The Medical journal of Australia
-
Comparative Study
Vascular access catheters for chemotherapy. Long-term follow-up.
Accessible surface veins become increasingly difficult to find after repeated venepunctures. This unfortunate situation often arises in patients on long-term chemotherapy, and can lead to soft tissue infiltration of toxic agents with resultant necrosis. A solution to this problem is the placement of long term indwelling vascular access catheters. ⋯ Thirty-five patients were available for long-term follow-up (greater than 6 months). Results in these show a mean catheter life varying from three to five months with a very low incidence of septicaemia, even in the immunologically compromised patients. The advantages of the various catheters are compared.
-
On the basis of observation of 26 patients, we consider that the common cause in trigeminal neuralgia and hemifacial spasm is compression of the nerve-root entry zone at the brainstem by a blood vessel, usually an artery. By mobilising the vessel, and securing it away from the nerve, symptoms were relieved in 16 of 17 patients with trigeminal neuralgia and in seven of nine patients with hemifacial spasm for a follow-up period of up to four years. Trigeminal microvascular decompression had few complications, but three patients treated for facial hemispasm had postoperative deafness and one had a probable small brainstem infarct. The major advantage of this surgical approach is that is possible to relieve the symptoms without facial anaesthesia or paralysis.