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Venous Pressure: The blood pressure in the Veins. It is usually measured to assess the filling Pressure to the Heart ventricle.

Normothermic Ex Vivo Kidney Perfusion for the Preservation of Kidney Grafts prior to Transplantation

1Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, 2Division of Nephrology, The Hospital for Sick Children, Toronto, 3Department of General, Visceral & Transplant Surgery, University Medical Center Mainz, 4Department of Abdominal, Vascular & Transplant Surgery, Merheim Medical Center Cologne, 5Laboratory Medicine & Pathobiology, Toronto General Hospital, 6Departments of Surgery (Urology) & Physiology, The Hospital for Sick Children, Toronto, 7Developmental & Stem Cell Biology, The Hospital for Sick Children, Toronto

JoVE 52909


 Medicine

Percutaneous Hepatic Perfusion (PHP) with Melphalan as a Treatment for Unresectable Metastases Confined to the Liver

1Department of Surgery, Leiden University Medical Centre, 2Department of Radiology, Leiden University Medical Centre, 3Department of Anesthesiology, Leiden University Medical Centre, 4Department of Extracorporeal Circulation, Leiden University Medical Centre, 5Department of Medical Oncology, Leiden University Medical Centre, 6Department of Surgery, Erasmus MC Cancer Institute

JoVE 53795


 Medicine

A Novel Method: Super-selective Adrenal Venous Sampling

1Department of Radiology, Nerima Hikarigaoka Hospital, 2Department of Uro-Oncology, Saitama Medical University International Medical Center, 3Endocrinology & Diabetes Center, Yokohama Rosai Hospital, 4Division of Endocrinology and Metabolism, Kanazawa University Graduate School of Medicine, 5Department of Medical Education, School of Medicine, California University of Science and Medicine, 6Department of Pathology, Saitama Medical University International Medical Center, 7Department of Radiology, Yokohama Rosai Hospital

JoVE 55716


 Medicine

Heterotopic Renal Autotransplantation in a Porcine Model: A Step-by-Step Protocol

1Multi Organ Transplant Program, Department of Surgery, Toronto General Hospital, 2Division of Nephrology, The Hospital for Sick Children, 3Programa de Doctorat en Medicina, La Universitat Autónoma de Barcelona, 4Laboratory Medicine and Pathobiology, Toronto General Hospital, 5Department of Medicine, Toronto General Hospital, 6Departments of Surgery (Urology) & Physiology, Developmental & Stem Cell Biology, The Hospital for Sick Children

JoVE 53765


 Medicine

Adult Mouse Venous Hypertension Model: Common Carotid Artery to External Jugular Vein Anastomosis.

1Department of Anesthesia and Perioperative Care and Center for Cerebrovascular Research, University of California, San Francisco, 2Department of Neurological Surgery, University of California, San Francisco, 3Department of Neurology, University of California, San Francisco

JoVE 50472


 Medicine

Visualization of Vascular and Parenchymal Regeneration after 70% Partial Hepatectomy in Normal Mice

1Department of General, Visceral and Vascular Surgery, Jena University Hospital, 2Experimental Molecular Imaging, RWTH Aachen University, 3Fraunhofer Institute for Medical Image Computing MEVIS, 4Institute of Pathology, Klinikum Chemnitz gGmbH

JoVE 53935


 Medicine

Continuous Manual Exchange Transfusion for Patients with Sickle Cell Disease: An Efficient Method to Avoid Iron Overload

1Reference Centre of Sickle Cell Disease, Hematology Unit, Robert Debré Hospital, AP-HP, 2School of Pharmacy, Université Paris Descartes, 3Etablissement Français du Sang, Robert Debré Hospital, AP-HP, 4Hematology Unit,, Robert Debré Hospital, AP-HP, Univsité Paris Diderot

JoVE 55172


 Medicine

Measuring Ascending Aortic Stiffness In Vivo in Mice Using Ultrasound

1Department of Biomedical Engineering, Johns Hopkins University, 2Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University, 3Department of Medicine (Cardiology), Johns Hopkins University, 4The Australian School of Advanced Medicine, Macquarie University

JoVE 52200


 Medicine

A Novel Murine Model of Arteriovenous Fistula Failure: The Surgical Procedure in Detail

1Department of Nephrology, Leiden University Medical Center, 2Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, 3Department of Surgery, Leiden University Medical Center, 4Division of Nephrology, University of Cincinnati

JoVE 53294


 Medicine

Cardiopulmonary Bypass in a Mouse Model: A Novel Approach

1Department of Cardiothoracic, Transplantation, and Vascular Surgery, Hannover Medical School, 2Department of Hematology, Oncology, Immunology, Rheumatology, and Pulmonology, University Hospital Tuebingen, 3Department of Pneumology, Hannover Medical School

JoVE 56017


 Medicine

Peripheral Vascular Exam Using a Continuous Wave Doppler

JoVE 10123

Source: Joseph Donroe, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT

Peripheral vascular disease (PVD) is a common condition affecting older adults and includes disease of the peripheral arteries and veins. While the history and physical exam offer clues to its diagnosis, Doppler ultrasound has become a routine part of the bedside vascular examination. The video titled "The Peripheral Vascular Exam" gave a detailed review of the physical examination of the peripheral arterial and venous systems. This video specifically reviews the bedside assessment of peripheral arterial disease (PAD) and chronic venous insufficiency using a handheld continuous wave Doppler. The handheld Doppler (HHD) is a simple instrument that utilizes continuous transmission and reception of ultrasound (also referred to as continuous wave Doppler) to detect changes in blood velocity as it courses through a vessel. The Doppler probe contains a transmitting element that emits ultrasound and a receiving element that detects ultrasound waves (Figure 1). The emitted ultrasound is reflected off of moving blood and back to the probe at a frequency directly related to the velocity of blood flow. The reflected signal is detected and transduced to an audible sound with a frequen


 Physical Examinations I

The Arteriovenous (AV) Loop in a Small Animal Model to Study Angiogenesis and Vascularized Tissue Engineering

1Department of Plastic and Hand Surgery and Laboratory for Tissue Engineering and Regenerative Medicine, University Hospital of Erlangen, Friedrich-Alexander University of Erlangen-Nürnberg (FAU), 2Genetic Engineering and Biotechnology Institute for Postgraduate Studies, Baghdad University, 3Department of Plastic, Hand and Microsurgery, Sana Klinikum Hof GmbH

JoVE 54676


 Bioengineering

Central Venous Catheter Insertion: Internal Jugular

JoVE 10237

Source: James W Bonz, MD, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA

Central venous access is necessary in a multitude of clinical situations, including vascular access, vasopressor and caustic medication delivery, central venous pressure monitoring, intravascular device delivery (pacing wires, Swann-Ganz catheters), volume resuscitation, total parental nutrition, hemodialysis, and frequent phlebotomy. Safe reliable placement of a central venous catheter (CVC) in the internal jugular (IJ) vein using ultrasound guidance has become the standard of care. It is therefore imperative to understand the anatomy, the relationship between the IJ and the carotid artery, and their appearance on ultrasound. It is also necessary to have the psychomotor skills of vessel cannulation under ultrasound guidance. Seldinger technique is an introduction of a device into the body over a guide wire, which is inserted through a thin-walled needle. In the case of CVC insertion, the device is an intravascular catheter and the target vessel is a central vein. First, the target vessel is cannulated with an 18 gauge thin-walled needle. A guide wire is then passed thought the needle until it is appropriately positioned within the vessel. The needle is removed,


 Emergency Medicine and Critical Care

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

1Department of Cardiology, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 2Department of Echocardiography, Shanghai Institute of Medical imaging, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University, 3Department of Cardiac surgery, Shanghai Institute of Cardiovascular Diseases, Zhongshan Hospital, Fudan University

Video Coming Soon

JoVE 56439


 JoVE In-Press

Isolated Hepatic Perfusion as a Treatment for Liver Metastases of Uveal Melanoma

1Department of Surgery, Institute of Clinical Sciences, 2Department of Thoracic Surgery, Institute of Clinical Sciences, 3Transplant Institute, Institute of Clinical Sciences, 4Sahlgrenska University Hospital, Sahlgrenska Academy at the University of Gothenburg

JoVE 52490


 Medicine

Procedure for Human Saphenous Veins Ex Vivo Perfusion and External Reinforcement

1Department of Surgery, Brigham and Women's Hospital/Harvard Medical School, 2Laboratory of Experimental Medicine, Department of Medicine, CHUV University Hospital, 3Department of Vascular Surgery, Pellegrin Hospital, University of Bordeaux, 4Department of Thoracic and Vascular Surgery, CHUV University Hospital

JoVE 52079


 Medicine

Peripheral Vascular Exam

JoVE 10122

Source: Joseph Donroe, MD, Internal Medicine and Pediatrics, Yale School of Medicine, New Haven, CT

The prevalence of peripheral vascular disease (PVD) increases with age and is a significant cause of morbidity in older patients, and peripheral artery disease (PAD) is associated with cardiovascular and cerebrovascular complications. Diabetes, hyperlipidemia, hypertension, and tobacco use are important disease risk factors. When patients become symptomatic, they frequently complain of limb claudication, defined as a cramp-like muscle pain that worsens with activity and improves with rest. Patients with chronic venous insufficiency (CVI) often present with lower extremity swelling, pain, skin changes, and ulceration. While the benefits of screening asymptomatic patients for PVD are unclear, physicians should know the proper exam technique when the diagnosis of PVD is being considered. This video reviews the vascular examination of the upper and lower extremities and abdomen. As always, the examiner should use a systematic method of examination, though in practice, the extent of the exam a physician performs depends on their suspicion of underlying PVD. In a patient who has or is suspected to have risk factors for vascular disease, the vascular exam should be thorough, beginning with inspection, fo


 Physical Examinations I

Determination of the Transport Rate of Xenobiotics and Nanomaterials Across the Placenta using the ex vivo Human Placental Perfusion Model

1Department of Obstetrics, Perinatal Pharmacology, University Hospital Zurich, 2Laboratory for Materials - Biology Interactions, EMPA Swiss Federal Laboratories for Materials Testing and Research, 3Graduate School for Cellular and Biomedical Sciences, University of Bern

JoVE 50401


 Bioengineering

Central Venous Catheter Insertion: Femoral Vein

JoVE 10240

Source: James W Bonz, MD, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA

Central venous access is necessary in a multitude of clinical situations, including vascular access, vasopressor and caustic medication delivery, central venous pressure monitoring, volume resuscitation, total parental nutrition, hemodialysis, and frequent phlebotomy. There are three veins in the body that are accessed for central venous cannulation: the internal jugular, the subclavian, and the femoral. Each of these vessels has distinct advantages and disadvantages with unique anatomical considerations. Femoral vein cannulation can be easily performed both under ultrasound guidance and using the surface landmarks; therefore, femoral access is often used when emergent placement of a central venous catheter (CVC) is needed (such as in the case of medical codes and trauma resuscitations). In addition, cannulation of the femoral artery allows one to simultaneously perform other procedures needed for stabilization, such as cardiopulmonary resuscitation (CPR) and intubation. Successful placement of a femoral CVC requires working understanding of the target anatomy, access to with procedural ultrasound, and fluidity in the Seldinger technique. Seld


 Emergency Medicine and Critical Care

Ex Situ Normothermic Machine Perfusion of Donor Livers

1Section of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, University of Groningen, University Medical Center Groningen, 2Surgical Research Laboratory, Department of Surgery, University of Groningen, University Medical Center Groningen, 3Center of Engineering in Medicine/Surgical Services, Massachusetts General Hospital, Harvard Medical School, and Shriners Burns Hospital, 4Division of Transplantation, Department of Surgery, Massachusetts General Hospital, Harvard Medical School

JoVE 52688


 Medicine

Intraluminal Drug Delivery to the Mouse Arteriovenous Fistula Endothelium

1Department of Surgery and the Vascular Biology and Therapeutics Program, Yale University, 2Department of Vascular Surgery, University of Tokyo, 3Department of Vascular Surgery, VA Connecticut Healthcare Systems, 4Department of Vascular Surgery, International University of Health and Welfare Mita Hospital

JoVE 53905


 Medicine

A Model to Simulate Clinically Relevant Hypoxia in Humans

1Department of Anaesthesiology and Intensive Care Medicine, University Hospital of Bonn, 2Institute of Clinical Chemistry and Clinical Pharmacology, University of Bonn, 3Institute for Terrestrial and Aquatic Wildlife Research, University of Veterinary Medicine Hannover, 4Institute of Physiology 2, University of Bonn

JoVE 54933


 Medicine

Central Venous Catheter Insertion: Subclavian Vein

JoVE 10241

Source: James W Bonz, MD, Emergency Medicine, Yale School of Medicine, New Haven, Connecticut, USA

Central venous access is necessary in a multitude of clinical situations for hemodynamic monitoring, medication delivery, and blood sampling. There are three veins in the body that are accessed for central venous cannulation: the internal jugular, the subclavian, and the femoral vein. Central venous access via the subclavian vein has several advantages over other possible locations. The subclavian central venous catheter (CVC) placement is associated with lower infection and thrombosis rate than internal jugular and femoral CVC. Subclavian line can be placed quickly using anatomic landmarks and are often performed in trauma settings when cervical collars obliterate the access to the internal jugular (IJ) vein. The most significant disadvantage of the subclavian access is the risk of pneumothorax due to the anatomic proximity to the dome of the lung, which lies just superficial to the subclavian vein. In addition, in the event of an inadvertent arterial puncture, the access to the subclavian artery is impeded by the clavicle, which makes it difficult to effectively compress the vessel. Successful placement of the subclavian CVC requires good working understanding of the tar


 Emergency Medicine and Critical Care

Patch Angioplasty in the Rat Aorta or Inferior Vena Cava

1Department of Surgery, Yale University, 2Vascular Biology and Therapeutics Program, Yale University, 3Department of Vascular Surgery, First Affiliated Hospital of Zhengzhou University, 4Basic Medical College of Zhengzhou University, 5VA Connecticut Healthcare Systems, West Haven, CT, 6Department of Vascular Surgery, Xiangya Second Hospital of Central South University, Changsha, China

JoVE 55253


 Medicine

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