Antecubital Vein (antecubital + vein)

Distribution by Scientific Domains


Selected Abstracts


Patent Foramen Ovale: Comparison among Diagnostic Strategies in Cryptogenic Stroke and Migraine

ECHOCARDIOGRAPHY, Issue 5 2009
Concetta Zito M.D.
Objective: The aim of this study was to compare transthoracic echocardiography (TTE) and transcranial Doppler ultrasonography (TCD) with transesophageal echocardiography (TEE) in order to define the best clinical approach to patent foramen ovale (PFO) detection. Methods: In total, 72 consecutive patients (33 men) with a mean age of 49 ± 13 years were prospectively enrolled. The TEE indication was cryptogenic stroke (36 patients) or migraine (36 patients, 22 with aura). All patients underwent standard TTE, TCD, and TEE examination. For any study, a contrast test was carried on using an agitated saline solution mixed with urea-linked gelatine (Haemaccel), injected as a rapid bolus via a right antecubital vein. A prolonged Valsalva maneuver was performed to improve test sensitivity. Results: TEE identified a PFO in 65% of the whole population: 56.5% in the migraine cohort and 43.5% in the cryptogenic stroke cohort. TTE was able to detect a PFO in 55% of patients positive at TEE (54% negative predictive value, 100% positive predictive value, 55% sensitivity, and 100% specificity). TCD was able to identify a PFO in 97% of patients positive at TEE (89% negative predictive value, 98% positive predictive value, 94% sensitivity, and 96% specificity). Conclusions: In patients with cryptogenic stroke and migraine, there is a fair concordance (k = 0.89) between TCD and TEE in PFO recognition. Accordingly, TCD should be recommended as a simple, noninvasive, and reliable technique, whereas TEE indication should be restricted to selected patients. TTE is a very specific technique, whose major advantage is the ability to detect a large right-to-left shunt, particularly if associated with an atrial septal aneurysm. [source]


Role of the Peripheral Intravenous Catheter in False-positive D-dimer Testing

ACADEMIC EMERGENCY MEDICINE, Issue 2 2001
Alan C. Heffner MD
Abstract. Objective: To determine whether inserting a peripheral intravenous catheter (IV) can significantly increase the circulating D-dimer concentration. Methods: Twenty healthy young adult volunteers underwent cannulation of an antecubital vein with a 20-gauge Teflon IV. Time 0 venous blood was drawn during IV insertion. The IV was salinelocked and left in place for 90 minutes, at which time a second venipuncture was performed in a contralateral antecubital vein (+90 min). A qualitative D-dimer assay [erythrocyte-agglutination assay, SimpliRED (SRDD)] and a quantitative spectrophotometric assay [enzyme-linked immunosorbent assay (EIA), Dimertest Gold] were performed on all samples. Time 0 means (±SD) were compared with +90 min means by paired t-test, and SRDD pairs were compared with McNemar's test. Results: Time 0 initial venipuncture blood samples yielded a mean D-dimer concentration of 15 ± 24 ng/mL, with 2/20 SRDD tests read as positive (95% CI = 1% to 32%). At +90 min, the D-dimer concentration was 33 ± 21 ng/mL (p = 0.04 vs time 0), with 5/20 SRDD tests read as positive (95% CI = 9% to 49%, p = 0.248). Conclusions: Insertion of an IV increased the circulating D-dimer concentration (determined by EIA), but did not lead to a significant increase in false-positive conversion of the SRDD. An effort should be made to perform D-dimer testing on "first-stick" blood to optimize specificity. However, a strongly positive D-dimer reaction cannot be ascribed to the presence of an IV. [source]


Percutaneous Left and Right Heart Catheterization in Fully Anticoagulated Patients Utilizing the Radial Artery and Forearm Vein: A Two-Center Experience

JOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 3 2006
TED S. N. LO M.R.C.P.
Background: Stopping oral anticoagulants prior to cardiac catheterization is associated with an increased risk of thromboembolism. Performing the procedures via the femoral artery and vein without interruption of anticoagulation is associated with a high rate of major access site complications. The transradial technique for left heart catheterization is safe in fully anticoagulated patients but few data are available on the percutaneous right and left heart catheterization utilizing a combination of the radial artery and antecubital vein in this group of patients. Methods: We report our experience in 28 consecutive patients that underwent left and right heart catheterizations via this percutaneous arm approach without interruption of anticoagulation. These were compared to 31 consecutive non-anticoagulated patients that underwent the procedure via a conventional femoral artery and vein approach. Results: Arterial and venous accesses were achieved and complete angiographic and hemodynamic data obtained in all patients. There were no access site complications in the anticoagulated patients despite an International normalized ratio (INR) of 2.5 ± 0.5. Procedural duration was longer in the anticoagulated group of patients, but fluoroscopy time and patient radiation dose were similar in both groups. Conclusion: Our experience suggests that left and right heart catheterization can be safely performed in most fully anticoagulated patients using this technique with a low bleeding and thromboembolic risk and no increase in radiation exposure. [source]


Changes of serum melatonin level and its relationship to feto-placental unit during pregnancy

JOURNAL OF PINEAL RESEARCH, Issue 1 2001
Yasuhiko Nakamura
Serum melatonin concentrations were studied in normal pregnant women and in women with several types of pathologic pregnancies, e.g., twins, preeclampsia or intrauterine growth retardation (IUGR). Blood samples were collected from the maternal antecubital vein at 14:00 hr (daytime) and 02:00 hr (nighttime) during pregnancy, and also from the umbilical vein and artery immediately after delivery. Serum melatonin concentrations were measured by radioimmunoassay. Daytime serum melatonin levels in normal (single fetus; singleton) pregnancies were low. While the levels showed an increasing tendency toward the end of pregnancy, no statistically significant changes occurred. On the other hand, the nighttime serum melatonin levels increased after 24 weeks of gestation, with significantly (P<0.01) high levels after 32 weeks; these values decreased to non-pregnant levels on the 2nd day of puerperium. Nighttime serum melatonin levels were significantly (P<0.05) higher in twin pregnancies after 28 weeks of gestation than in singleton pregnancies, whereas the patients with severe preeclampsia showed significantly (P<0.05) lower serum melatonin levels than the mild preeclampsia or the normal pregnant women after 32 weeks of gestation. Melatonin concentrations in umbilical vessels showed a higher tendency in neonates who were born during at night compared with the other neonates; moreover, those in the umbilical artery were generally higher than those in the umbilical vein. The present results indicate that in humans, the maternal serum melatonin levels show a diurnal rhythm, which increases until the end of pregnancy, reflecting some pathologic states of the feto-placental unit. Fetuses may produce melatonin with a circadian rhythm. [source]


2351: Intravenous hypertonic saline reduces intraocular pressure

ACTA OPHTHALMOLOGICA, Issue 2010
M HARJU
Purpose To study the effect of intravenous hypertonic saline (HTS) solution on intraocular pressure (IOP). Methods Nineteen patients (mean age ±SD, 66 ± 11 years) with glaucoma and IOP ,30 mmHg were recruited. HTS solution with sodium chloride concentration of 7,5% (Natriumklorid Braun 234 mg/ml, B.Braun Medical Oy, ) was given intravenously in an antecubital vein. IOP was measured every minute for 10 minutes and less frequently for up to 2 hours after treatment. The dosage given was 0,5 mmol/kg in 11 patients (Group05) and 1,0 mmol/kg in eight patients (Group1). Results The maximum mean (±SD) IOP reduction was achieved 5 minutes after treatment at which point mean IOP had reduced from 40 ± 11 mmHg before treatment to 33 ± 12 mmHg (P < 0.001). The mean percentage IOP reduction was 20 ± 10 % (range 8% , 40%) and the absolute IOP reductions ranged 4 to 16 mmHg. Two hours after treatment, mean IOP was still reduced to 33 ± 13 mmHg (P< 0.001). There was no difference between Group05 and Group1 in the amount of IOP reduction, but there was a trend that the IOP reduction sustained longer in Group1. Four patients reported mild to severe pain in the arm after injection. Especially patients in Group1 had a feeling of warmth in the head and neck region. These symptoms lasted for 1-2 minutes. Conclusion Intravenous HTS solution reduces IOP within minutes after injection. [source]