The Fogarty arterial embolectomy catheter, while indispensible in the armamentarium of the vascular surgeon, is not entirely benign instrument. A case is desribed in which the balloon was lost in its entirety from the catheter and immediately retrieved using a second identical instrument. A comprehensive survey of the literature reveals that a variety of arterial injuries have occurred during the use of the Fogarty catheter. Each of the major ones is discussed in depth. Amongst the most serious are arterial perforation and rupture occasionally followed by loss of the involved extremity. All previously reported complications following use of the Fogarty catheter are tabulated and reviewed. Additionally, a formal classification of these complications is proposed. Since the time of its introduction in 1963 the Fogarty ballon-tipped catheter has become an indispensible tool in the armamentarium of the vascular surgeon. Its use for arterial embolectomy has been responsible for the salvage of many thousands of limbs. Over the course of the past decade, however, a number of complications referable to this instrument have appeared in the literature. These include perforation of vessels, intimal disruption and foreign body embolization amongst others. To our knowledge, however, there has been only one reported case of a balloon having been lost intra-arterially in toto without obvious cause. It is the purpose of this paper to present the second such case where the balloon, which had separated entirely from the catheter during the course of an arterial embolectomy, was later retrieved by passage of a second Fogarty catheter. In addition, a comprehensive review of the literature is undertaken, and all arterial complications reported to date summarized and tabulated.
To our knowledge, this is the first reported case of primary Pseudomonas maltophilia pneumonia. Presenting symptoms were fever and chills of two days' duration and a density in the right upper lobe. Sputum culture showed normal flora, and multiple blood cultures were negative. Antibiotic therapy initially with penicillin and then with carbenicillin was unsuccessful. Selective bronchial aspiration yielded pure cultures of P maltophilia. When an appropriate antibiotic, chloramphenicol, was given, a prompt therapeutic response followed.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.