Validation of tracheal intubation of wire-reinforced endotracheal tube with ultrasonography

Objective. Te use of ultrasonography (US) is a new method for verifying the location of the endotracheal tube. Design. Our study was designed as a paired-data and investigator-blind clinical study for evaluating the efectiveness of US for verifcation of wire-reinforced endotracheal tube (WR-ETT) placement compared with capnography. Setting. Tis study was conducted on 56 patients scheduled for elective surgery under general anesthesia. Patients. Fify patients completed the study as 6 were excluded for various reasons. Intervention. Two diferent investigators performed the ultrasonography and intubation independently from one another. While investigator 1 attempted to verify the location of the WR-ETT with a portable ultrasonography with sagittal trans-tracheal view, investigator 2 intubated the patient and verifed the location of the ETT using capnography. Measurements. Time for verifying the location of the ETT using both US and capnography was recorded. Main Results. When the ultrasonography method was compared with capnography for verifcation of the WR-ETT placement, the results showed 95.75% sensitivity and 100% specifcity. Te average verifcation times for endotracheal intubation were 12.78 ± 7.46 s. and 24.44 ± 1.45 s. with US and capnography, respectively (p=0.003). Conclusion. Our results suggest that ultrasound identifcation of a WR-ETT within the trachea is a rapid and accurate method for confrmation of tracheal placement. Larger studies are needed before widespread use of this technique

Treatment outcomes of mosaicplasty followed by postoperative hyaluronic acid injection in patients with osteochondritis dissecans (OCD) of the knee

Aim: Mosaicplasty is a common surgical technique performed in patients with osteochondritis dissecans (OCD) of the knee. In the present study, we aimed to investigate the effectivity of mosaicplasty followed by intraarticular hyaluronic acid (HA) injection on the functional outcomes of the knee joint in patients with osteochondral lesions of the knee. Methods: The retrospective study included 41 patients (32 men and 9 women) that underwent mosaicplasty due to the detection of an OCD lesion larger than 1 cm2 on magnetic resonance imaging (MRI). The patients were randomly divided into HA (n=22) and control (n=19) groups. The HA group received 2 ml of HA injection at two weeks after surgery and the control group received no additional treatment. At postoperative months 6 and 12, functional outcomes of the patients were graded using the Lysholm knee score and pain intensity was assessed using Visual Analog Scale (VAS) in both groups. Results: The HA group included 22 (53.7%) and the control group included 19(46.3%) patients. The mean age was 31.5 in the HA group and 31.47 years in the control group. The Lysholm scores at postoperative months 6 and 12 were significantly higher in the HA group compared to the control group (p<0.01). Similarly, the VAS scores at postoperative months 6 and 12 were significantly higher in the HA group compared to the control group (p<0.01). Conclusion: The administration of mosaicplasty followed by instant intraarticular HA injection led to better clinical outcomes and less postoperative pai

Comparison of endotracheal intubation successes with macintosh, glidescope and airtraq laryngoscopes

Amaç: Başarılı hava yolu yönetimi, anestezi uygulamalarında hasta güvenliğinde gerekli birincil ve en önemli adımdır. Son yıllarda ventilasyon ve entübasyon için kullanılan malzemelerin çeşitliliğinin artmasından dolayı zor hava yolu yönetiminde daha avantajlı duruma gelinmiştir. Glidescope ve Airtraq laringoskoplar da bu amaçla geliştirilmiş alternatif laringoskopi cihazlarıdır. Bu prospektif, randomize, klinik çalışmamızda Macintosh, Glidescope ve Airtraq laringoskoplar ile gerçekleştirilen endotrakeal entübasyon başarısını; Cormack-Lehane laringoskopik sınıflaması, entübasyon süresi, deneme sayısı, entübasyon için ihtiyaç duyulan kolaylaştırıcı manevra kullanımı yönünden birbirlerine olan üstünlüklerini karşılaştırmayı amaçladık. Yöntem: Çalışmaya elektif cerrahi uygulanacak, 18 yaşından büyük, ASA I-II fizyolojik risk grubundaki 180 hasta dahil edildi. Hastalar rastgele üç gruba ayrıldı. Grup-A’ da Macintosh laringoskopla, Grup-B’de Glidescope laringoskopla ve Grup-C’de Airtraq laringoskopla entübe edilen hastaların Cormack-Lehane laringoskopik sınıflaması, entübasyon süresi, entübasyon deneme sayısı, entübasyon için ihtiyaç duyulan kolaylaştırıcı manevralar ve entübasyona ait komplikasyonlar kaydedildi ve karşılaştırıldı. Bulgular: Demografik veriler gruplar arasında benzer bulundu. Glidescop ve Airtraq laringoskop gruplarının Cormack Lehane laringoskopik skoru, entübasyon süreleri, deneme sayıları ve kolaylaştırıcı manevra kullanımı parametreleri benzer olup Macintosh grubundan üstündü. Grupların entübasyon başarı oranları ve entübasyona bağlı komplikasyonlar açısından, Glidescope ve Airtraq laringoskopi grupları ile Macintosh laringoskopi grubu ile sıklığı benzerdi. Sonuç: Çalışmamızın sonucunda Glidescope ve Airtraq laringoskoplarının Macintosh laringoskopa kıyasla daha iyi glotis görüntüsü sağladığı ve entübasyonu kolaylaştırdığı kanısına vardık. Bununla birlikte gruplar arasında entübasyon başarı oranlarında ve komplikasyon sıklıklarında ise farklılık tespit etmedik.Objective: Successful airway management is the primary and most crucial step required for patient safety in anesthetic application. Due to the increase in the variety of materials used for ventilation and intubation in recent years, successful airway management has become more advantageous in difficult airway management. The development of Glidescope and Airtraq laryngoscopes are used as alternative laryngoscopy devices. The aim of the present prospective randomized study is to compare superiority of the success of endotracheal intubation performed with Macintosh, Glidescope and Airtraq laryngoscopes in terms of Cormack-Lehane laryngoscopic classification, intubation duration, number of attempts, and use of facilitating maneuvers required for intubation. Methods: Totally 180 patients over 18 years of age, in ASA I-II physiological risk group, who would undergo elective surgery were included in the study. The patients were randomly divided into three groups. Cormack-Lehane laryngoscopic classification, intubation duration, number of intubation attempts, facilitating maneuvers required for intubation, and complications related to intubation were recorded and compared in patients who were intubated with Macintosh laryngoscope in Group-A, Glidescope laryngoscope in Group-B, and Airtraq laryngoscope in Group-C. Results: It was found that demographic data were similar between groups. Cormack-Lehane laryngoscopic score, intubation duration, number of attempts and use of facilitating maneuver parameters of the Glidescope and Airtraq laryngoscope groups were similar and superior to the Macintosh group. In terms of intubation success rates and complications related to intubation, the frequency of the Macintosh laryngoscope group was similar to the Glidescope and Airtraq laryngoscope groups. Conclusion: According to the result of the study, it was concluded that Glidescope and Airtraq laryngoscopes provide a better view of glotis and ease intubation compared to Macintosh laryngoscope. However, we did not find any difference in intubation success and complication rates between the groups

Çin Halk Cumhuriyeti’nde Sovyet Revizyonizmi’ne Karşı Kitapların Propaganda Amaçlı Kullanımı

Objective: The conversion of the alphabet letters of a language to another alphabet letters and the transfer of a work or text to another language are achieved by translation systems. In this study, it is aimed to address the problems encountered during translation. Method: The issue of transformation of letters and problems that occur during the transfer of texts have been today's matters of debate. The research topic was evaluated with the help of related keywords scanned from domestic and international literature, and electronic resources were used. Results: In this study, along with the concepts of transliteration and romanization, the problems encountered during transformation and transfer are discussed. Studies in the interdisciplinary field and in the field of librarianship have shown that there are problems in this regard. Originality: Studies have been carried out in different fields related to the subject and in the field of librarianship. With this study, it was tried to shed light on the subject in terms of librarianship. Conclusion: Concepts are dealt with in terms of librarianship and the problems experienced in this field are evaluated in terms of cataloging and user.Çin Halk Cumhuriyeti (ÇHC)’nde Sovyet Revizyonizmi olarak adlandırılan ve Marksizm’e ihanet olarak değerlendirilen Kruşçev’in politikaları, Soğuk Savaş içerisinde Çin-Sovyet Ayrılığı olarak bilinen dönemin başlamasına yol açmıştır. Bu dönemde ÇHC, Sovyet Revizyonizmi’ne karşı propagandaya girişmiş, Çin halkının Sovyet Revizyonizmi’ne yönelik fikirlerden uzak durmasını amaçlamıştır. Propaganda sürecinde Çin halkının MarksistLeninist temelli kitaplar okuması teşvik edilerek, ideolojik sapmanın önüne geçilmeye çalışılmıştır. Bu dönemde hazırlanan ideolojik temelli posterlerde de kitaplar propaganda amaçlı olarak ön plana çıkarılmıştır. Amaç: Bu çalışmada, dönemin ideolojik yansımalarının kitaplarla propaganda kapsamında nasıl kullanıldığını göstermek amaçlanmıştır. Yöntem: Çalışmada ÇHC tarafından Sovyet Revizyonizmi’ne ve ideolojik sapmaya karşı hazırlanan posterlerde kitapların propaganda amaçlı ne şekilde sunuldukları Jakobson’un göstergebilim yöntemi üzerinden incelenmiştir. Göstergebilim yöntemi olarak Jakobson’un iletişim modelindeki altı temel işlevden üçü (duygusal boyut, gönderimsel boyut ve çağrışımsal boyut) kullanılmıştır. Bulgular: Çalışmada elde edilen bulgularda, posterler üzerinden Çin toplumunda Marksist-Leninist kitapların okunmasına yönelik genel bir seferberliğin başlatıldığına ve bu seferberliğin kitleler tarafından desteklendiğine yönelik algının ön plana çıkarıldığı sonucuna ulaşılmıştır. Özgünlük: Konuya ilişkin Türkiye adresli yapılan çalışmalar sınırlıdır. Araştırmanın özündeki tarihsel geçmiş incelendiğinde Sovyetler Birliği’nde Joseph Stalin’in ölümünden sonra ülkenin liderliğine gelen Nikita Kruşçev döneminde destalinizasyon sürecine girildiği ve dış siyasette Sovyetler Birliği ile ABD arasındaki ilişkilerin uzlaşı temelinde ilerlemesine çalışıldığı görülmektedir. Tüm bu süreçte Mao Zedong liderliğindeki ÇHC, Sovyetler Birliği’ndeki uygulamalara karşı çıkmış, iki ülke arasında ciddi ideolojik farklılıklar ortaya çıkmıştır. Yapılan çalışmada bu ideolojik farklılıkları yansıtan kitaplar konu edinilmiştir. Sonuç: ÇHC’nin Sovyetler Birliği’yle ideolojik açıdan mücadelesinde kitaplar önemli bir rol üstlenmektedir. ÇHC’nin, Çin halkını Sovyet Revizyonizmi’nden korumak için kitapları kullandığı ve Marksist-Leninist ideolojisine yönelik yayınların okunmasını teşvik ettiği ortaya çıkmaktadır

Sovyet Ermenistan’ında Komünizm propagandası

The Soviet Union brought communist regimes to power in the socialist republics affiliated to it and spread communist propaganda to ensure that the people embraced these regimes. The Soviet administration used discourses that glorified the ideology of communism through the mass media it dominated, and in this way, it aimed for the peoples of the Soviet Union to embrace communism and implement the decisions taken by the regime without question. The Armenian Soviet Socialist Republic (ASSR) was also one of the Soviet socialist republics of the Soviet Union where communist propaganda was implemented. The Soviet Union made effective use of various mass media for propaganda in the ASSR. One type of mass media used was propaganda posters. Propaganda posters in this study directly reflect the features of Soviet Totalitarian Media Theory. For this reason, the examination of the posters containing the communist propaganda is important in terms of revealing the Soviet Union’s propaganda in the ASSR. Thus, this study aims to explain which messages the Soviet Union used in the communist propaganda in the ASSR through the visual and written indicators on the posters. For this purpose, the posters that include communist propaganda in the ASSR are analyzed using the semiotics method in the light of the semiotic concepts of the linguist Karl Bühler. How Soviet propaganda presented communist ideology in the ASSR and how it established a link between the Armenian people and communism are examined in the posters. In the light of the findings obtained in the study, it is revealed that the messages that communism played a leading role in the construction of contemporary and prosperous Armenia, and at the same time, that the Armenian people were loyal to the communist ideology are given in the posters. In this way, this study concludes that Soviet propaganda tried to legitimize the decisions taken by the communist regime in the ASSR in the Armenian public opinion.Sovyetler Birliği, kendisine bağlı sosyalist cumhuriyetlerde komünist rejimleri iktidara getirmiş ve iktidara getirdiği bu rejimlerin halk tarafından benimsenmesini sağlamak için komünizm propagandasına yönelmiştir. Sovyet yönetimi, egemen olduğu kitle iletişim araçları üzerinden komünist ideolojisini yücelten söylemlere yer vermiş, bu şekilde Sovyetler Birliği halklarının komünizmin sahiplenmesini ve rejimin aldığı kararların Sovyetler Birliği halkı tarafından sorgulanmadan uygulanmasını amaçlamıştır. Ermenistan Sovyet Sosyalist Cumhuriyeti (ESSC) de, Sovyetler Birliği’nin komünizm propagandasının uygulandığı Sovyet Sosyalist Cumhuriyetleri’nden biri olmuştur. Sovyetler Birliği, ESSC’de propaganda yaparken çeşitli kitle iletişim araçlarından etkin bir şekilde yararlanmıştır. Bu kitle iletişim araçlarından biri de propaganda posterleri olmuştur. İncelenen propaganda posterleri, Sovyet Totaliter Medya Kuramı özelliklerini de doğrudan yansıtmaktadır. Bu nedenle ESSC’deki komünizm propagandasını içeren posterlerin incelenmesi, Sovyetler Birliği’nin ESSC’deki komünizm propagandasının ortaya koyulması bakımından önem taşımaktadır. Böylece çalışmada propaganda posterlerinde yer alan görsel ve yazılı göstergeler üzerinden Sovyetler Birliği’nin ESSC’de komünizm propagandasında hangi mesajlara yer verdiğinin açıklanması amaçlanmıştır. Bu amaçla ESSC’deki komünizm propagandasına yer veren posterler, dilbilimci Karl Bühler’in göstergebilim kavramları ışığında göstergebilim yöntemi kullanılarak analiz edilmiştir. Posterlerde Sovyet propagandasının ESSC’deki komünizm ideolojini ne şekilde sunduğu ve Ermeni halkı ve komünizm arasında nasıl bir bağ kurduğu incelenmişti

Levosimendan ve N-Asetilsistein kombinasyonu deneysel karaciğer iskemi/reperfüzyon hasarı üzerine olumlu etkiler göstermektedir

BACKGROUND: Ischemia-reperfusion injury (IRI) is cellular damage that emerges from re-oxygenation of a hypoxic organ. In the present study, we aimed to examine the effects of a combination of levosimendan, an inotropic agent, and N-Acetylcysteine, the precursor of antioxidants and glutathione, in an experimental liver IRI model. METHODS: In this study, 38 rats were randomly divided into five groups. Before the ischemia, study arms were given physiological saline solution, N-Acetylcysteine (NAS), levosimendan or a combination of NAS+levosimendan in a predetermined amount and duration, and the infusion was continued until the end of this study. The hepatic pedicle was occluded using an atraumatic vein clamp, and 60 minutes of ischemia was achieved. The clamp was then opened and 60 minutes of reperfusion was ensured. Liver tissue samples were obtained after sacrifice, and tissue malondialdehyde (MDA) and myeloperoxidase (MPO) levels were determined. Serum Tumor Necrosis Factor (TNF)-α, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and MPO levels of blood samples were also measured. RESULTS: Among the histopathological changes in the liver tissue after IRI, differences between groups were statistically significant in the injury scoring system based on congestion, vacuolization and necrosis levels. Histopathological injury score, plasma MPO, AST, ALT, tissue MPO and tissue MDA values were statistically significantly lower in the treatment groups, prominently in the levosimendan and NAS combination group concerning liver histopathological damage. CONCLUSION: The use of a levosimendan plus NAS combination in liver IRI markedly suppressed inflammation and oxidative stress and significantly reduced liver ischemia-reperfusion injury and can be recommended for decreasing IRI instead of single agent use of levosimendan or NAS.AMAÇ: İskemi/reperfüzyon hasarı (IRH), hipoksik bir organın yeniden oksijenlenmesi sonucu ortaya çıkan hücresel bir hasardır. Bu çalışmada, inotropik bir ajan olan levosimendan ile antioksidanların ve glutatyonun öncüsü olan N-Asetilsistein (NAS) kombinasyonunun deneysel bir karaciğer IRH modelindeki etkilerini incelemeyi amaçladık. GEREÇ VE YÖNTEM: Otuz sekiz sıçan rastgele beş gruba ayrıldı. İskemiden önce çalışma gruplarına önceden belirlenmiş bir miktarda ve sürede fizyolojik salin çözeltisi, NAS, levosimendan veya NAS+levosimendan kombinasyonu verildi ve infüzyon çalışmanın sonuna kadar devam etti. Hepatik pedikül, bir atravmatik ven klempi kullanılarak bağlandı ve 60 dakikalık iskemi sağlandı. Daha sonra klemp açıldı ve 60 dakika reperfüzyon sağlandı. Karaciğer dokusu örnekleri sıçanlar sakrifiye edildikten sonra alındı ​​ve doku malondialdehit (MDA) ve miyeloperoksidaz (MPO) seviyeleri belirlendi. Ayrıca alınan kan örneklerinden serum tümör nekrozis faktör (TNF)-α, aspartat aminotransferaz (AST), alanin aminotransferaz (ALT) ve MPO düzeylerine de bakıldı. BULGULAR: IRH sonrası karaciğer dokusundaki konjesyon, vakuolizasyon ve nekroz düzeylerine dayanarak oluşturulan histopatolojik hasar skorlama sisteminde gruplar arasında, histopatolojik değişiklikler bakımından, istatistiksel olarak anlamlı farklılıklar bulundu. Histopatolojik hasar skoru, plazma MPO, AST, ALT, doku MPO ve doku MDA değerleri, tedavi alan gruplarda kontrol gruplarına oranla istatistiksel olarak anlamlı derecede düşük bulunurken, levosimendan ve NAS kombinasyon grubunda karaciğer histopatolojik hasar skoru diğerlerine oranla istatistiksel olarak ciddi anlamda düşük bulundu. TARTIŞMA: Literatürde ilk kez, karaciğer IRH’sında levosimendan ve NAS kombinasyonunun kullanılması ile enflamasyon ve oksidatif stresin belirgin şekilde baskılandığı ve karaciğer iskemisi reperfüzyon hasarının önemli ölçüde azaldığı gösterilmiştir. Bu sonuca göre, IRH durumunda levosimendan veya NAS’nin tek ajan olarak kullanımı yerine kombinasyon olarak kullanımı önerilebilir

Dorsal Extrinsic Ligament Injury and Static Scapholunate Diastasis on Magnetic Resonance Imaging Scans

Purpose: Current biomechanical data suggest that static scapholunate (SL) ligament dissociation occurs only when there is loss of competence of the extrinsic ligaments either acutely or with attenuation over time. We aimed to identify whether patients with an SL gap greater than 2 mm demonstrated concomitant dorsal radiocarpal ligament (DRC) and dorsal intercarpal ligament (DIC) ligament changes on magnetic resonance imaging (MRI) scans that were identified as having an SL ligament tear. Methods: We included 90 patients who had a posttraumatic MRI scan of the wrist diagnosed with an SL injury. We recorded basic demographics; 2 attending fellowship-trained musculoskeletal radiologists evaluated the integrity of the SL, DRC, and DIC ligaments and graded these as normal, low-grade injury (sprain or partial tear) or full-thickness tear. The association between the integrity of the DRC and DIC ligaments and the presence of a scapholunate gap of 2 mm or greater was analyzed. Results: A total of 48 patients (53%) had an SL distance of 2 mm or greater on MRI. Of these patients, 28 (58%) had a partial or total tear of the DIC and/or DRC ligament. Compared with patients with an SL interval less than 2 mm, patients with an SL interval 2 mm or greater more often demonstrated DIC signal change (31% vs 12%), DRC signal change (52% vs 14%), or combined or isolated DIC and/or DRC signal change (52% vs 14%). Conclusions: Dorsal extrinsic ligaments demonstrate MRI signal change suggestive of acute or chronic injury in patients with an SL interval 2 mm or greater more often than in patients with an SL interval less than 2 mm. These results reinforce that MRI findings of SL ligament tear need to be interpreted in a larger context, perhaps with additional attention to the DIC and DRC appearance upon MRI. In addition, MRI evaluation of dorsal extrinsic ligaments may aid in clinical decision-making for patients with SL injury. Type of study/level of evidence: Diagnostic IV

What Is the Effect of Vitamin C on Finger Stiffness after Distal Radius Fracture? A Double-blind, Placebo-controlled Randomized Trial

BackgroundIt is proposed that vitamin C administration can reduce disproportionate pain and stiffness after distal radius fracture; however, randomized trials that tested this hypothesis have had inconsistent results.Questions/purposes(1) Is administering vitamin C after distal radius fracture associated with better ROM, patient-reported upper extremity function, and pain scores? (2) What factors are associated with post-fracture finger stiffness and worse upper extremity function?MethodsThis is a double-blind, randomized, placebo-controlled, noncrossover study. Between August 2014 and July 2017, we approached 204 consecutive patients, of which 195 were eligible, and 134 chose to participate. Participants were randomized to receive once-daily 500 mg vitamin C (67 participants) or placebo (67 participants) within 2 weeks after distal radius fracture. All patients received usual care at the discretion of their surgeon. The mean age of participants was 49 ± 17 years, 99 patients (74%) were women, and 83 (62%) were treated nonoperatively. The primary outcome was the distance between the fingertip and distal palmar crease 6 weeks after fracture. This measure is easy to obtain and previously has been shown to correlate with aggregate ROM of all finger joints. The secondary outcomes were total active finger motion, total active thumb motion, upper extremity-specific limitations, and pain intensity.An a priori power analysis suggested 126 patients would provide 80% power to detect a difference of 2 cm (SD 4.0) fingertip distance to palmar crease with α set at 0.05 using a two-tailed Student's t-test. Accounting for 5% lost to followup, we included 134 patients.All analyses were intention-to-treat. Ten participants of the intervention group and five of the placebo group were lost to followup. Their missing data were addressed by multiple imputation, after which we performed linear regression analysis for our outcome variables.ResultsAdministration of vitamin C was not associated with ROM, function, or pain scores at 6 weeks (distance to palmar crease: β -0.23; 95% CI -1.7 to 1.2; p = 0.754; finger ROM: β 4.9; 95% CI, -40 to 50; p = 0.829; thumb ROM: β 0.98; 95% CI, -18 to 20; p = 0.918, Patient-Reported Outcomes Measurement Information System [PROMIS] score: β 0.32; 95% CI, -2.6 to 3.2; p = 0.828; pain score: β -0.62; 95% CI, -0.62 to 0.89; p = 0.729) nor at 6 months (PROMIS score: β -0.21; 95% CI, -3.7 to 3.3; p = 0.904; pain score: β 0.31; 95% CI, -0.74 to 1.4; p = 0.559). At 6 weeks, we found that more finger stiffness was mildly associated with greater age (β -1.5; 95% CI, -2.8 to -0.083; p = 0.038). Thumb stiffness was mildly associated with greater age (β -0.72; 95% CI, -1.3 to -0.18; p = 0.009) and strongly associated with operative treatment (β -32; 95% CI, -50 to -13; p = 0.001). Greater pain interference was modestly associated with greater functional limitations at 6 weeks (β -0.32; 95% CI, -0.52 to -0.12; p = 0.002) and 6 months (β -0.36; 95% CI, -0.60 to -0.11; p = 0.004).ConclusionsVitamin C does not seem to facilitate recovery after distal radius fracture, but amelioration of maladaptation to nociception (pain interference) merits greater attention.Level of EvidenceLevel I, therapeutic study

Radial Artery Pseudoaneurysm

PURPOSE: To review the causes, clinical course, and management of patients with catheter-associated radial artery pseudoaneurysm (PSA). METHODS: We reviewed all patients diagnosed with radial artery PSA resulting from arterial line placement or radial artery access for cardiac procedures from 2010 to 2015. RESULTS: We identified 11 cases: 5 caused by arterial lines and 6 by cardiac procedures. The diagnosis was confirmed by duplex ultrasound in all cases; PSA size ranged from less than 1 cm to 5 cm in diameter. Spontaneous thrombosis (over a mean of 27 days) occurred in 4 patients; each PSA was smaller than 3 cm. Surgery was performed in 7 patients with excision of the stalk and repair of the artery as the most common procedure. Only one case was performed emergently for acute carpal tunnel syndrome. Complications occurring owing to either the PSA or the treatment were recorded in 5 patients. CONCLUSIONS: Spontaneous thrombosis may occur in smaller lesions over a few weeks. When required, surgery to evacuate the hematoma and repair the artery was effective in all cases. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV