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At least 973 records · Page 54Linked to original sources
PubMed2003

[Temporary emergency cardiac pacing under continuous echocardiographic control. Feasibility and safety of the procedure without using fluoroscopy].

BACKGROUND: Cardiac pacing often turns out to be the only effective treatment of severe brady-arrhythmias. Several invasive and noninvasive temporary pacing procedures are known, whose application is sometimes difficult or time-consuming. An alternative temporary cardiac pacing procedure is described in this article, which is based on echocardiographic control. METHODS: Fifty-four nonconsecutive patients were studied; they all were needing urgent cardiac pacing. A first choice attempt to perform an ultrasound-guided temporary cardiac pacing, by using a right jugular venous approach, was done. The catheter pathway was monitored by means of echocardiography performed by another operator. All data concerning time of execution, pacing parameters, acute or chronic complications and the in situ time duration of the catheter without needing to be repositioned were obtained. RESULTS: Ultrasound-guided cardiac pacing was not feasible in 3 patients (6%), because of a high thoracic acoustic impedance or failing to perform right jugular venous catheterization. Mean execution time was 680 +/- 179 s. Echocardiographic monitoring was performed in 50 patients by a cardiologist, in 1 patient by a non-cardiologist physician, and in 3 patients by a nurse, who had been previously trained to keep the transducer in the right position. No serious complications occurred. On 4 occasions (8%) the catheter had to be repositioned during the following hours. On 25 occasions (46%) permanent cardiac pacing was finally performed. CONCLUSIONS: Temporary ultrasound-guided cardiac pacing seems to be a safe and easy procedure; it can be performed in a broad range of clinical and logistic scenarios and does not require fluoroscopic monitoring. A limited number of human resources is needed, but technical skills in central venous catheterization are required. Further studies are needed to validate this procedure; however it shows several potential benefits as compared to the other temporary cardiac pacing techniques.

Adult↗
PubMed1979

[Targeted heart fluoroscopy in radiologic and internistic practice].

Fluoroscopic examination of the heart requires a special technique if it is to provide useful diagnostic information. Information can be obtained regarding coronary calcifications, slight enlargement of a heart chamber or great vessel, localization and extension of abnormal contours within the heart shadow, pulsatory phenomena at the heart border or the great vessels, and functional changes of lung structures during respiration. This information may be decisive for the further evaluation or treatment of the patient.

Cardiomegaly↗
PubMed2005

Incorrect needle position during lumbar epidural steroid administration: inaccuracy of loss of air pressure resistance and requirement of fluoroscopy and epidurography during needle insertion.

Loss of air pressure resistance leads to a high rate (25.7%) of inaccurate needle-tip placement in the posterior soft tissues of the back during lumbar epidural steroid administration employing a 20-gauge Tuohy needle. Imaging and epidurogram are essential for confident identification of the lumbar epidural space to enable accurate location of steroid administration. Studies assessing efficacy of lumbar epidural steroid injection and individual patient treatments should ensure location of administration with epidurogram to enhance the validity of results.

Adult↗
PubMed2005

Coronary angiography with flat panel digital detectors significantly increases the sensitivity for calcium detection in relation to conventional fluoroscopy: comparison of both systems with intravascular ultrasound.

OBJECTIVE: To compare the sensitivity and specificity for coronary calcium detection of two fluoroscopic systems: 1) conventional system based on image intensifier chains (CONV); and 2) flat panel digital detector (FPDD) system, using intravascular ultrasound (IVUS) as the gold standard. BACKGROUND: Coronary calcification represents advanced atherosclerotic disease and has implications during coronary interventions. Angiography has been reported to have low sensitivity for calcium detection compared with IVUS. METHODS: Lesion calcification was assessed by two different fluoroscopic systems (FPDD and CONV), and by IVUS. RESULTS: In two consecutive periods, a total of 200 consecutive patients were included, 100 in each group. Clinical characteristics were similar, without significant differences between groups. In the CONV group, IVUS detected calcium in 77% of cases, and angiography in 32%. Sensitivity was 41.6% and specificity 91.3%. In the FPDD group, IVUS reported calcification in 79% of patients, and angiography in 57%. Sensitivity was 72% (p < 0.0001 for comparison with CONV) and specificity was 90.4%. CONCLUSION: The new fluoroscopic systems, based on FPDD, considerably increase the sensitivity for calcium detection without detrimental effect on specificity.

Calcinosis↗
PubMed2005

A fluoroscopy-based surgical navigation system for high tibial osteotomy.

High tibial osteotomy is a widely accepted treatment for unicompartmental osteoarthritis of the knee and other lower extremity deformities, particularly in young and active patients. However, it is generally recognized as a technically demanding procedure. The lack of intraoperative control of the mechanical axis of the affected limb often results in postoperative malalignments, which is one of the main reasons for poor long-term results. Moreover, inaccurate osteotomies, such as insufficient or excessive bone cut, or incorrect orientation of the chisel or saw blade, have been observed. A computer assisted intraoperative planning and navigation system is therefore proposed in order to address these technical problems. During operation, fluoroscopic images are acquired and anatomical landmarks are digitized; a patient-specific coordinate system is established accordingly. After the three-dimensional measurement of the deformity and interactive planning of the osteotomy plane, the deformity is corrected under navigational guidance. The proposed system has been successfully introduced into the clinical practice of surgery after encouraging laboratory evaluations, with results affirming that it is safe and accurate.

Fluoroscopy↗
PubMed2006

TRUS-fluoroscopy fusion for intraoperative prostate brachytherapy dosimetry.

A fluoroscopic to TRUS fusion based approach for intraoperative prostate brachytherapy dosimetry was developed. Seed images were identified from multiple fluoroscopic images and reconstructed to determine the three dimensional distribution of the implanted seeds. Seeds identified from the TRUS images were used as fiducials for the registration between fluoroscopic and TRUS images. Dose analysis was then performed based on the fused images. A phantom study was performed to test this approach and a 3 mm registration error was observed. Radiation isodose contours were generated and superimposed on the TRUS images.

Brachytherapy↗