MyMedR

Fulltext eComment: Trans-pericardial extra-anatomic aortic bypass for coarctation of the aorta

Sachithanandan A, Badmanaban B

Interact Cardiovasc Thorac Surg, 2011 Jul;13(1):100.

PMID: 21697404 DOI: 10.1510/icvts.2010.265264A

Matched MeSH terms: Device Removal*

Tracheostomy decannulation readiness: A cross sectional study comparing standardised evaluation for tacheostomy decannulation to flexible endoscopic evaluation of swallowing examination

Tamin S, Shabrina F, Hutauruk SM, Rachmawati EZK, Fardizza F, Koento T, et al.

Med J Malaysia, 2024 Mar;79(2):119-123.

PMID: 38553913

INTRODUCTION: Tracheostomy is a procedure commonly performed in neurocritical and mechanically ventilated patients in the intensive care unit. Dysphagia and impaired airway protection are the main causes for a delay in tracheostomy decannulation in patients with neurological disorders. Endoscopic evaluation is an objective examination of readiness for tracheostomy decannulation with flexible endoscopic evaluation of swallowing (FEES) as the most commonly used method, yet it requires special expertise and is heavily dependent on its operator in assessing the parameters. A relatively new method for assessing decannulation readiness in neurologic disorder, the Standardized Endoscopic Swallowing Evaluation for Tracheostomy Decannulation (SESETD) was introduced in 2013 by Warnecke, et al. This method includes stepwise evaluation of secretion management, spontaneous swallowing and laryngeal sensitivity. This study aims to find conformity between the SESETD and FEES in assessing readiness for tracheostomy decannulation in patients with neurologic disorders.

MATERIALS AND METHODS: This study is a cross-sectional study conducted on 36 neurologic patients at Cipto Mangunkusumo General Hospital which was aimed to find the agreement between two modalities for tracheostomy decannulation readiness, FEES and SESETD based on parameters, standing secretion, spontaneous swallowing and laryngeal sensitivity.

RESULT: A total of 36 subjects were examined and 22 of them underwent successful tracheostomy decannulation. The agreement between FEES and SESETD showed significant results with p-value <0.0001 and Kappa value = 0.47.

CONCLUSION: There was conformity between FEES and SESETD in evaluating tracheostomy decannulation readiness based on three parameters: standing secretion, spontaneous swallowing and laryngeal sensitivity.

Matched MeSH terms: Device Removal/methods

The efficacy of a subhypnotic dose of propofol in preventing laryngospasm following tonsillectomy and adenoidectomy in children

Batra YK, Ivanova M, Ali SS, Shamsah M, Al Qattan AR, Belani KG

Paediatr Anaesth, 2005 Dec;15(12):1094-7.

PMID: 16324030 DOI: 10.1111/j.1460-9592.2005.01633.x

BACKGROUND: Laryngospasm is a well-known problem typically occurring immediately following tracheal extubation. Propofol is known to inhibit airway reflexes. In this study, we sought to assess whether the empiric use of a subhypnotic dose of propofol prior to emergence will decrease the occurrence of laryngospasm following extubation in children.
METHODS: After approval from the Institutional Ethics Committee and informed parental consent, we enrolled 120 children ASA physical status I and II, aged 3-14 years who were scheduled to undergo elective tonsillectomy with or without adenoidectomy under standard general anesthesia. Before extubation, the patients were randomized and received in a blinded fashion either propofol 0.5 mg.kg(-1) or saline (control) intravenously. Tracheal extubation was performed 60 s after administration of study drug, when the child was breathing regularly and reacting to the tracheal tube.
RESULTS: Laryngospasm was seen in 20% (n = 12) of the 60 children in the control group and in only 6.6% (n = 4) of 60 children in the propofol group (P < 0.05).
CONCLUSIONS: During emergence from inhalational anesthesia, propofol in a subhypnotic dose (0.5 mg.kg(-1)) decreases the likelihood of laryngospasm upon tracheal extubation in children undergoing tonsillectomy with or without adenoidectomy.

Matched MeSH terms: Device Removal

Fulltext The 50% and 95% effective doses of desflurane for removal of the classic laryngeal mask airway in spontaneously breathing anaesthetised adults

Hui MT, Subash S, Wang CY

Anaesthesia, 2011 Apr;66(4):274-7.

PMID: 21401540 DOI: 10.1111/j.1365-2044.2011.06620.x

The 50% and 95% effective doses of desflurane for removal of the classic laryngeal mask airway after suction of the upper airway, in anaesthetised spontaneously breathing adult patients, are not known. To determine these, we studied 38 healthy patients, aged between 18 and 44 years. The target desflurane concentration in each individual patient was determined by the Dixon up-and-down method. When the predetermined target end-tidal desflurane concentration reached steady state, we kept a constant end-expiratory partial pressure between the alveolus and the brain for 10 min before attempting to remove the classic laryngeal mask airway after suctioning the upper airway. The initial desflurane target concentration was set at 6% and up-down desflurane increments were 0.1%. This continued until there were at least six crossover pairs. From the probit analysis, the 50% effective dose of desflurane was 5.29% (95% CI 5.132-5.379%) and the 95% effective dose was 5.55% (95% CI 5.429-6.394%).

Matched MeSH terms: Device Removal/methods

Techniques for successful early retrieval of the Micra transcatheter pacing system: A worldwide experience

Afzal MR, Daoud EG, Cunnane R, Mulpuru SK, Koay A, Hussain A, et al.

Heart Rhythm, 2018 06;15(6):841-846.

PMID: 29427820 DOI: 10.1016/j.hrthm.2018.02.008

BACKGROUND: Experience with retrieval of the Micra transcatheter pacing system (TPS) is limited because of its relatively newer technology. Although abandonment of the TPS at end of life is recommended, certain situations such as endovascular infection or device embolization warrant retrieval.

OBJECTIVE: The purpose of this study was to report the worldwide experience with successful retrieval of the Micra TPS.

METHODS: A list of all successful retrievals of the currently available leadless pacemakers (LPs) was obtained from the manufacturer of Micra TPS. Pertinent details of retrieval, such as indication, days postimplantation, equipment used, complications, and postretrieval management, were obtained from the database collected by the manufacturer. Other procedural details were obtained directly from the operators at each participating site.

RESULTS: Data from the manufacturer consisted of 40 successful retrievals of the Micra TPS. Operators for 29 retrievals (73%) provided the consent and procedural details. Of the 29 retrievals, 11 patients underwent retrieval during the initial procedure (immediate retrieval); the other 18 patients underwent retrieval during a separate procedure (delayed retrieval). Median duration before delayed retrieval was 46 days (range 1-95 days). The most common reason for immediate retrieval was elevated pacing threshold after tether removal. The most common reasons for delayed retrieval included elevated pacing threshold at follow-up, endovascular infection, and need for transvenous device. Mean procedure duration was 63.11 ± 56 minutes. All retrievals involved snaring via a Micra TPS delivery catheter or steerable sheath. No serious complications occurred during the reported retrievals.

CONCLUSION: Early retrieval of the Micra TPS is feasible and safe.

Matched MeSH terms: Device Removal/methods*

Stent dislodgement in left anterior descending coronary artery and successful deployment with two parallel wires and a small balloon

Ngow H

Kardiol Pol, 2009 Sep;67(9):1040-2 discussion 1043.

PMID: 19838965

Coronary artery stent dislodgement during angioplasty is a rare complication. Stent dislodgement was more frequent in the past when stents were manually crimped onto the balloon. Newer and improved balloon-mounted stents with better radio-opacity have reduced the incidence of stent dislodgement but do not completely eliminate it. We report a case of balloon-mounted stent dislodgement in the proximal left anterior descending (LAD) coronary artery prior to deployment. This patient however was successfully treated with re-wiring of the artery with two parallel wires and the stent's reposition prior to deployment with the help of a small balloon.

Matched MeSH terms: Device Removal/instrumentation; Device Removal/methods

Spontaneous knot formation impeding the removal of a silicone urethral catheter

Mustafa NA, Lope RJ, Cheah FC

Arch. Dis. Child. Fetal Neonatal Ed., 2006 Jul;91(4):F287.

PMID: 16790731

Matched MeSH terms: Device Removal/methods

Sonographically guided removal of a double J ureteral stent in an infant

Jutti RC, Subramaniam R, Balsingh D, Qureshi AM

J Clin Ultrasound, 2002 May;30(4):232-5.

PMID: 11981933 DOI: 10.1002/jcu.10062

A 2-month-old male infant with a prenatally diagnosed obstruction of the ureteropelvic junction underwent a dismembered Anderson-Hynes pyeloplasty. A transanastomotic double J ureteral stent was placed between the renal pelvis and the urinary bladder. This report describes the subsequent removal of the double J ureteral stent from the patient's urinary bladder without the aid of a cystoscope: a rigid biopsy forceps was introduced trans-urethrally into the urinary bladder, and the stent was removed with sonographic guidance. Removal of a ureteral stent with sonographic guidance has not been previously reported in infants. This technique may be particularly useful in developing countries, where appropriate-sized cystoscopes and accessories may not be available.

Matched MeSH terms: Device Removal/instrumentation; Device Removal/methods*

Fulltext Schizophrenia and anaesthesia

Constance LSL, Lansing MG, Khor FK, Muniandy RK

BMJ Case Rep, 2017 Nov 23;2017.

PMID: 29170175 DOI: 10.1136/bcr-2017-221659

Administering anaesthesia for elderly patients with chronic schizophrenia has always been a great challenge to anaesthetists. These patients will usually be on multiple antipsychotic drugs for many years and may lead to delayed awakening, cardiovascular instability, arrhythmias and sudden cardiac death during general anaesthesia. This case report is about the perioperative anaesthetic management of an elderly schizophrenic patient undergoing removal of femur implant. This article will explore important drug interactions and available options for a successful anaesthesia.

Matched MeSH terms: Device Removal/adverse effects; Device Removal/methods

Revision of total hip arthroplasty using an anterior cortical window, extensive strut allografts, and an impaction graft: follow-up study

Arif M, Sivananthan S, Choon DS

J Orthop Surg (Hong Kong), 2004 Jun;12(1):25-30.

PMID: 15237118

To report the outcome of revised total hip arthroplasty procedures involving an anterior cortical window, extensive strut allografts, and an Exeter impaction graft.

Matched MeSH terms: Device Removal

Retained haemodialysis-catheter guidewire in the head and neck: a multidisciplinary team approach

Xiao Hong C, Abd Wahab S, Azman M

BMJ Case Rep, 2020 Oct 27;13(10).

PMID: 33109696 DOI: 10.1136/bcr-2020-236484

Penetrating foreign body in the head and neck can be catastrophic from injury to the constellation of vascular and neural structures in the neck. Early recognition and prompt surgical intervention is imperative to save lives. Herein, we present an unusual case of iatrogenic foreign body-a coiled guidewire embedded in the deep neck space. The complications, radiological investigation and multidisciplinary surgical management are further discussed.

Matched MeSH terms: Device Removal/methods

Retained Endoscope: An Unexpected but Serious Complication of Hemospray®

Yii RSL, Chuah KH, Poh KS, Lau PC, Ng KL, Ho SH, et al.

Dig Dis Sci, 2022 01;67(1):344-347.

PMID: 33491164 DOI: 10.1007/s10620-021-06835-4

Matched MeSH terms: Device Removal/methods*

Fulltext Removal of failed dental implant with application of concentrated growth factor (CGF): a case report

Nurul Ain Mohamed Yusof, Mohd Salman Masri, Erni Noor

Compendium of Oral Science, 2018;5(1):46-53.

MyJurnal

Introduction: High survival rates of dental implants were commonly reported even after 10 years of follow up. Nevertheless, complications and failure may occur and the implant would need to be removed. In recent years, the use of autogenous blood products in dental surgery has increased due to its ability to aid the healing of the soft and hard tissues. Clinical case: The case demonstrated the utilisation of concentrated growth factor (CGF) from the patient’s blood for healing following conservative removal of a failed dental implant. Subsequently, the patient showed satisfactory recovery without any infections and clinical complaints. Conclusion: This explantation procedure, together with the use of CGF, may prevent the normal bone resorption and accelerate soft tissue healing. As it is biological in nature having originated from the patient’s blood, it is more readily accepted by the tissues and the risk of infection is low.

Matched MeSH terms: Device Removal

Pyogenic Granuloma Formation Following Ahmed Valve Glaucoma Implant

Chendran P, Seng Fai T, Wan Abdul Halim WH, Md Din N

J Glaucoma, 2019 10;28(10):e162-e164.

PMID: 31368915 DOI: 10.1097/IJG.0000000000001334

Ocular pyogenic granuloma is a benign tumor seen after ocular insult secondary to ocular surgeries, trauma or infection. Although benign, intervention is sometimes necessary. Previous authors have reported pyogenic granuloma formation following oculoplastic surgeries. We report a pyogenic granuloma after an Ahmed glaucoma valve implantation. A 65-year-old gentleman presented with right eye redness associated with pain and swelling ~2 months after Ahmed glaucoma valve implantation. Examination found a sessile growth on the tube extruding puss with signs of endophthalmitis. The glaucoma drainage device was explanted and culture results grew Staphylococcus aureus. This article discusses the formation of pyogenic granuloma on a glaucoma drainage device and its management.

Matched MeSH terms: Device Removal

Placement of removable metal biliary stent in post-orthotopic liver transplantation anastomotic stricture

Tee HP, James MW, Kaffes AJ

World J Gastroenterol, 2010 Jul 28;16(28):3597-600.

PMID: 20653071

Postoperative biliary strictures are the most common cause of benign biliary stricture in Western countries, secondary to either operative injury or bile duct anastomotic stricture following orthotopic liver transplantation (OLT). Surgery or endoscopic interventions are the mainstay of treatment for benign biliary strictures. We aim to report the outcome of 2 patients with refractory anastomotic biliary stricture post-OLT, who had successful temporary placement of a prototype removable covered self-expandable metal stent (RCSEMS). These 2 patients (both men, aged 44 and 53 years) were given temporary placement of a prototype RCSEMS (8.5 Fr gauge delivery system, 8 mm x 40 mm stent dimensions) in the common bile duct across the biliary stricture. There was no morbidity associated with stent placement and removal in these 2 cases. Clinical parameters improved after the RCSEMS placement. Long-term biliary patency was achieved in both the patients. No further biliary intervention was required within 14 and 18 mo follow-up after stent removal.

Matched MeSH terms: Device Removal

Fulltext Peripheral Intravenous Catheterisation in Obstetric Patients in the Hand or Forearm Vein: A Randomised Trial

Tan PC, Mackeen A, Khong SY, Omar SZ, Noor Azmi MA

Sci Rep, 2016 Mar 18;6:23223.

PMID: 26987593 DOI: 10.1038/srep23223

A peripheral intravenous catheter is often inserted as part of care during labour. The catheter is inserted into the back of the hand or lower forearm vein in usual practice. There is no trial data to guide the care provider on which is the better insertion site in any clinical setting. 307 women admitted to the labour ward who required insertion of intravenous catheter were randomised to back of hand or lower forearm vein catheter insertion. Catheter insertion is by junior to mid-grade providers. We evaluated insertion success at the first attempt, pain during insertion and catheter replacement due to malfunction as main outcomes. After catheter removal, we recorded patient satisfaction with site, future site preference and insertion site swelling, bruising, tenderness, vein thrombosis and pain. Insertion of a catheter into back of hand vein is more likely to be successful at the first attempt. Insertion pain score, catheter replacement rate, patient satisfaction, patient fidelity to site in a future insertion and insertion site complications rate are not different between trial arms. In conclusion, both insertion sites are suitable; the back of the hand vein maybe easier to cannulate and seems to be preferred by our frontline providers.

Matched MeSH terms: Device Removal

Pediatric empyema thoracis: roles and outcomes of surgery in advanced disease

Ho YL, Jamaluddin MF, Krishinan S, Salleh A, Khamis AY, Abdul Kareem BA

Asian Cardiovasc Thorac Ann, 2020 Mar;28(3):152-157.

PMID: 32122151 DOI: 10.1177/0218492320910932

Matched MeSH terms: Device Removal

Opacification of AcriFlex 50CSE hydrophilic acrylic intraocular lenses

Lim AK, Goh PP, Azura R, Mariam I

J Cataract Refract Surg, 2011 Apr;37(4):655-9.

PMID: 21420589 DOI: 10.1016/j.jcrs.2010.10.050

PURPOSE: To determine the prevalence of and risk factors for AcriFlex 50CSE hydrophilic acrylic intraocular lens (IOL) opacification approximately 3 years after implantation.
SETTING: Selayang Hospital, Selangor, Malaysia.
DESIGN: Cross-sectional study.
METHODS: Patients who had AcriFlex 50CSE IOL implantation in 2005 and 2006 were identified from operating logbooks and recalled via telephone and letters. Opaque IOLs were explanted and sent for scanning electron microscopy (SEM) and energy-dispersive x-ray spectroscopy (EDS).
RESULTS: The review showed that 18 patients had died and 67 had declined examination or could not be contacted, leaving 239 eyes for evaluation. The age of the patients ranged from 25 to 85 years. Of the patients, 83 (34.7%) were Malay, 127 (53.1%) Chinese, and 29 (12.1%) East Indian. The male:female ratio was 1:1. Fourteen eyes of 13 patients (5.4%) had IOL opacification; 1 had bilateral opacification. Five eyes had fine deposits, and 9 eyes had dense opaque deposits. Seven opaque IOLs required explantation. There was no correlation between age (P=.645), sex (P=.319), or race (P=.860) and IOL opacification. Pearson chi-square analysis showed a strong association between diabetes mellitus and IOL opacification (P=.019). Nine (69.2%) of the 13 patients with opacification had diabetes. Scanning electron microscopy and EDS showed calcium and phosphate deposits on the optic surface and intralenticularly near the anterior surface of the optic.
CONCLUSIONS: Results indicate that diabetes mellitus is a risk factor for AcriFlex hydrophilic acrylic IOL opacification. In some cases, opacification affected vision, necessitating explantation. The pathophysiology of this complication is unknown.
FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Matched MeSH terms: Device Removal

Fulltext Infective endocarditis and the pacemaker: cardiac implantable electronic device infection

Yew KL

Med J Malaysia, 2012 Dec;67(6):618-9.

PMID: 23770958 MyJurnal

We are seeing more implantation of cardiac device such as pacemakers and defibrillators and also cardiac implantable electronic device infection. The infection may affect just the pocket site or progress to deeper infection and bacteraemia. Inadequately treated infection may lead to right sided endocarditis, cardiotomy for pacemaker explantation and increased cost and length of stay in the hospital. We report a Staphylococcal infection of a pacemaker system, its successful medical and surgical management.

Matched MeSH terms: Device Removal

Impact of interventional nephrology on outcome and penetration rate of a CAPD program

Wong CM, Ng KP, Keng TC, Lim SK, Tan SY

Perit Dial Int, 2011 3 24;31(2):194-6.

PMID: 21427247 DOI: 10.3747/pdi.2009.00237

Matched MeSH terms: Device Removal/statistics & numerical data

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