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- McGreevy, David, 1988-
(författare)
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Endovascular Management following Unintentional Subclavian Artery Injury during Central Venous Catheter Placement
- 2019
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Ingår i: Journal of endovascular resuscitation and trauma management. - Örebro : Örebro University Hospital. - 2002-7567. ; 3:1, s. 51-53
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Tidskriftsartikel (refereegranskat)abstract
- Background: Traumatic injury to the subclavian artery during central venous catheter (CVC) placement is rare but can be catastrophic. Standard open surgical treatment is challenging and associated with significant complications. Presented is a case of endovascular treatment of these injuries and associated complications.Methods and Results: This is a description of the endovascular repair of a subclavian artery injury during CVC placement at Orebro University Hospital.Conclusions: This case report suggests that endovascular repair of subclavian artery injuries a less invasive and may decrease the morbidity and mortality associated with open surgical repair.
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- McGreevy, David, 1988-, et al.
(författare)
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Metabolic Response to Claudication in Peripheral Arterial Disease : a Microdialysis pilot study
- 2019
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Ingår i: Annals of Vascular Surgery. - : Elsevier. - 0890-5096 .- 1615-5947. ; 58, s. 134-141
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: In a pilot study investigate the possible use of microdialysis in the calf muscle to assess the metabolic response to intermittent claudication (IC). In addition, evaluate the simultaneous systemic inflammatory reaction.METHODS: With one microdialysis catheter in the gastrocnemic muscle and one subcutaneously in the pectoral region (as a reference), and a peripheral venous catheter, dialysate and venous blood sampling was performed before, during and after walking on a treadmill to maximal tolerable claudication (controls 10 minutes).RESULTS: A total of 9 participants were recruited, six patients with IC and three healthy controls. At baseline, IC and control subjects did not differ in metabolic findings (glucose, lactate, pyruvate, glycerol) in the gastrocnemic muscle. Subcutaneous glucose concentration was higher in controls. After physical exertion, gastrocnemic and subcutaneous glycerol, lactate and pyruvate concentrations increased in IC subjects. Plasma concentrations of Tumor Necrosis Factor--α (TNF- α), Interleucin-6 (IL-6), Interleucin-1ß (IL-1ß), Hepatocyte Growth Factor (HGF) and Vascular Endothelial Growth Factor (VEGF) were higher in IC subjects at baseline, and TNF-α, (IL-6) and Interleukin-18 (IL-18) increased after walking as did IL-6 and (IL-1ß) in controls. The muscle catheters did not show any signs of causing harm.CONCLUSIONS: Microdialysis can be used to study the ongoing metabolic response during walking and claudication. Our results suggest both an acute local and a systemic inflammatory reaction during development of claudication pain.
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- Sadeghi, Mitra, 1982-, et al.
(författare)
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Endovascular Resuscitation with Aortic Balloon Occlusion in pediatric trauma
- 2019
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Ingår i: Journal of Endovascular Resuscitation and Trauma Management. - : Örebro University Hospital. - 2002-7567 .- 2002-7567. ; 3:3
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Tidskriftsartikel (refereegranskat)abstract
- Background: The use of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) in resuscitation and trauma management in adults is increasing. However, there is limited data published concerning its use in pediatric patients.Methods: We describe a case using REBOA for traumatic hemorrhagic shock in a pediatric patient according to the concept of EndoVascular resuscitation and Trauma Management (EVTM) at Örebro University Hospital in April 2019. Informed consent has been received.Results: An 11-year-old boy arrived at the emergency room (ER) after a motor vehicle accident. Due to total hemo-dynamic collapse, cardiopulmonary resuscitation was initiated with return of spontaneous circulation. Zone 1 total REBOA was successfully performed for 7 minutes while damage control surgery was performed and massive transfu-sion was initiated to stabilize the patient. The patient survived and returned to almost normal daily activity.Conclusion: REBOA for endovascular resuscitation and trauma management may be an additional method for tem-porary hemodynamic stabilization in pediatric patients and, in this specific patient, was used instead of resuscitative thoracotomy.
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