Biomedical subjects
Publications and source records attributed to J O Roehm.
The Bird's Nest Filter femoral catheter set has proven to be too short in some patients to permit placement in close proximity to the renal veins via the left femoral vein approach. The use of the longer, but otherwise identical Bird's Nest Filter jugular catheter set via the left femoral vein eliminates this problem.
PURPOSE: To determine whether a twist technique can help reduce the occurrence of fine-wire prolapse proximal to the hooks of the Bird's Nest filter in the inferior vena cava. MATERIALS AND METHODS: Abdominal radiographs were retrospectively analyzed after placement of filters with no twist (n = 100), with two 360 degree twists (n = 55), or with three 360 degree twists (n = 61). RESULTS: Prolapse of 5 mm or more was encountered in 32% of cases (32 of 100 cases) in which no twists were imparted. The average length of prolapse was 2.8 cm (range, 0.5-5.1 cm). The average length of the filter nest was 9.4 cm (range 5.1-13.6 cm). Use of two 360 degree twists reduced the rate of prolapse to 9.1% (five of 55 cases) (P < .005 vs no twist); the average length of prolapse was 2.8 cm (range, 0.6-6.4 cm). The average filter-nest length was reduced 7.5 cm (range, 4.0-13.3 cm). With three 360 degree twists, prolapse occurred in 4.9% of cases (three of 61 cases) (P < .005 vs no twist). The average length of prolapse was 2.6 cm (range, 0.7-4.8 cm). The average filter-nest length was 7.8 cm (range, 3.5-12.8 cm). The difference in prolapse frequency when two twists were used as opposed to three is not statistically significant. CONCLUSION: Application of two or three 360 degree twists to the catheter-sheath unit during insertion of the Bird's Nest filter produces a statistically significant reduction in the occurrence of wire prolapse.
Iohexol is a new, nonionic water-soluble contrast agent undergoing early clinical trials in the United States. Using a double-blind, parallel format, iohexol was compared with meglumine iothalamate (60 patients) for selective cerebral angiography, and with sodium meglumine diatrizoate (40 patients) for arch aortography. Iohexol produced significantly less pain than meglumine iothalamate or sodium meglumine diatrizoate. There were no significant differences in terms of heart rate, blood pressure, or electrocardiogram (ECG) changes. Both produced a transient tachycardia and hypotension after arch aortography, but significantly less so with iohexol. No significant complications occurred. Film quality was comparable between contrast agents except for diminished motion artifacts with iohexol. Iohexol appears to be a superior neuroangiographic contrast agent to current ionic drugs.