period hemodialysis catheters were inserted and validated by utilizing a dual vector positioning system instead of chest X-ray. During the study period, 260 hemodialysis catheters were inserted without chest X-ray and validated for use via the dual vector positioning system. An additional 74 inserted catheters required follow-up chest X-rays because of failure to obtain technological validation. During the study period, no patients had a pneumothorax or hemothorax complication subsequent to catheter placement. The use of a dual vector positioning system in this study demonstrated optimal hemodialysis catheter insertion can be done with no X-ray and no increase in mechanical complications.
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Sampson, John H., Gary Archer, Christoph Pedain, Eva Wembacher-Schröder, Manfred Westphal, Sandeep Kunwar, Michael A. Vogelbaum, et al. "Poor drug distribution as a possible explanation for the results of the PRECISE trial." Journal of Neurosurgery 113, no. 2 (August 2010): 301–9. http://dx.doi.org/10.3171/2009.11.jns091052.

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Object Convection-enhanced delivery (CED) is a novel intracerebral drug delivery technique with considerable promise for delivering therapeutic agents throughout the CNS. Despite this promise, Phase III clinical trials employing CED have failed to meet clinical end points. Although this may be due to inactive agents or a failure to rigorously validate drug targets, the authors have previously demonstrated that catheter positioning plays a major role in drug distribution using this technique. The purpose of the present work was to retrospectively analyze the expected drug distribution based on catheter positioning data available from the CED arm of the PRECISE trial. Methods Data on catheter positioning from all patients randomized to the CED arm of the PRECISE trial were available for analyses. BrainLAB iPlan Flow software was used to estimate the expected drug distribution. Results Only 49.8% of catheters met all positioning criteria. Still, catheter positioning score (hazard ratio 0.93, p = 0.043) and the number of optimally positioned catheters (hazard ratio 0.72, p = 0.038) had a significant effect on progression-free survival. Estimated coverage of relevant target volumes was low, however, with only 20.1% of the 2-cm penumbra surrounding the resection cavity covered on average. Although tumor location and resection cavity volume had no effect on coverage volume, estimations of drug delivery to relevant target volumes did correlate well with catheter score (p < 0.003), and optimally positioned catheters had larger coverage volumes (p < 0.002). Only overall survival (p = 0.006) was higher for investigators considered experienced after adjusting for patient age and Karnofsky Performance Scale score. Conclusions The potential efficacy of drugs delivered by CED may be severely constrained by ineffective delivery in many patients. Routine use of software algorithms and alternative catheter designs and infusion parameters may improve the efficacy of drugs delivered by CED.
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Theodosopoulos, Philip V., Aviva Abosch, and Michael W. McDermott. "Intraoperative Fiber-Optic Endoscopy for Ventricular Catheter Insertion." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 28, no. 1 (February 2001): 56–60. http://dx.doi.org/10.1017/s0317167100052562.

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ABSTRACT:Objective:Ventricular catheter placement is a common neurosurgical procedure often resulting in inaccurate intraventricular positioning. We conducted a comparison of the accuracy of endoscopic and conventional ventricular catheter placement in adults.Methods:A retrospective analysis of data was performed on 37 consecutive patients undergoing ventriculo-peritoneal shunt (VPS) insertion with endoscopy and 40 randomly selected, unmatched patients undergoing VPS insertion without endoscopy, for the treatment of hydrocephalus of varied etiology. A grading system for catheter tip position was developed consisting of five intraventricular zones, V1-V5, and three intraparenchymal zones, A, B, C. Zones V1 for the frontal approaches and V1 or V2 for the occipital approaches were the optimal catheter tip locations. Postoperative scans of each patient were used to grade the accuracy of ventricular catheter placement.Results:Seventy-six percent of all endoscopic ventricular catheters were in zone V1 and 100% were within zones V1-V3. No endoscopically inserted catheters were observed in zones V4, V5 or intraparenchymally. Thirty-eight percent of the conventionally placed catheters were in zone V1, 53% in zones V1-3 and 15% intraparenchymally. There was a statistically significant difference in the percentage of catheters in optimal location versus in any other location, favoring endoscopic guidance (p<0.001).Conclusion:We conclude that endoscopic ventricular catheter placement provides improved positioning accuracy than conventional techniques.
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Pettorini, Benedetta L., Gianpiero Tamburrini, Luca Massimi, Massimo Caldarelli, and Concezio Di Rocco. "Endoscopic transventricular positioning of intracystic catheter for treatment of craniopharyngioma." Journal of Neurosurgery: Pediatrics 4, no. 3 (September 2009): 245–48. http://dx.doi.org/10.3171/2009.4.peds0978.

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The intracystic injection of chemo- and radiotherapeutic agents was introduced for the treatment of craniopharyngioma to control tumor growth and to delay the potentially harmful effects of surgery or radiation therapy. The positioning of cyst catheters has been performed by means of direct vision, stereotactically guided insertion, and ultrasonographic and ventriculoscopic guidance. The insertion of a catheter into the cyst is not devoid of complications, with an incidence ranging up to 16%, independent of the surgical technique used. Eight patients (mean age 25.8 years) with symptomatic cystic craniopharyngioma were treated by means of an endoscopic transventricular approach for the insertion of an intracystic catheter for intratumoral therapy with interferon-α. A single right precoronal bur hole is made, and the frontal horn of the lateral ventricle is accessed under neuronavigation guidance. A ventricular catheter with an inserted stylet was advanced anterior to the endoscope sheath through the same cortical access as the endoscope and was guided under endoscopic view down to the cyst dome wall. The coagulated surface of the craniopharyngioma cyst was punctured and the tip of the ventricular catheter was advanced; the depth was established preoperatively on MR scans and confirmed by neuronavigation guidance. The proximal end of the cystic catheter was connected to an access chamber to be left in the subcutaneous space, and the endoscope was slowly retracted. The authors' experience favors the use of neuroendoscopic positioning of intracystic catheters as safer than open and stereotactic approaches.
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MARCELLI, E., S. PIRANI, I. CORAZZA, and L. CERCENELLI. "ELECTROLOC: A SIMPLE, FAST AND ACCURATE SYSTEM FOR LOCALIZATION OF ENDOCARDIAL CATHETERS." Journal of Mechanics in Medicine and Biology 15, no. 04 (August 2015): 1550062. http://dx.doi.org/10.1142/s0219519415500621.

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Accurate positioning of endocardial catheters inside cardiovascular structures is crucial in electrophysiology (EP) procedures. Improvements in cardiac mapping are required for a better understanding and treatment of arrhythmias. The proposed Electroloc system is a simple, fast and accurate method for endocardial catheters localization. The key features of Electroloc are the use of conventional EP catheters and the simple data processing for providing localization. Electroloc is able to locate any conventional EP mapping catheter with respect to a noncontact EP catheter used as reference, by sequentially passing a sub-threshold current between the mapping electrode (ME) of the mapping catheter and each electrode of the reference catheter. This creates different potential gradients across the reference catheter used to compute two spatial coordinates (horizontal and vertical coordinates) intended for positioning the ME in the cardiac chamber. In vitro experiments demonstrated that Electroloc is a reliable and sensitive system for localizing the ME with a spatial resolution of 2 mm in the vertical localization and of 5 mm in the horizontal localization. Further studies will be required to improve Electroloc accuracy and to extend its sensitivity range.
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Bloemen, Arthur, Anne M. Daniels, Martine G. Samyn, Roel JL Janssen, and Jan-Willem Elshof. "Electrocardiographic-guided tip positioning technique for peripherally inserted central catheters in a Dutch teaching hospital: Feasibility and cost-effectiveness analysis in a prospective cohort study." Journal of Vascular Access 19, no. 6 (March 21, 2018): 578–84. http://dx.doi.org/10.1177/1129729818764051.

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Introduction: Peripherally inserted central catheters are venous devices intended for short to medium periods of intravenous treatment. Positioning of the catheter tip at the cavoatrial junction is necessary for optimum performance of a peripherally inserted central catheter. In this study, safety, effectiveness and cost-effectiveness of electrocardiographic-guided peripherally inserted central catheter positioning in a Dutch teaching hospital were evaluated. Methods: All patients who received a peripherally inserted central catheter in 2016 using electrocardiographic guidance were compared to those where fluoroscopy guidance was used in a prospective non-randomized cohort study. Relevant data were extracted from electronic health records. Cost-effectiveness analysis was performed. Results: A total of 162 patients received a peripherally inserted central catheter using fluoroscopy guidance and 103 patients using electrocardiographic guidance in 2016. No significant difference was found in malposition, infection or other complications between these groups. Due to personnel reduction and omission of fluoroscopy costs, cost reduction for each catheter insertion was €120 in the first year and, as a result of discounted acquisition costs, €190 in subsequent years. Discussion: The positioning results and complication rate are comparable to the previously reported literature. The cost reduction may vary in different hospitals. Other benefits of the electrocardiographic-guided technique are omission of X-ray exposure and improved patient service. Conclusion: Implementation of electrocardiographic-guided tip positioning for peripherally inserted central catheter was safe and effective in this study and led to an improved high value and cost-conscious care.
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Hugenholtz, Herman, Robert F. Nelson, and Eric Dehoux. "Intrathecal Baclofen – The Importance of Catheter Position." Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques 20, no. 2 (May 1993): 165–67. http://dx.doi.org/10.1017/s0317167100047776.

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ABSTRACT:In a patient receiving intrathecal baclofen injections for intractable trunk and leg spasms, positioning the subarachnoid catheter tip just caudal to the spinal segments innervating the spastic muscles enhanced the spasmolytic effect of bolus injections of intrathecal baclofen on the affected muscles. Such selective positioning of subarachnoid catheters may facilitate segmental spasmolysis with lower intrathecal doses of baclofen and provide an important alternative to relying only on ascending CSF concentration gradients of baclofen from chronic lumbar intrathecal infusion.
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Yıldızeli, Bedrettin, Tunç Laçin, Feyyaz Baltacıoğlu, Hasan F. Batırel, and Mustafa Yüksel. "Approach to Fragmented Central Venous Catheters." Vascular 13, no. 2 (March 1, 2005): 120–23. http://dx.doi.org/10.1258/rsmvasc.13.2.120.

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Prolonged venous access devices are needed in cancer patients for central venous access. Catheter fragmentation leading to catheter malfunction represents a rare problem. Herein we present our experience in the management of fragmented catheters. Between 2001 and 2003, 183 catheters were placed via the subclavian vein, and five cases of fragmented catheters were observed. Fragments were removed by an Amplatz gooseneck snare (Microvena, St. Paul, MN) with angiographic intervention. The diagnosis of the breakage was made by chest radiography. The incidence of catheter rupture was 2.7%. All fragments were removed by the snare, without any complications. Catheter narrowing and breakage owing to its medial positioning in the subclavian vein were the main causes of catheter malfunction. In any case of catheter malfunction, radiologic evaluation of the catheter must be done to rule out its rupture. Removal of the fragments using the Amplatz snare is a safe and easily applied procedure.
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Yazbek, Guilherme, Antonio Eduardo Zerati, Luiz Caetano Malavolta, Kenji Nishinari, and Nelson Wolosker. "Endovascular techniques for placement of long-term chemotherapy catheters." Revista do Hospital das Clínicas 58, no. 4 (2003): 215–18. http://dx.doi.org/10.1590/s0041-87812003000400005.

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PURPOSE: To analyze the results from using endovascular techniques to place long-term chemotherapy catheters when advancing the catheter using the external jugular vein is difficult due to obstructions or kinking. METHODS: Between July 1997 and August 2000, 320 long-term chemotherapy catheters were placed, and in 220 cases the external jugular vein was used as the primary venous approach. In 18 of these patients, correct positioning was not achieved and several endovascular techniques were then utilized to overcome these obstacles, including manipulation of a J-wire with a moveable core, venography, and the exchange wire technique. RESULTS: In 94.5% of the patients with difficulties in obtaining the correct positioning, we were able to advance the long-term catheter to the desired position with the assistance of endovascular techniques. CONCLUSIONS: Venography and endovascular guidance techniques are useful for the placement of long-term catheters in the external jugular vein.
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Dissertations / Theses on the topic "Catheter positioning"

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Le, Vi T. H. "Accurate modelling and positioning of a magnetically-controlled catheter tip." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2015. https://ro.ecu.edu.au/theses/1711.

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This thesis represents the initial phase of a proposed operator and patient friendly method designed to semi-automate the positioning and directing of an intravascular catheter in the human heart using a variable electromagnetically induced field to control a catheter tip equipped with three tiny fixed magnets oriented in XYZ planes. Here we demonstrate a comprehensive mathematical model which accurately calculates the magnetic field generated by the electromagnet system, and the magnetic torques and forces exerted on a three-magnet tip catheter. From this we have developed an iterative predictive computer algorithm to show the displacement and deflection of the catheter tip. Using an eight variable power electromagnet system around a 250mm sphere of air we have proven the ability of this to accurately move the catheter tip from an initial position to a designated position within the field.
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Books on the topic "Catheter positioning"

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Patel, Mikin V., and Steven Zangan. Minimally Invasive Repair of Azygos Catheter Migration. Edited by S. Lowell Kahn, Bulent Arslan, and Abdulrahman Masrani. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199986071.003.0041.

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Central venous catheters are frequently placed to facilitate the care of patients with multiple conditions, often via jugular approach. Occasionally, the catheter tip can migrate after placement and become positioned within the azygos arch. This abnormal catheter positioning can lead to an increased number of complications, including catheter malfunction, thrombosis, or even rupture of the azygos vein requiring surgical intervention. Although invasive repositioning of the catheter is always an option, minimally invasive options can be attempted to repair azygos catheter malposition. Fortunately, noninvasive maneuvers, including manipulation of the port on the skin and patient breathing instructions, can sometimes repair the malpositioned catheter.
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Patel, Mikin V., and Steven Zangan. Drainage of the Multiloculated Collection. Edited by S. Lowell Kahn, Bulent Arslan, and Abdulrahman Masrani. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199986071.003.0099.

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Percutaneous drainage of an abscess is the standard of care and significantly improves patient outcomes. Typically, either trocar or Seldinger technique is used to access the abscess under ultrasound or computed tomography guidance. Pre-procedural planning is the most important step of the procedure, with the goal of using a safe, direct, short route to the collection. Vital anatomic structures such as sizeable arteries, solid organs (with a few exceptions), or a hollow viscus such as the stomach or colon should be avoided. Placement of a drain must balance effective positioning with a safe anatomic window for access. A multiloculated collection presents a special challenge because only one safe catheter approach may be available. In these cases, catheters with multiple side holes or multiple loops can be used to access the separate isolated components. Tissue plasminogen can also be utilized to break down the loculations and improve drainage.
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Carberry, George, and Orhan Ozkan. Transurethral Retrograde Approach to Pelvic Abscess Drainage in Post-cystectomy Patients. Edited by S. Lowell Kahn, Bulent Arslan, and Abdulrahman Masrani. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780199986071.003.0100.

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One potential complication of radical cystectomy is the development of a pelvic abscess requiring drainage. Transurethral drainage has been described for the treatment of prostatic abscesses but is particularly well tolerated in patients for whom pelvic fluid drainage is needed following radical cystectomy. Although percutaneous, transrectal, or transvaginal approaches to pelvic drain placement are possible, the transurethral route provides a fully epithelialized tract through which the drainage catheter can traverse and which does not require unnecessary tissue puncture. Although blind Foley catheter placement could potentially be used for transurethral drainage in these patients, urologic surgeons have preferred fluoroscopically guided drain placement to ensure atraumatic placement and optimal drain positioning. In a stepwise fashion, this chapter describes how to perform fluoroscopy-guided transurethral abscess drainage in patients following cystectomy.
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Book chapters on the topic "Catheter positioning"

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Clementi, Anna, Pasquale Zamboli, Viviana Rosalia Scarfia, Fulvio Fiorini, and Antonio Granata. "US-Assisted Positioning of Central Venous Catheter." In Atlas of Ultrasonography in Urology, Andrology, and Nephrology, 673–81. Cham: Springer International Publishing, 2017. http://dx.doi.org/10.1007/978-3-319-40782-1_57.

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Vandini, Alessandro, Stamatia Giannarou, Su-Lin Lee, and Guang-Zhong Yang. "3D Robotic Catheter Shape Reconstruction and Localisation Using Appearance Priors and Adaptive C-Arm Positioning." In Augmented Reality Environments for Medical Imaging and Computer-Assisted Interventions, 172–81. Berlin, Heidelberg: Springer Berlin Heidelberg, 2013. http://dx.doi.org/10.1007/978-3-642-40843-4_19.

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van Boxtel, Antonius J. H. "Maneuvers, Precautions, and Tricks for PICC Positioning Procedure." In Peripherally Inserted Central Venous Catheters, 121–26. Milano: Springer Milan, 2014. http://dx.doi.org/10.1007/978-88-470-5665-7_11.

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Christopher, Nim. "General Urological and Endourological Considerations in the Care for Transgender Patients: Catheters, Scopes and Haematuria, UTI, Stones and Surgical Positioning." In Urological Care for the Transgender Patient, 185–92. Cham: Springer International Publishing, 2021. http://dx.doi.org/10.1007/978-3-030-18533-6_13.

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Lalwani, Kirk, and Philip W. Yun. "Central Venous Catheter Placement Using the Seldinger Technique." In Ultrasound Guided Procedures and Radiologic Imaging for Pediatric Anesthesiologists, edited by Anna Clebone, Joshua H. Finkle, and Barbara K. Burian, 55–64. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780190081416.003.0006.

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Chapter 6 covers central venous catheter placement, which is often performed for major procedures or in critical pediatric patients. Indications include hemodynamic monitoring, administration of hyperosmolar medications, hemodialysis, and rapid infusion of fluids. Internal jugular, subclavian, and femoral veins are commonly used for central venous access. In the pediatric patient, factors that influence the site of placement include age, likely duration of use, operator expertise, and the need for sedation. After the site of placement is determined, optimal positioning of the patient and meticulous technique are paramount to increase the chance for success. The Seldinger technique is the preferred method for catheterizing the vein following needle venipuncture and is outlined step-by-step in this chapter.
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Sheerer, Christopher, and Kurt Ruetzler. "Atrial Fibrillation." In Anesthesiology: A Problem-Based Learning Approach, edited by Tracey Straker and Shobana Rajan, 21–28. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190850692.003.0003.

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Atrial fibrillation is the most common arrhythmia worldwide and carries a high rate of mortality if not properly treated. Numerous theories exist in terms of its pathophysiology, with the leading theory demonstrating abnormalities in ectopic electrical pathways originating from the pulmonary veins leading into the atria. The anesthesiologist must be familiar with this arrhythmia as it commonly presents in the perioperative period. Atrial fibrillation arising during surgery requires prompt attention and treatment, and the anesthesiologist should know how to respond accordingly. Catheter ablation is a common non-operating room procedure that requires the anesthesiologist’s knowledge and attention about the procedure, patient positioning, intraoperative monitoring, and complications that may arise from the procedure. Furthermore, an anesthesiologist should be adept to caring for patients in the postoperative period who develop atrial fibrillation and understand the various treatment options.
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Keong, Ching Chi, J. David Burkhardt, Thomas Dresing, and Andrea Natale. "Venous and Arterial Access, EP Catheters, Positioning of Catheters." In Handbook of Cardiac Electrophysiology, 190–97. CRC Press, 2020. http://dx.doi.org/10.1201/9781315118086-23.

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Mattei, Eugenio, Giovanni Calcagnini, Michele Triventi, Federica Censi, Pietro Bartolini, Wolfgang Kainz, and Howard Bassen. "MRI Induced Heating on Pacemaker Leads." In Encyclopedia of Healthcare Information Systems, 950–57. IGI Global, 2008. http://dx.doi.org/10.4018/978-1-59904-889-5.ch117.

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Magnetic resonance imaging (MRI) is a widely accepted tool for the diagnosis of a variety of disease states. The presence of a metallic implant, such as a cardiac pacemaker (PM), or the use of conductive structures in interventional therapy, such as guide wires or catheters, are currently considered a strong contraindication to MRI (Kanal, Borgstede, Barkovich, Bell, Bradley, Etheridge, Felmlee, Froelich, Hayden, Kaminski, Lester, Scoumis, Zaremba, & Zinninger, 2002; Niehaus & Tebbenjohanns, 2001; Shellock & Crues, 2002). Potential effects of MRI on PMs’ implantable cardioverter defibrillator (ICDs) include: force and torque effects on the PM (Luechinger, Duru, Scheidegger, Boesiger, & Candinas, 2001; Shellock, Tkach, Ruggieri, & Masaryk, 2003); undefined reed-switch state within the static magnetic field (Luechinger, Duru, Zeijlemaker, Scheidegger, Boesiger, & Candinas, 2002); potential risk of heart stimulation and inappropriate pacing (Erlebacher, Cahill, Pannizzo, & Knowles, 1986; Hayes, Holmes, & Gray, 1987); and heating effects at the lead tip (Achenbach, Moshage, Diem, Bieberle, Schibgilla, & Bachmann, 1997; Luechinger, Zeijlemaker, Pedersen, Mortensen, Falk, Duru, Candinas, & Boesiger, 2005; Sommer, Vahlhaus, Lauck, von Smekal, Reinke, Hofer, Block, Traber, Schneider, Gieseke, Jung, & Schild, 2000). In particular, most of the publications dealing with novel MRI techniques on patients with implanted linear conductive structures (Atalar, Kraitchman, Carkhuff, Lesho, Ocali, Solaiyappan, Guttman, & Charles, 1998; Baker, Tkach, Nyenhuis, Phillips, Shellock, Gonzalez-Martinez, & Rezai, 2004; Nitz, Oppelt, Renz, Manke, Lenhart, & Link, 2001) point out that the presence of these structures may produce an increase in power deposition around the wire or the catheter. Unfortunately, this increased local specific absorption rate (SAR) is potentially harmful to the patient, due to an excessive temperature increase which can bring living tissues to necrosis. The most direct way to get a measure of the SAR deposition along the wire is by using a temperature probe: the use of fluoroptic® thermometry to measure temperature has become “state-of-the-art,” and is the industry standard in this field (Shellock, 1992; Wickersheim et al., 1987). When the investigation involves small objects and large spatial temperature gradients, the measurement of the temperature increase and of the local SAR may become inaccurate, unless several precautions are taken. It seems obvious to: (1) evaluate the error associated with temperature increase and SAR measurements; (2) define a standard protocol for probe positioning, which minimizes the error associated with temperature measurement.
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"Venous and arterial access, EP catheters, positioning of catheters Andrea Natale." In Handbook of Cardiac Electrophysiology, 233–40. CRC Press, 2007. http://dx.doi.org/10.3109/9780203089866-29.

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Luther, Evan, Stephanie H. Chen, Pascal M. Jabbour, and Eric C. Peterson. "Transradial Access Techniques." In Radial Access for Neurointervention, 9–22. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780197524176.003.0002.

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The room set-up and patient positioning of the transradial approach (TRA) are different from that of the transfemoral approach (TFA). This is critical to the success of transitioning a medical practice. The most important areas are keeping the hand tight on the patient’s hip, minimal hand supination, and building up the space next to the knee to provide a platform for the catheters to lie during a transradial procedure. The initial patient positioning, room set-up, access techniques, and medications are reviewed, including cocktail, puncture techniques and sheath placement, as well as setup and hand positioning for left radial access procedures.
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Conference papers on the topic "Catheter positioning"

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Zaffora, Adriano, Paola Bagnoli, Roberto Fumero, and Maria Laura Costantino. "Computational Fluid Dynamic Analysis of an Instrumented Endotracheal Tube for Total Liquid Ventilation to Optimize Pressure Transducer Positioning." In ASME 2009 Summer Bioengineering Conference. American Society of Mechanical Engineers, 2009. http://dx.doi.org/10.1115/sbc2009-206457.

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Despite advances in respiratory care, the treatment of critical neonatal patients with conventional mechanical ventilation (CMV) techniques has still many drawbacks. To address this issue, Total Liquid Ventilation (TLV) with liquid perfluorocarbons (PFC) has been investigated as an alternative respiratory modality [1,2]. A dedicated TLV ventilator supplies PFC tidal volumes (TV) through an endotracheal tube (ETT) inserted into the trachea. In experimental studies, TLV proved to be able to support pulmonary gas exchange while preserving lung structure and function. Moreover, PFC properties make these liquids an optimal medium to treat neonatal respiratory failure [1–3]. However, different aspects of TLV have to be further investigated for a safe transition from the laboratory experience to the clinical application. One of these aspects is the possible airway and lung injury that may be caused by the peculiar fluid dynamics developed when using an incompressible and viscous liquid instead of air as a respiratory medium. To overcome this issue, continuous reliable real-time monitoring of airway pressure during TLV is crucial. Thus, the instrumentation of the ETT with a pressure transducer (PT) is mandatory to perform a safe TLV treatment [4–6]. At present, no commercial instrumented ETTs designed for TLV are available; thus during TLV experimental animal trials [4–6] ETT prototypes instrumented with homemade PT-equipped catheters are currently used. However, the positioning of this catheter has to be optimized in order to reduce fluid dynamic disturbances that can alter pressure measurements. Aim of this study is to investigate on the PFC fluid-dynamic patterns in the presence of the catheter by computational fluid dynamic (CFD) analysis, in the view of the development of a TLV dedicated instrumented ETT. In particular, the effect of two different positioning of the PT catheter on the PFC fluid dynamics and airway pressure measurement was evaluated for a neonatal ETT.
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Liu, Enkang, Yixin Ma, Mingzhu Zhang, and Hao Ge. "The possibility to have 1 mm positioning accuracy of intracardiac catheter via electrical measurement." In 2020 IEEE International Instrumentation and Measurement Technology Conference (I2MTC). IEEE, 2020. http://dx.doi.org/10.1109/i2mtc43012.2020.9129035.

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Chang, Carl W., Paul Lum, and Richard S. Muller. "Magnetically Actuated Microplatform Scanners for Intravascular Ultrasound Imaging." In ASME 2000 International Mechanical Engineering Congress and Exposition. American Society of Mechanical Engineers, 2000. http://dx.doi.org/10.1115/imece2000-1162.

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Abstract We have fabricated a magnetically actuated microplatform scanner for use in a catheter-based intravascular ultrasound imaging (IVU) system. The torsional microplatform is fabricated from low stress silicon nitride with electroplated-Ni stripes for the magnetic material. Experiments with the microplatform have shown it capable of positioning an attached ultrasonic source (350 by 350 by 400 μm3 with a mass of 150 μg) through a total scan angle of 90°. The devices were evaluated in both air and immersed in deionized water. An IVU system based on this microplatform promises lower cost and greater flexibility than are provided by present state-of-the-art mechanically driven IVU systems.
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Chitalia, Yash, Abdulhamit Donder, and Pierre E. Dupont. "Modeling Telescoping Tendon-actuated Continuum Robots." In The Hamlyn Symposium on Medical Robotics: "MedTech Reimagined". The Hamlyn Centre, Imperial College London London, UK, 2022. http://dx.doi.org/10.31256/hsmr2022.65.

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Tendon actuation is the most common method for producing flexure in continuum medical devices. Examples include catheters, ureteroscopes, bronchoscopes and colonoscopes. These devices are comprised of an elongated tube with a short steerable tip portion and a long passively flexible proximal portion. The shape of the proximal portion conforms to the shape of the body lumen as it is advanced into the body while the tendon-actuated tip portion provides for tip positioning and steering. While many of these devices are comprised of a single elongated tube, there are important clinical examples for which a single steerable tip section is insufficient and the increased steerability provided by additional telescoping steerable sections is needed (Fig. 1). For example, the delivery systems used for heart valve repair and replacement employ 2-3 tendon-actuated telescoping sections [1]. Additional examples include Hansen Medical’s robotic electrophysiology catheter [2] and Auris Health’s robotic endoscope for peripheral lung biopsies [3] each of which possess two telescoping steerable sections. While a variety of models mapping tendon actuation to robot shape have been developed, they are all limited to consideration of a single tube [4-6]. They cannot accurately predict the shape of multi-tube robots because they do not model the twisting that occurs between the tubes. The contribution of this paper is to produce a model that includes tube twisting and to illustrate it experimentally using the system of Fig. 1.
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Loschak, Paul M., Yaroslav Tenzer, Alperen Degirmenci, and Robert D. Howe. "A 4-DOF Robot for Positioning Ultrasound Imaging Catheters." In ASME 2015 International Design Engineering Technical Conferences and Computers and Information in Engineering Conference. American Society of Mechanical Engineers, 2015. http://dx.doi.org/10.1115/detc2015-47693.

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In this paper we present the design, fabrication, and testing of a robot for automatically positioning ultrasound imaging catheters. Our system will point ultrasound (US) catheters to provide real-time imaging of anatomical structures and working instruments during minimally invasive surgeries. Manually navigating US catheters is difficult and requires extensive training in order to aim the US imager at desired targets. Therefore, a four DOF robotic system was developed to automatically navigate US imaging catheters for enhanced imaging. A rotational transmission enables three DOF for pitch, yaw, and roll of the imager. This transmission is translated by the fourth DOF. An accuracy analysis was conducted to calculate the maximum allowable joint motion error. Rotational joints must be accurate to within 1.5° and the translational joint must be accurate within 1.4 mm. Motion tests were then conducted to validate the accuracy of the robot. The average resulting errors in positioning of the rotational joints were measured to be 0.28°–0.38° with average measured backlash error 0.44°. Average translational positioning and backlash errors were measured to be significantly lower than the reported accuracy of the position sensor. The resulting joint motion errors were well within the required specifications for accurate robot motion. Such effective navigation of US imaging catheters will enable better visualization in various procedures ranging from cardiac arrhythmia treatment to tumor removal in urological cases.
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Konh, Bardia, Russell K. Woo, and Scott Miller. "Design and Fabrication of a MirtaClip Locator Prototype for Percutaneous Transcatheter Mitral Valve Repair System." In 2017 Design of Medical Devices Conference. American Society of Mechanical Engineers, 2017. http://dx.doi.org/10.1115/dmd2017-3468.

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Mitral Regurgitation (MR) is a malfunction of the mitral valve where the blood flows backward because of improper closure of the valve. The blood flows back through the mitral valve to the left atrium during the contraction of the left ventricle. This condition usually causes shortness of breath, fatigue, lightheadedness, and a rapid heartbeat. It is estimated that 2% of the global population have significant mitral valve disease. In US, more than 200,000 patients are diagnosed with this condition each year [1]. Current treatments include anticoagulation medication, and surgeries to replace or repair the dysfunctional mitral valve. Open heart surgery has been the conventional approach to repair or replace the mitral valve. However, for a large percentage of patients (almost 30%), open heart surgery carries increased risk of mortality and morbidity due to their advanced age and dysfunction of the left ventricle [2]. Recently, less invasive, transcatheter approaches to mitral valve disease have been developed to decrease the surgical risk for these patients. [3]. One of the approaches that has recently shown promising outcomes is the placement of a MitraClip system (Abbott Vascular, Inc., Santa Clara, California) to stop or decrease the undesired leakage. MitraClip is a metal clip coated with fabric that is implanted on the mitral valve leaflets to allow the valve to close more completely. After clip placement, blood flows in an assisted fashion as the mitral valve opens and closes on the either sides of the clip. The whole procedure for placement of the MitraClip in Transcatheter Mitral Valve Repair (TMVR) takes 2 to 3 hours under general anesthesia. A transesophageal echocardiogram is used to observe the blood flow and to trace the placement of the clip. A catheter is guided inside the femoral artery after percutaneous access is established. Then a guide wire is inserted to reach the mitral valve. At this time the MitraClip is threaded into the target position between the leaflets, and then, the guide is removed. Precise placement and orientation must be achieved at this point to best secure the clip with the minimum leakage possible. Since the implantation is being done inside a beating heart, this precise placement is the most challenging part of the surgery. Currently trial and error along with precise measurements are being utilized to find the best position. This work introduces an innovative MitraClip locator device based on the most advanced materials and actuators to assist in the positioning of the MitraClip during implantation; this would potentially facilitate the most challenging and improtant step of the procedure. Currently, doctors are spending most of their surgical time (roughly 90 min) finding the correct orientation for the clip. The proposed self-actuated MitraClip locator device uses active Shape Memory Alloys (SMAs), Nitinol wires, in order to expedite surgical procedures with a higher precision. SMA wires have been used in medical devices safely and effectively [4,5]. Fig. 1 shows the schematic picture of our novel design that includes evenly distributed SMA wires inside a shaft to enable orientations in multiple directions. This design is proposed as a scaled model for preliminary testing. After thorough testing and evaluation on this model a real size prototype will be made for the real application. This work presents a detailed design of our innovative device. This device has been fabricated and tested to show the proof of concept. The main purpose of this work is to show the feasibility of achieving movements in multiple directions using three shape memory alloy wires. As a long term plan, the authors aim to have this mechanism (while its accuracy and safety is assured) attached behind the MitraClip to facilitate controlled, accurate positioning.
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Elaanba, Abdelfettah, Mohammed Ridouani, and Larbi Hassouni. "Automatic detection Using Deep Convolutional Neural Networks for 11 Abnormal Positioning of Tubes and Catheters in Chest X-ray Images." In 2021 IEEE World AI IoT Congress (AIIoT). IEEE, 2021. http://dx.doi.org/10.1109/aiiot52608.2021.9454205.

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Haigh, Casey D., John H. Crews, Shiquan Wang, and Gregory D. Buckner. "Modeling and Experimental Validation of Shape Memory Alloy Bending Actuators." In ASME 2012 Conference on Smart Materials, Adaptive Structures and Intelligent Systems. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/smasis2012-7974.

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In this paper, we develop a computational model that can be used to investigate and optimize the performance of shape memory alloy (SMA) bending actuators. These actuators (approximately 7–21 mm in length) consist of curved SMA wires embedded within elastic sleeves and are intended for positioning and anchoring robotic catheters inside blood vessels during clinical treatments. Each SMA wire is shape-set to an initial curvature and inserted along the neutral axis of a straight elastic member (cast heat-resistant silicone with varying section modulus). The elastic member preloads the SMA (or produces a stress-induced phase transformation), reducing the equilibrium curvature of the composite actuator. Temperature-induced phase transformations in the SMA (via Joule heating) enable strain recovery and increased bending (increased curvature) in the composite actuator. The homogenized energy framework is utilized to model the behavior of this composite actuator, and the effects of several critical design parameters (initial SMA curvature and section modulus of the elastic member) on the deactivated and activated curvatures are investigated. Experimental results validate the model, enabling its use as a design tool for bending performance optimization.
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