Ambulatory sclerotherapy is a safe, viable alternative to conventional inpatient treatment of malignant pleural effusions.

Introduction: The incidence of cephalic arch (CA) and central venous (CV) stenosis has been reported in the range of 30% in the literature. The purpose of this study is to compare contrast use, fluoroscopy time, and procedure time between standard imaging by injection of contrast through the access sheath versus injection of contrast through a novel PTA balloon with an integrated injection port. Methods: A multi-centered, retrospective evaluation of consecutive patients treated for CA and CV stenosis was performed. Data captured included demographics, co-morbidities, lesion characteristics/location, procedural details, volume of contrast used, fluoroscopy time, and procedure time. The control group was imaged and treated using standard practice with pre and post imaging performed through the sheath and intervention using standard PTA balloon. Imaging and treatment were performed using the Chameleon™ PTA catheter in the treatment arm. Results: A total of 68 consecutive patients were included. There were 34 patients in Group A and 34 patients in Group B. Average age was 65.2 versus 66.5 ( p = 0.284), respectively. There were no significant gender differences between groups. Prevalence of co-morbidities of hypertension, coronary artery disease, and diabetes was similar to national rates in both groups. Contrast volume, fluoroscopy time, and procedure time in Group B were significantly less when compared by multiple regression to Group A, correcting for potential confounders ( p = 0.0001, 0.0180, and 0.0008, respectively). Conclusion: Use of a PTA balloon with an integrated injection port shows potential for significant reduction in contrast dose, fluoroscopy time, and procedure time.

Introduction: Sheath placement in dialysis access interventions is traditionally necessary to obtain imaging, guide percutaneous angioplasty, and evaluate results. The aim of this study was to assess the feasibility of performing sheathless Arterio-venous (AV) access interventions using a novel percutaneous angioplasty balloon catheter. Methods: Between May and September 2017, data on all dialysis access interventions using a novel percutaneous angioplasty balloon with a dedicated injection port were collected. All procedures were performed without a sheath. Success was established as no conversion to sheath placement. Demographic data, location of lesion, time to perform procedure, amount of contrast used, radiation exposure, and access complications were recorded. Ultrasound was used to evaluate access site complications. Results: Sheathless interventions were successful in 24 patients with the mean age of 62 years (29–94). There were 5 PTFE grafts and 19 native fistulas. Lesions were located anywhere from the arterial anastomosis to the cephalic arch. The average balloon size was 6 mm (5–7 mm), and the procedure time was 15.8 min (8–45 min). No access site complications were observed. Conclusion: Sheathless intervention is feasible with several potential advantages, including short procedure time, minimal contrast volume, and reduced radiation exposure. Finally, the lower profile at the access site may result in fewer complications.

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