1/533. Central venous catheter-associated thrombosis in severe haemophilia.Significant subclavian vein thromboses associated with indwelling fully implanted (port-a-cath) devices are described in two boys with severe haemophilia A and factor viii inhibitors. Investigations were prompted by prominent chest wall veins in one case, whereas the thrombosis was a chance finding in the other case during investigation of mechanical dislocation of the catheter tubing. Extensive collateral venous circulations were demonstrated by venography in both instances indicating that the thrombus had been present for some time. Possible contributing factors to the thromboses included desensitization therapy (both patients), high-dose FEIBA (in one patient) and use of lower doses of heparin for line flush than that recommended by some authors. Neither patient had a familial or non-familial predisposition to thrombosis.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
2/533. Migration of sterilisation clips: case report and review.A case is reported of a sterilisation clip which was discovered, three years after operation, to have migrated to the subcutaneous tissue. A review of current techniques of female sterilisation is given together with a discussion of other relevant accounts of clip migration. It is shown to be a rare event with no reported serious sequelae. There is no conclusive evidence to suggest that one type of clip is more likely to migrate than another.- - - - - - - - - - ranking = 2keywords = rate (Clic here for more details about this article) |
3/533. Shear syndrome: the worst case scenario of crush syndrome.Shear syndrome is described as a complication of crush syndrome. In addition to compression of and injury to the electrode, complete transection occurs. In this case, the free end migrated to the pulmonary artery with the potential for further complications.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
4/533. Pulmonary embolization of a pacing electrode fragment complicating lead extraction.We present a case that demonstrates an unusual complication of electrode extraction, namely asymptomatic embolization of a pacing electrode fragment into the pulmonary vascular bed.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
5/533. A case of dislodged atrial screw-in lead with migration to the ventricle 1 year postoperatively.We report a rare case of a 53-year-old woman with a dislodged atrial screw-in lead that migrated to the ventricle 1 year after pacemaker implantation. While such an event is quite unusual, we should be aware of its possibility.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
6/533. fatal outcome in atrial migration of the Tempofilter.PURPOSE: To report the risk of fatal atrial migration with the Tempofilter. methods: Among temporary filters, the high safety profile Tempofilter has been marketed as offering protection for up to 6 weeks. We implanted about 60 Tempofilters to prevent pulmonary embolism. The main indications were temporary thromboembolic risk, recurrent pulmonary embolism, and contraindication to or failure of anticoagulant therapy. Follow-up was performed regularly by plain abdominal film and Doppler ultrasound. Filters were removed about 4 weeks after placement. RESULTS: We encountered three cases (5%) of atrial migration and one case of 5-cm cephalad displacement of the filter. Of the three patients with atrial migration, two died within 3 days of implantation, one from a massive pulmonary embolism and the other with cardiac tamponade. One patient did not show any serious complications. CONCLUSIONS: The Tempofilter may actively migrate cranially and become dangerous in the case of migration within the heart.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
7/533. Retrieval of distally migrated, impacted biliary endoprostheses using a novel guidewire/basket "lasso" technique.BACKGROUND: Migration of biliary endoprostheses is a recognized complication of bile duct stenting. Removing a stent that has migrated is usually straightforward, but this can be challenging when the stent is firmly impacted in the opposite wall of the duodenum or within a diverticulum. We describe a new technique for removing such impacted stents using a guidewire/basket lasso. methods: To perform the lasso technique, a retrieval basket and a guidewire are passed side-by-side through the accessory channel of the duodenoscope. The basket catheter is advanced underneath the stent and the guidewire manipulated over the stent; the basket is opened and the guidewire advanced through it. Closure of the basket creates a loop around the stent that can then be removed using gentle traction. RESULTS: The lasso technique was successfully used in three cases where other maneuvers failed. CONCLUSIONS: Biliary endoscopists should find this technique useful for retrieval of distally migrated biliary stents that are impacted against mucosa or the wall of a diverticulum so as to prevent standard basket extraction.- - - - - - - - - - ranking = 6keywords = rate (Clic here for more details about this article) |
8/533. An unusual complication of retinal reattachment surgery.The authors report a case with an unusual late extraocular complication of scleral buckling and local silicone sponge implant. Four years after the reattachment surgery, a ptotic upper eyelid perforated by local silicone sponge implant and fistula between upper eyelid and sclera were detected. Primary repair of upper eyelid and removal of silicone sponge were performed. One year later, the retina was attached and there was no problem with the upper eyelid. cryotherapy, episcleral explant (scleral buckling), and local implant (sponge) are frequently used and effective methods for retinal reattachment surgery. Postoperative early and late complications have been reported. To our knowledge, there is no report of upper eyelid perforation, ptosis and fistula formation caused by silicone sponge implant rejection.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
9/533. Aortoduodenal fistula: a late complication of intraluminal exclusion of an infrarenal aortic aneurysm.During recent years, considerable clinical experience has been gained with endoluminal stent-graft procedures. Several studies have shown promising results up to a period of 4.5 years. However, long-term follow-up studies are still limited. Late endoleaks caused by stent-graft migration, disconnection of single components in modular stent-grafts, and limb thrombosis have been observed as long-term complications. We report a case in which a migrated and kinked bifurcated stent-graft caused an aortoduodenal fistula 20 months after stent-graft insertion. To our knowledge, such a complication has not been reported before.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
10/533. Buckling of the tethering catheter causes migration of a temporary caval filter to the right atrium.AIM: To report problems in the tethering catheter shaft of the Tempofilter, temporary caval filter. MATERIALS AND methods: Two cases are reported where the tethering catheter shaft of the Tempofilter buckled within the jugular vein. RESULTS: Buckling of the tethering shaft caused cephalic migration of the filter into the right atrium. Both filters were uneventfully removed without adverse sequelae. CONCLUSION: These cases demonstrate another mechanism of tethering shaft shortening which results in unexpected migration of the filter. This device is potentially dangerous because of the liability of the tethering cather to buckle at or near the insertion site with cephalic migration of the filter. Improvements in the tethering catheter mechanism need to be made before further patient usage.- - - - - - - - - - ranking = 1keywords = rate (Clic here for more details about this article) |
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