Subject(s)
Device Removal/instrumentation , Device Removal/nursing , Embolectomy/instrumentation , Embolectomy/nursing , Stents , Stroke/nursing , Thrombectomy/instrumentation , Thrombectomy/nursing , Thrombolytic Therapy/instrumentation , Thrombolytic Therapy/nursing , Equipment Design , Humans , Randomized Controlled Trials as TopicABSTRACT
The surgery required to remove a renal cell carcinoma with inferior vena cava (IVC) tumor thrombus is complex. IVC tumor thrombus is a complicating factor that occurs in 4% to 10% of patients with renal cell carcinoma. Nurses need to understand this surgical procedure and its inherent risks to proactively and successfully manage the patient's post-operative care and discharge plan.
Subject(s)
Carcinoma, Renal Cell/surgery , Kidney Neoplasms/surgery , Neoplastic Cells, Circulating , Nephrectomy/nursing , Postoperative Care/nursing , Thrombectomy/nursing , Vena Cava, Inferior/pathology , Carcinoma, Renal Cell/pathology , Humans , Kidney Neoplasms/pathology , Postoperative Complications/nursingABSTRACT
Treatment of deep vein thrombosis traditionally has focused on preventing the potentially life-threatening complication of pulmonary embolism rather than on removing or reducing the thrombus. Although treatment with anticoagulants may prevent thrombus propagation, the body's intrinsic thrombolytic system is left to attempt clot dissolution. Because this natural process is generally ineffective in its ability to fully recanalize a proximal vein, the risks of recurrent thrombosis as well as the disabling complication of postthrombotic syndrome increase. Moreover, the long-term consequences of postthrombotic syndrome include pain, disability, and, for many, a significant decrease in the quality of life. Recent technology using high-frequency, low-power ultrasound, or mechanical thrombectomy with catheter-directed delivery of a thrombolytic drug directly into the clot is available and showing promise. Nurses are caring for patients who receive endovascular interventions with lytic infusions. The nursing challenge is to provide safe and effective patient care.
Subject(s)
Radiology, Interventional/methods , Thrombectomy/methods , Thrombolytic Therapy/methods , Ultrasonic Therapy/methods , Venous Thrombosis/therapy , Acute Disease , Anticoagulants/therapeutic use , Causality , Critical Care/methods , Critical Care/trends , Humans , Nurse's Role , Patient Discharge , Postphlebitic Syndrome/etiology , Postphlebitic Syndrome/prevention & control , Practice Guidelines as Topic , Pulmonary Embolism/etiology , Pulmonary Embolism/prevention & control , Radiology, Interventional/trends , Recurrence , Technology Assessment, Biomedical , Thrombectomy/nursing , Thrombectomy/trends , Thrombolytic Therapy/nursing , Thrombolytic Therapy/trends , Ultrasonic Therapy/nursing , Ultrasonic Therapy/trends , Vena Cava Filters , Venous Thrombosis/complications , Venous Thrombosis/diagnosis , Venous Thrombosis/epidemiologyABSTRACT
Pulmonary artery thromboendarterectomy (PTE) is a surgical procedure that offers the only cure for chronic thromboembolic pulmonary hypertension (TPH), a progressive form of secondary pulmonary hypertension. Current estimates indicate that 1% to 5% of patients who survive a pulmonary embolus will develop chronic TPH with progressively worsening pulmonary hypertension and right-sided heart failure. This bilateral procedure is performed through a sternotomy incision using cardiopulmonary bypass, profound hypothermia, and intermittent circulatory arrest with antegrade cerebral perfusion. As an alternative to lung transplantation, PTE offers patients with chronic TPH an improved quality of life.
Subject(s)
Endarterectomy , Hypertension, Pulmonary/etiology , Pulmonary Embolism/surgery , Thrombectomy , Thromboembolism/surgery , Cardiopulmonary Bypass , Chronic Disease , Disease Progression , Endarterectomy/methods , Endarterectomy/nursing , Heart Arrest, Induced , Humans , Hypertension, Pulmonary/physiopathology , Hypothermia, Induced , Incidence , Nurse's Role , Operating Room Nursing/organization & administration , Patient Care Planning , Patient Education as Topic , Patient Selection , Perioperative Care/methods , Perioperative Care/nursing , Pulmonary Circulation , Pulmonary Embolism/complications , Pulmonary Embolism/epidemiology , Risk Factors , Severity of Illness Index , Thrombectomy/methods , Thrombectomy/nursing , Thromboembolism/complications , Thromboembolism/epidemiology , Treatment Outcome , United States/epidemiologyABSTRACT
Since its inception in 1929, cardiac catheterization has undergone many changes. In the last two decades we have seen an evolution in cardiac catheterization from a diagnostic (anatomic and physiologic) to a therapeutic modality. This article highlights some of the more common and newer interventional procedures now performed.
