Ureteral perfusion studies in patients without preexisting renal access currently must be intermittently interrupted for intrarenal pressure measurement. A double-lumen needle has been successfully placed in four patients (two with native and two with transplanted kidneys). This permits simultaneous perfusion and intrarenal pressure monitoring yet maintains the safety and ease of use of a single skinny needle.
The thrombogenicities of stainless steel spring guide wires and two hydrophilically coated guide wires were compared. The guide wires were placed in canine femoral arteries for 30 minutes. The guide wires were removed, the thrombi were stripped off, and the clots were weighed. Clot weights obtained with the two hydrophilically coated guide wires were significantly less than those obtained with the stainless steel spring guide wires. The thrombogenicities of hydrophilically coated catheters and noncoated nylon catheters were compared with and without the use of heparin. Carotid arteries, jugular veins, femoral arteries, and femoral veins were used. Catheters were left in place for 45 minutes. The animals were heparinized and killed. The vessels were then removed en bloc with the catheter clamped in place. The vessels were incised, and the clot was removed and weighed. In arterial and venous catheterization, no significant difference in clot deposition was shown between the hydrophilically coated catheters and the noncoated nylon catheters. A striking reduction of thrombogenicity was achieved with heparinization of the catheters in both arteries and veins.
Eighty-two percutaneous enterostomies were performed at three institutions with the Cope suture anchor for stomach or jejunal wall stabilization during alimentation tube placement. The anchors were successfully placed into the stomach or jejunum in 81 cases. Early in the series, two anchors were misplaced, with no sequelae. There were no other complications at the time of placement. In all successful cases, excellent immobilization of the viscus was achieved. Tract dilation and tube placement were easily performed, and there were no guidewire or tube dislodgments.
The Amplatz retrievable inferior vena cava filter was designed to be used as either a permanent indwelling filter or a short-term, percutaneously removable filter. The authors placed 52 filters in 52 patients. No deaths occurred as a result of filter placement or usage. Follow-up in 42 (81%) patients included inferior vena cavography (n = 31), computed tomography (n = 4), duplex ultrasound (n = 4), and autopsy (n = 3). Inferior vena cava thrombosis was found in seven (17.5%) of the 40 previously nonobstructed venae cavae studied. Two patients with caval thrombosis required a second filter to prevent embolization of thrombus that had extended to the lung side of the first filter. No clinically evident pulmonary emboli after filter placement have been noted. Six filters were successfully retrieved or repositioned percutaneously. The relatively high rate of caval thrombosis with extension above the filter may be due to a higher trapping efficiency or to filter geometry. The role of this filter in the treatment of deep venous thrombosis and pulmonary emboli is unclear.
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