government site. Long-term bladder drainage: Suprapubic catheter versus other methods: a scoping review. Anchor with POD400 and pack with PAC400 to optimize effectiveness. For each catheter setup, four experienced neurointerventionalists (each with >10 years' experience as an independent operator) performed three attempts at delivering the aspiration catheter from the sheath to the proximal M1 segment of the middle cerebral artery under fluoroscopy and roadmap-guidance. As part of the Penumbra System, the Reperfusion Catheters and Separators are indicated for use in the revascularization of patients with acute ischemic stroke secondary to intracranial large vessel occlusive disease (within the internal carotid, middle cerebral M1 and M2 segments, basilar, and vertebral arteries) within 8 hours of symptom onset. Penumbras ACEReperfusion Catheters (ACE68 and ACE60) are intended for use in the revascularization of patients with acute ischemic stroke secondary to large vessel occlusion. The .gov means its official. The Penumbra JET D is designed to navigate smaller, distal vessels and extract clot efficiently with the power of the Penumbra ENGINE aspiration source. Nurs Stand. The ACE catheter design further increases the distal and proximal lumen sizes, providing optimal trackability and even greater aspiration power. Care of patients undergoing removal of an indwelling urinary catheter. I could not be more excited to be part of the team advancing this effort., MIVI names Dr. Waleed Brinjikji as medical director, WLNC Highlights Q Catheter Compatibility in Simulated Robotic Thrombectomy, MIVI Neuroscience, Inc. 6545 City West Parkway Eden Prairie, MN USA 55344, info@mivineuro.com customerservice@mivineuro.com. Do not use kinked or damaged devices. With an updated browser, you will have a better Medtronic website experience. Do not use the Penumbra System with a pump other than the Penumbra Aspiration Pump. Inspira aspiration catheters are designed to access the targeted vessels to restore cerebral blood flow and retrieve clots in patients experiencing acute ischemic stroke (AIS) due to a large vessel occlusion (LVO) Infinity aspiration catheters approved in EU. ACE68 Reperfusion Catheter Large .068 (1.73 mm) inner lumen designed to optimize clot extraction from proximal large vessels Extended flexible distal shaft enhances tracking through tortuosity 16 transition zones enable 1:1 force transmission 132 cm length Unique coil winding geometry and new proximal polymer segment maximize pushability Learn how Route 92 Medical is overcoming these limitations with advanced products and an innovative approach. The Q Aspiration Catheter is indicated for use in the removal of fresh, soft emboli and thrombi in the peripheral and neurovascular systems. The NeuronTMGuide catheter (Penumbra, Inc. Alameda, CA, USA) was placed distally at the carotid siphon to obtain maximum support for use of the mechanical stroke devices. Administration of anticoagulants and antiplatelets should be suspended until 24 hours post-treatment. We hypothesized that labeled catheter inner diameter (labeled-ID) is not the only parameter . Learn more Excelsior 1018 Microcatheters Proven performance The Excelsior 1018 Microcatheter incorporates thin-wall technology and a supportive distal shaft designed to provide high performance. Penumbra Aspiration Tubing View our full product portfolio, find news and education events, access reimbursement support, and more. Contact us Avigo Hydrophilic Guidewire The workhorse Providing smooth tracking, stable delivery and a versatile platform, the Excelsior XT-17 Microcatheter is designed to be your go-to microcatheter. Avigo hydrophilic guidewire provides support for tracking, crossing, and maintaining catheter stability. Prior to use, please refer to the Instructions for Use for complete product indications, contraindications, warnings, precautions, potential adverse events, and detailed instructions for use. The Apollo Onyx delivery microcatheter was expressly designed to access the neuro vasculature for the controlled selective infusion of the Onyx liquid embolic system (LES).1, The Marathon flow directed microcatheter was designed for the infusion of therapeutic agents such as embolization materials.2. Official Wechat, 2022 Wallaby Medical. It will reduce service life of the Penumbra ENGINE. Marksman microcatheter solution features astainless-steel braid design and a long length for symbiotic use with distal access catheters. Penumbras second generation device, Artemis Neuro Evacuation Device, is specifically designed for the controlled evacuation of fluids and tissues from the Ventricular System and Cerebrum. The safety and performance of the Q Catheter was assessed using a direct aspiration first pass technique in patients with acute ischemic stroke at four neurointerventional centers in Spain. Adams, et al., Guidelines for the Early Management of Adults with Ischemic Stroke: A Guideline from the AHA/ASA Stroke Council, Clinical Cardiology Council, Cardiovascular Radiology and Intervention Council, and the Atherosclerotic Peripheral Vascular Disease and Quality of Care Outcomes in Research Interdisciplinary Working Groups: The American Academy of Neurology affirms the value of this guideline as an educational tool for neurologists, Stroke May 2007; 38:1655-1711. Access & Delivery Products, Designed for the unique demands of accessing the neurovasculature thorugh the radial pathway, providing radial-specific transition zones, ideal lumen diameter, and the range of lengths required for optimal device delivery to target vessel.6,7. Use of this equipment adjacent to or stacked with other equipment should be avoided because it could result in improper operation. The Penumbra ENGINE is indicated as a vacuum source for the Penumbra Aspiration Systems. Wallaby Medical Holding, Inc. ("Wallaby") is a global innovative medical technology company focused on developing and commercializing neurovascular interventional products for treating stroke. MIVI High Flow Tubing HFT 110 is to be used in conjunction with commercially available aspiration pumps and aspiration catheters to aspirate . Neurological Cello balloon guide catheter is intended to block blood flow inside the vessel during operations. 2013 Sep;32(7):944-51. doi: 10.1002/nau.22356. Stryker manufactures the AXS Infinity LS Long Sheath (0.088in ID / 8F OD) and the new AXS Infinity LS Plus Long Sheath (0.091in ID / 8F OD) DFU excerpt See package insert for complete indications, complications, warnings, and instructions for use. Infinity Neuro announced today that its Inspira aspiration catheters have received CE-mark approval and are now commercially available in Europe.. vs. SOFIA* Plus, Zoom* 71, RED* 72 and Vecta* 71. MIVIs commitment to delivering breakthrough distal stroke products backed by science is unwavering. Penumbra has combined advanced engineering with features of current 10-System coils to create SMART COIL, an embolization system designed to simplify complex cases. Contraindications JNP has received honoraria from Novartis, Coloplast and Wellspect. The FreeClimb 70 and FreeClimb 88 catheter systems are. Design and Optimization of Urinary Real-Time Nursing Model Based on Medical Internet of Things. Limited by federal (or United States) law to investigational use. BMJ Case Rep. 2015, 2015:011782. Commonly utilized aspiration catheters in neuro-interventional procedures for cerebral venous sinus thrombosis (CVST) are the AngioJet device, clot retraction with Penumbra System, balloon venoplasty with . 13 products Infusion Aspiration Needles 6 products Intravascular Lithotripsy 2 products Intravascular Ultrasound 9 products Invasive Hemodynamic Management Systems 1 product Manifolds 8 products Mechanical Thrombectomy (Neurovascular) 13 products Mechanical Thrombectomy/Thrombolysis (Peripheral/Venous) 48 products Medical Device Retention Tools eCollection 2022. Background We describe the first-in-human experience using the Route 92 Medical Aspiration System to perform thrombectomy in the initial 45 consecutive stroke patients enrolled in the SUMMIT NZ trial. The Penumbra System should only be used by physicians who have received appropriate training in interventional neuro-endovascular techniques and treatment of acute ischemic stroke. Penumbra offers access devices specifically designed to facilitate the treatment of a wide range of conditions, including disorders in the most challenging neurovasculature. The site is secure. The commercial launch of Inspira aspiration catheters in Europe is currently underway in collaboration with an EU distributors network. Common emitters (such as RFID emitters, security systems, diathermy equipment, and portable transmitters) should not be used in close proximity to the Penumbra ENGINE as they can interfere with and result in degradation of the performance of the equipment. Avigo hydrophilic guidewire provides support fortracking, crossing and maintaining catheter stability. We also discuss alternatives to catheterisation, such as non-invasive containment products and surgical treatments, and the indications for urological referral. Federal government websites often end in .gov or .mil. Penumbra Reperfusion Catheters and Separators The Q Aspiration Catheter* is uniquely designed to deliver up to 2x greater flow rates to maximize clot removal in even the most challenging vessels. Reactcatheter features an unique COil + BRAid design that provides the perfect balance between navigability and durability. Remove and service the Penumbra ENGINE if liquids or solids have been drawn into the Penumbra ENGINE. *Investigational Use Only. Patients who are ineligible for intravenous tissue plasminogen activator (IV t-PA) or who fail IV t-PA therapy are candidates for treatment. Our team is happy to help answer any questions you may have. Refer to the Reperfusion Catheter labeling for dimensional information. All Rights Reserved |. thrombectomy; catheter; device; We read with great interest the recent paper by Li et al, which concluded that the tip of an aspiration catheter can expand to 115-125% of its original inner diameter (ID) when corked by a clot analog, creating an 'aspiration force' 61-99% higher than the theoretical value based on the labelled ID.1 We want to congratulate the authors on this novel . Proven performance The Excelsior 1018 Microcatheter incorporates thin-wall technology and a supportive distal shaft designed to provide high performance. Background A direct aspiration first pass thrombectomy (ADAPT) is a fast-growing technique for which a broad catalog of catheters that provide a wide range of aspiration forces can be used. Return all damaged devices and packaging to the manufacturer/distributor. Penumbra 3D Revascularization Device Privacy Statement The Q Aspiration Catheter* is uniquely designed to deliver up to 2x greater flow rates to maximize clot removal in even the most challenging vessels. Unrestrained torquing or forced insertion of the catheter, revascularization device, or separator against resistance may result in damage to the device or vessel. sharing sensitive information, make sure youre on a federal *In the United States, the Q Aspiration Catheter is for Investigational Use Only and is not for sale. Penumbra ENGINE Indication For Use 2015 Dec 10;2015(12):CD004203. For more information on the personal data that is collected by this website, please refer to Penumbras Privacy Notice. Possible complications include, but are not limited to, the following: Recent data reveal that current approaches to neurointervention are moderately effective and have limitations: Large-bore catheters are often not able to navigate through tortuous curves and past vessel origins1, Conventional devices can take too long to reach a target location, Current technologies have high rates of failure in reaching the target location, Clinicians often must create work-arounds to make devices from different companies work together. Do you need support for procedures? The means of mains disconnect is to remove the power cord. Cochrane Database Syst Rev. Do not position the Penumbra ENGINE so that it is difficult to remove the power cord. Accessibility Neurologists should therefore be aware of the different types of catheters and appliances and their risks, benefits and complications. [1] In: SNIS 19th annual meeting oral poster abstracts; 2022 JUL 2529; Toronto, Ontario, Canada: SNIS; 2022, 3. Products ORYON has been carefully engineered to reach the deep into the brain where blood clots become lodged. vs. SOFIA* Plus, Zoom* 71, RED* 72 and Vecta* 71. The device is intended for single use only. Neurourol Urodyn. Superior access for accurate deployment Introducing the most advanced 0.027in ID microcatheter for delivery of interventional devices, Advanced design for access Featuring Synchro Guidewire technology designed to enhance proximal torque transmission through its microfabricated outer structure. Do not use in arteries with diameters smaller or equal to the distal outer diameter of the Penumbra Reperfusion Catheters. Navien intracranial support catheter features a unique and sturdy design allowing device and microcatheter manipulation when using different device combinations. Do not resterilize or reuse. Bunegin, et. CAUTION: Investigational device. This website is intended for US audience only. Healthcare Professionals If such use is necessary, this equipment and the other equipment should be observed to verify that they are operating normally. 6,7 Contact us Navien Intracranial Support Catheter Our sole mission at MIVI is to expand the boundaries of whats possible in stroke treatment, by equipping physicians with the advanced tools they need to continually improve outcomes, even in the most challenging cases. Learn More *In the United States, the Q Aspiration Catheter is for Investigational Use Only and is not for sale. Navien A+ intracrancial support catheter is designed for versatile and controlled device delivery, minimalovalization and optimal support. The latest generation of the Penumbra System features the Penumbra RED Reperfusion Catheters (RED 62, RED 68 and RED 72). 10.1136/bcr-2015-011782 The latest generation of the Penumbra System features the Penumbra REDReperfusion Catheters (RED 62, RED 68 and RED 72). Do not advance, retract or use any component of the Penumbra System against resistance without careful assessment of the cause using fluoroscopy. Combined with image-guided techniques, the most advanced devices like aspiration catheters, cerebral coils etc. Phase 1 of new Shanghai Xingchuang Park facility completed, Avenir Coil System obtained NMPA registration approval and was listed in the Innovative Medical Device Product List, China, 2022 Wallaby Medical. These innovative devices are designed to address additional clinical challenges specific to the neurovascaulture. ward tendency in the use of larger-bore aspiration catheters. It was introduced by Hans Karl Wendl [ de] in 1958. He has received royalty for book editing from Cambridge University Press. The catheter is introduced through a guide catheter or sheath and into the intracranial vasculature and guided over a neurovascular guidewire and/or microcatheter to the site of the primary occlusion. Available in different sizes, Phenom can support various product deliveries for Neurovascular procedures. Echelon microcatheter solutions for aneurysm treatment features a strong nitinol design for confident and stable delivery of coils when minimal paint-brushing effect is desired. The FreeClimb 70 and FreeClimb 88 catheter systems are advanced neurointervention systemsdesigned to provide superior performanceeven in the most tortuous anatomy. Patients with neurological disorders often have lower urinary tract dysfunction, manifesting as urinary retention or urinary incontinence, and so commonly use catheters. Mi-R4Q Competitive Comparison Catheter Distal ID Proximal ID Flow Rate (ml/s) Mi-R4Q70 0.070" 0.090" 5.39 Penumbra ACE68 0.068" 0.068" 4.27 Sophia Plus 0.070" 0.070 . Epub 2020 Sep 28. The Inspira aspiration catheters are physician inspired to deliver next-level navigation and aspiration performance; designed to access targeted vessels easily, quickly restore cerebral. Before Whether youre looking for procedural support, or additional information on our products and solutions our team is here to help. Published by BMJ. Reuse may result in canister cracking or vacuum filter blockages, which may result in the inability to aspirate. 8600 Rockville Pike ORYON is unique in that the inner diameter of the . It may also be used as a diagnostic angiographic catheter. Flow Rate of the Q Catheter vs the competition1. suction in small vessels . Our commercialized product portfolio includes the Avenir Coil System, a technically differentiated neuro embolic coil system for treating intracranial aneurysms and other neurovascular abnormalities, the Esperance Aspiration Catheters for use in the revascularization of patients with acute ischemic stroke, and the Esperance Distal Access Catheter for general intravascular usage including neuro. Epub 2020 Oct 19. al., found that maximal air aspiration from a . The Riptideaspiration system is designed to effectively restore blood flow via continuous aspiration in neurovascular procedures. Potential Adverse Events Do not use petroleum base compounds, acids, caustics, or chlorinated solvents to clean or lubricate any parts. Warnings/Precautions All efforts should be taken to maintain a patient's airway via non-invasive methodology unless indications for invasive airway management are apparent. MIVI Neuroscience, Inc. 6545 City West Parkway Eden Prairie, MN USA 55344, info@mivineuro.com customerservice@mivineuro.com, The innovative Q Catheter delivers unprecedented aspiration by increasing the systems average diameter and extending the powerful aspiration flow from the guide catheter to the Q catheter tip, even in the smallest vessels. Medical management and acute post stroke care should follow the ASA guidelines.1 Any neurological deterioration should be evaluated by urgent CT scan and other evaluations as indicated according to investigator/hospital best practice. For more information on the personal data that is collected by this website, please refer to Penumbras Privacy Notice. CH has received an honoraria from Coloplast and Wellspect. Home Along blood vessels, this catheter is able to reach lesions. PC400 System has incorporated the latest SMART COIL innovations resulting in a new range of large volume coils, specifically designed for large and giant aneurysms, fistulas, and vessel sacrifice. Disclaimer. As in all fluoroscopy procedures, consider all necessary precautions to limit patient radiation exposure by using sufficient shielding, reducing fluoroscopy times and modifying radiation technical factors whenever possible. Indication for Use If the cause cannot be determined, withdraw the device or system as a unit. POD400 and PAC400 devices are designed for predictable, precise vessel occlusion. Methods We included adult patients who . Use prior to the Use By date. The SUMMIT MAX trial is currently underway to evaluate the safety and efficacy of the Monopoint Reperfusion System. Established options for access Transend Guidewires offer proven control and responsiveness. The Penumbra System is a fully-integrated system designed specifically for mechanical thrombectomy, first receiving 510(k) clearance by the FDA in December 2007. Artemis is a minimally invasive surgical tool that utilizes Pump MAX for powerfuland controlled hematoma evacuation. Update my browser now, Nitinol coil transitions to a stainless steel cross coil, Scout Introducer,2x peel-away introducer,Short Tuohy Borst, 115cm AXS Vecta 71 Aspiration Catheter + Scout Introducer, 125cm AXS Vecta 71 Aspiration Catheter + Scout Introducer, 132cm AXS Vecta 71 Aspiration Catheter + Scout Introducer. 2020 Nov 4;35(11):37-42. doi: 10.7748/ns.2020.e11599. MIVI collaborates closely with neurointerventional specialists to develop solutions for pressing needs in stroke treatment that have been historically difficult to address. Do not use automated high-pressure contrast injection equipment with the Penumbra Reperfusion Catheter because it may damage the device. Every case is different, and the RED family of catheter provides a full range of products that are designed to optimize lumen size and trackability for the situation. Success accelerated The CAT 6 Distal Access Catheter is designed for fast access and rapid revascularization with Trevo XP Retriever. As in all surgical interventions, monitoring of intra-procedural blood loss is recommended so that appropriate management may be instituted. See rights and permissions. Managing complications associated with the use of indwelling urinary catheters. Bethesda, MD 20894, Web Policies neurogenic bladder. The Penumbra Aspiration Pump is indicated as a vacuum source for Penumbra Aspiration Systems. Dr. Lee A. Balaklaw raised a valid concern about positioning a catheter in the right atrium for the purposes of air aspiration since & September 1989 guidelines (APSF Newsletter 4:28, 1989) on central venous catheter safety noted that the catheter tip should not be placed in the heart. With an updated browser, you will have a better Medtronic website experience. The PubMed wordmark and PubMed logo are registered trademarks of the U.S. Department of Health and Human Services (HHS). Unable to load your collection due to an error, Unable to load your delegates due to an error. Refining Access Introducing the Monopoint Reperfusion System Established in 2015, we currently have over 250 employees located in Laguna Hills, California and Shanghai, China. 1. As part of the Penumbra System, the Penumbra Sterile Aspiration Tubing is indicated to connect the Penumbra Reperfusion Catheters to the Penumbra Aspiration Pump. This short, self-published book would be a good resource for training new nurses in the care of cardiology patients anywhere along the continuum. Cochrane Database Syst Rev. Resterilization and/or Reuse may result in ineffective catheter coating lubrication, which may result in high friction and the inability to access the target neuro vasculature location. While this study demonstrates differences in tip force and flow rate of different commercially available catheters, cli The Penumbra JET D Reperfusion Catheter is intended for use in the revascularization of patients with acute ischemic stroke secondary to large vessel occlusion. Medtronic Operational Headquarters 710 Medtronic Parkway Minneapolis, MN 55432-5640 USA, Central/Eastern Europe, Middle East & Africa, Electromagnetic Compatibility Guide for Cardiac Devices, Arteriovenous Malformations Embolization Products, Electromagnetic Compatibility for Cardiac Devices, California Transparency in Supply Chains Act, Information About Proposition 65 for California Customers, Digital Millennium Copyright Act (DMCA) Notification. Remollo, S., Terceno, M., Werner, M. et al. Home Otherwise, this could result in degradation of the performance of this equipment. Clean intermittent self-catheterisation is preferable to an indwelling catheter; however, if this is not possible, then a suprapubic indwelling catheter is preferable to a urethral catheter for long-term management. It is intended for use in the revascularization of patients with acute ischemic stroke secondary to intracranial large vessel occlusions. The 10.8cm nitinol coil distal flex zone combined with a highly supportive proximal shaft for pushability leads to the smooth tracking design. Climb with confidence AXS Infinity LS Long Sheath is the next-generation neurovascular sheath designed for rapid access and excellent support. No commercial re-use. REACT 68 and REACT 71 (Medtronic, Minneapolis, MN, USA) are large-bore aspiration catheters that feature a PTFE liner, nitinol reinforcement with a hybrid configuration combined coil and braid, flexible polymer jacket, and hydrophilic coat-ing on the devices' distal end. doi: 10.1002/14651858.CD004203.pub3. Excessive aspiration or failure to close the Penumbra Aspiration Tubing valve when aspiration is complete is not recommended. Warnings Do not use open or damaged packages. Do not reuse. Indications, Safety, and Warnings. Enter your email address and we will contact you. Inability to draw back on aspiration conrms the optimal position of the aspiration catheter abutting the thrombus. Confirm vessel diameter, and select an appropriate size Penumbra Reperfusion Catheter. Monteiro A, Makalanda L, Wareham J, et al. Caution: Federal (USA) law restricts this device to sale by or on the order of a physician. Kidd EA, Stewart F, Kassis NC, Hom E, Omar MI. As part of the Penumbra System, the Penumbra 3D Revascularization Device is indicated for use in the revascularization of patients with acute ischemic stroke secondary to intracranial large vessel occlusive disease (within the internal carotid, middle cerebral M1 and M2 segments) within 8 hours of symptom onset. We review the decision-making process when selecting catheters for neurological patients, the evidence base regarding the different options and how neurologists can recognise and address complications. Proven performance The Excelsior SL-10 Microcatheter with thin-wall technology and lubricious Hydrolene outer surface is designed to provide versatility in performance. Unauthorized use of these marks is strictly prohibited. Methods The SUMMIT NZ trial is a prospective . Unit may overheat and shut off or fail to restart if run for extended periods without airflow. ACE68 is designed to easily navigate tortuous vessels to facilitate extraction of clot quickly and reliably through its large .068 (1.73 mm) inner lumen with the deep vacuum power of the Penumbra ENGINE aspiration source. Do not use in an oxygen rich environment. Or information on our products and solutions? If repositioning of the Penumbra Reperfusion Catheter is necessary during the revascularization procedure, such repositioning should be performed over an appropriate neurovascular guidewire using standard microcatheter and guidewire techniques. To avoid risk of electrical shock, this equipment must only be connected to a supply mains with protective earth. MIVI High Flow Tubing HFT 110 is to be used in conjunction with commercially available aspiration pumps and aspiration catheters to aspirate, remove, or sample body fluids. (Uploaded on November 14, 2018. Learn more We market our products in over 60 countries and regions around the world, including the U.S., China, Europe and Japan. Solitaire X is a new generation revascularization device with a unique parametric design, featuring an overlapping technology, providing physicians with improved delivery performance, effective clot retention and faster flow restoration timelines, designed to be deployed with a lower microcatheter profile, to provide expanded ease of delivery. AIS Revascularization Products. Do not block bottom or back air vents. PMC Epub 2012 Nov 28. Use the Penumbra System in conjunction with fluoroscopic visualization. Combined Approach to Stroke Thrombectomy Using a Novel Short Flexible Aspiration Catheter with a Stent Retriever. Our portfolio takes aim at unmet neurointervention needs to deliver more meaningful solutions. Patients who are ineligible for intravenous tissue plasminogen activator (IV t-PA) or who fail IV t-PA therapy are candidates for treatment. Nurs Stand. Update my browser now. 2004;(1):CD004013. Methods The 6F R4Q aspiration catheter system comprises a proximal . (Credit: jesse orrico on Unsplash) Update my browser now. Heart Attack, Cardiac Cath, and Bypass provides the "what happens next" scenario beyond what we normally teach when addressing specific health care problems or diagnoses. The catheter is connected to the Riptide Aspiration Pump through the aspiration tubing. He has no disclosures related to this work. An official website of the United States government. AXS Infinity LS Long Sheath is the next-generation neurovascular sheath designed for rapid access and excellent support. The common surgical aneurysm treatment was open surgery to the skull (craniotomy) where a clip device is placed to stop blood flow in the affected blood vessel to assist to prevent rupture. ), Update your browser to view this website correctly. This perspective helps new nurses understand what they can anticipate and . doi: 10.1002/14651858.CD004013.pub2. Available in 3F (Q3), 4F (Q4), 5F (Q5), 6F (Q6). Competing interests: SM has received an educational grant from Medtronic. Equipment is not safe for MR use. allergic reaction and anaphylaxis from contrast media; acute occlusion; air embolism; arteriovenous fistula; death; device malfunction; distal embolization; emboli; false aneurysm formation; hematoma or hemorrhage at access site; inability to completely remove thrombus; infection; intracranial hemorrhage; ischemia; kidney damage from contrast media; neurological deficits including stroke; vessel spasm, thrombosis, dissection, or perforation; radiation exposure that may lead to cataracts, skin reddening, burns, alopecia, or neoplasia from x-ray exposure.
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