Guide wire extension.
Any specialized guide wire can be converted to an exchange guide wire by the addition of an eyelet on its stiff end to which an extension guide wire may be hooked.
Biomedical subjects
Publications and source records attributed to C Cope.
Any specialized guide wire can be converted to an exchange guide wire by the addition of an eyelet on its stiff end to which an extension guide wire may be hooked.
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The incidence of postbiopsy vascular lesions of the transplanted kidney is unknown. The complications of these lesions should be promptly recognized and treatment initiated when indicated. We have found transplant angiography and selective arterial embolization to be a safe and effective modality.
Intraarterial tolazoline, injected before the contrast medium in peripheral and visceral arteriography, has been shown to enhance the diagnostic value of the examination by inducing vasodilation. The time of maximal dilatation after injection, however, has not been clearly established. Photophlethysmography (PPG) was used to measure blood flow changes in 20 consecutive patients with lower-extremity arterial disease at rest and during the first 10 min after intraarterial tolazoline injection. Neither time to maximal dilatation (mean, 5.9 +/- 2.1 min) or PPG amplitude increase (mean, 251 +/- 177.2%) was significantly affected by the level of disease, severity of disease, or number of vessels present at the ankle. To make optimal use of tolazoline's vasodilatory effect, a waiting period of 6 min is recommended between tolazoline administration and contrast-medium injection in peripheral arteriography.
We report and document angiographically a case of selective venous hypertension, masquerading as an infection, which involved the three middle digits of the right hand in a patient with an access arteriovenous (AV) fistula. This complication arose following hemodialysis and was resolved after resection of the right radial artery at the site of AV fistula and re-anastomosis.
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Tuberculous involvement of the jejunum with thickening and infiltration of the bowel wall and subsequent gastrointestinal hemorrhage from multiple bleeding points was encountered. Bleeding could not be controlled by intra-arterial vasopressin infusion. To our knowledge this is the first report of angiographically demonstrated and treated tuberculous gastrointestinal hemorrhage.
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Significant persistent or recurrent bleeding associated with renal arterial pseudoaneurysms was noted in three of 300 nephrostomy procedures. The angiographic diagnosis was made at 9, 6, and 21 days after nephrostomy. The lesions were successfully treated by embolization in two and by intimal dissection in one. The arterial tears were caused by a 16 gauge Teflon-sheathed needle inserted too deeply into the kidney. It is suggested that the lesions can be largely prevented by using only 22 gauge needles for renal puncture and dilating the skinny needle tract by a special guide wire exchanger. A renal angiogram should be obtained promptly if the urine continues to be grossly bloody 3-4 days after nephrostomy. Embolization of a bleeding segmental renal vessel is simple and safe, whereas a conservative approach may lead to severe complications.
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