Acknowledgments
Ministry of Health, Nicaragua (Ministerio de Salud y Asistencia, MINSA) for review and approval of this project. Universidad Nacional Autónoma de Nicaragua—León, Nicaragua for surgical, medical and radiological services. Hospital Metropolitano Vivian Pellas, Managua, Nicaragua for surgical and radiological services. Mauricio Jarquin, MD for design of the pre-catheterization protocol. Hospital Alfredo Pellas Chamorro, Ingenio San Antonio, Chichigalpa, Nicaragua for laboratory services and data collection with the coordination of Denis Chavarria, MD. Carlos Rivas, director Rivas Opstaele for the donation of catheters and introducers. Grupo Pellas and SER San Antonio for logistical support.