OBJECTIVE To determine whether novices can distinguish between properly and improperly placed guidewires in a vascular access model after only minimal training. METHODS This was a prospective study involving trainees with no previous training in sonographic guidewire visualization. A vascular access model was created with guidewires positioned inside or adjacent to simulated veins. Subjects w...

Since it was first described in 1990, subintimal angioplasty (SIA) has proven to be a valuable alternative for bypass surgery in patients with atheroocclusive disease of the superficial femoral artery (SFA).1 In this minimally invasive technique, a guidewire is intentionally placed between the intima and the media to create a new track along the vessel wall, bypassing the atherosclerotic occlus...

INTRODUCTION AND OBJECTIVES Occasionally, implanting a left ventricular pacing electrode for cardiac resynchronization therapy via the coronary sinus may be complicated by the presence of anatomical structures that obstruct the access to the target vein. Our objective was to report on experience using a double-wire technique for implanting left ventricular venous leads gained at the Dr Negrín H...

Dual injection is recommended for nearly all chronic total occlusion (CTO) percutaneous coronary intervention (PCI) to determine the optimal crossing strategy and guide wire advancement into the distal true lumen. Strategies that provide enhanced guide catheter support (such as long sheaths, large-bore guiding catheters, use of guide catheter extensions, and anchor techniques) are important for...

BACKGROUND AND PURPOSE Published reports of controlled experiments designed to evaluate the performance of over-the-wire microcatheter systems are rare and have often been based on subjective impressions from small clinical series. This investigation was designed to compare the load forces required to propel state-of-the-art, hydrophilically coated microcatheters from each of four manufacturers...

In this article, we present the work towards improving the overall workflow of the Percutaneous Coronary Interventions (PCI) procedures by capacitating the imaging instruments to precisely monitor the steps of the procedure. In the long term, such capabilities can be used to optimize the image acquisition to reduce the amount of dose or contrast media employed during the procedure. We present t...

Introduction: Conductive structures, such as guidewires and implanted device leads, present a safety hazard in MRI. The coupling between these structures and the RF transmit field can result in currents being induced, which can lead to dangerous heating [1, 2]. In previous work [3], it was shown that the magnitude and phase of current induced in a wire depends on the position of the RF coil wit...

INTRODUCTION AND OBJECTIVES In some patients, cardiac contractions cause the coronary artery segment adjacent to a stent to move in such a way that accurate stent positioning is difficult. A number of techniques have been described for immobilizing the stent at the target site by inducing periods of either asystole or tachycardia. This study shows how pulsatile motion can be controlled by means...

Cannulation is the passage of a guidewire, catheter, or other device through a duodenoscope into the bile duct or pancreatic duct at Endoscopic Retrograde Cholangiography and Pancreatography (ERCP). It is the initial step in all diagnostic and therapeutic ERCP and is a major hurdle for many individuals performing this procedure. Failed cannulation is also the most common cause for failure to ac...