Objective: To determine the patency rates and reasons for failure using different access routes for tunneled hemodialysis catheters. Methods: The records of patients who underwent insertion of 14 French tunnelled hemodialysis catheters were retrospectively analyzed. Catheter patency survival was demonstrated using Kaplan-Meier survival curve. Catheter failure and exchange reasons were evaluated. Results: One hundred and six patients underwent 474 catheter exchanges (mean/patient 4.47±1.62). Access was via right internal jugular vein (IJV) n=40, left IJV n=23, right femoral vein (FV) n=18, left FV n=11 and transhepatic vein n=14. The causes of catheter failure and exchange were: catheter-associated infection, catheter thrombosis, fibrin sheath and catheter tip malposition. Mean primary and cumulative catheter patency time was higher in the right IJV group (732 and 1337 days, respectively) compared with the others (p

Background: Preoperative ultrasound (US) for cephalic cut-down is related to shorter procedure time and higher success rate. This study aimed to assess efficiency of US-guided percutaneous cephalic vein (CV) puncture for placement of cardiac implantable electronic devices (CIEDs). Methods: Patients undergoing a procedure including both US-guided pectoral nerve block (PECS) and percutaneous CV puncture were retrospectively investigated. Patient medical history and demographic data was collected. Clinical features of the procedures and intra- and post-operative complications occurring were collected from patient records. Clinical data included target vessel features, and the time taken for the following: CV puncture; CV and PECS puncture; total procedure. Results: In total 34 patients had CV puncture with US-guided PECS block was attempted in all patients and the procedure was successful in 27 of 34 (79.4%) patients. The total number of CV puncture attempts was 62 for 34 leads (mean attempts per lead = 1.82). The mean ± standard deviation time for CV puncture was 137.5 ± 27.4 s. There were no venous access-related complications. Conclusion: US-guided CV puncture appears feasible and safe with an acceptable success rate. In case of failure of the US-guided axillary or subclavian vein approach, it may be preferred as an alternative to the cephalic cut-down procedure, where the success rate is relatively lower and the risk of bleeding is higher.

Pulmonary carcinoid tumors are rare neuroendocrine neoplasms that carry a risk of bleeding. We report a case of a tumor with unusual arterial supply from m

Objective: We aimed to investigate whether different inflammatory spondyloarthropathy (ISPA) subtypes demonstrate distinct topographic patterns of sacroiliac joint involvement on their initial MRI examinations. Methods: Initial MRI studies of 126 patients with clinically confirmed ISPA were retrospectively evaluated. Bone marrow edema (BME) was classified as an acute finding, while subchondral sclerosis, erosions, fatty infiltration, and ankylosis were classified as chronic changes. All findings were documented according to their location in the upper, middle, and lower thirds of the joint, as well as involvement of the ligamentous versus synovial portions and sacral versus iliac dominance. Results: The study included 62 patients with ankylosing spondylitis (AS), 19 with psoriatic spondyloarthritis (PSA), 17 with undifferentiated spondyloarthritis (USPA), 14 with enteropathic spondyloarthritis (ESPA), and 14 with other inflammatory conditions. On initial MRI, BME was most frequently observed in the middle third (68%) and lower third (52%) of the joints. PSA showed significantly more frequent lower third involvement (80% vs 41–58% in other subtypes, p=0.024). AS demonstrated sacral-dominant BME (44% vs 9–40%, p=0.013), while ESPA showed iliac-dominant involvement (66% vs 16–26%, p=0.003). PSA exhibited a symmetrical pattern more frequently (60% vs 23–50%, p=0.043). No significant differences were observed among subtypes regarding chronic structural changes. Conclusion: Different ISPA subtypes demonstrate distinct topographic patterns of sacroiliac joint involvement on initial MRI, which may aid in early differential diagnosis.