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Aneurysm IV: Nursing Management01:22

Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...

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Fully Endoscopic Mitral Valve Repair with Percutaneous Cannulation of Groin Vessels
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Unipuncture double-access method in emergent endovascular procedures.

Tal M Hörer1, Sari Hammo, Lars Lönn

  • 1Department of Cardio-Thoracic and Vascular Surgery, Örebro University Hospital, Örebro, Sweden. Tal.horer@orebroll.se

Innovations (Philadelphia, Pa.)
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Summary

This study introduces a novel technique for achieving a second endovascular access using an existing large-bore introducer. This method facilitates rapid, unplanned access for procedures like angiography and embolization, especially in challenging patient cases.

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Area of Science:

  • Vascular Surgery
  • Interventional Radiology
  • Endovascular Techniques

Background:

  • Gaining additional endovascular access can be challenging in acute situations.
  • Existing percutaneous femoral artery access may become impaired or insufficient for multiple devices.
  • Unplanned extra access is often required during complex endovascular procedures.

Purpose of the Study:

  • To describe a novel technique for establishing a second endovascular access.
  • To demonstrate the utility of this technique in situations requiring immediate, additional catheter access.
  • To highlight its applicability in hemodynamically unstable patients and complex aortic interventions.

Main Methods:

  • Utilizing an existing percutaneous femoral artery access with a large-bore introducer.
  • Inserting a second guidewire into the existing introducer.
  • Withdrawing the introducer and repositioning it over one of the two guidewires to achieve double-wire access.

Main Results:

  • Successful creation of a double-wire endovascular access.
  • The achieved access is suitable for introducing angiography or embolization catheters.
  • The technique provides a rapid and unplanned additional access route.

Conclusions:

  • This double-wire technique offers a valuable solution for obtaining emergent or unplanned endovascular access.
  • It is particularly useful when initial access is compromised or multiple catheters are needed.
  • The method enhances procedural flexibility in critical care and complex endovascular scenarios.