Background: Laparoscopic cholecystectomy in acute calculous cholecystitis in high risk patients can lead to significant morbidity and mortality. Percutaneous cholecystostomy may be an alternative treatment option but the current literature does not provide the surgical community with evidence based advice.
Boston Scientific Corporation (Natick, MA) announced that interim data from the REDUCE-HTN clinical program were presented at EuroPCR 2013 in Paris by Joachim Schofer, MD, of the Hamburg University Cardiovascular Center in Hamburg, Germany.
Objective: This study was designed to establish guinea pigs as an animal model for uterine artery embolization (UAE) with tris-acryl gelatin microspheres (TAGM).
Radioembolization is a form of brachytherapy in which intra-arterially injected 90Y-loaded microspheres serve as sources for internal radiation purposes. It produces average disease control rates above 80% and is usually very well tolerated. Main complications do not result from the microembolic effect, even in patients with portal vein occlusion, but rather from an excessive irradiation of non-target tissues including the liver. All the evidence that support the use of radioembolization in HCC is based on retrospective series or non-controlled prospective studies. However, reliable data can be obtained from the literature, particularly since the recent publication of large series accounting for nearly 700 patients. When compared to the standard of care for the intermediate and advanced stages (transarterial embolization and sorafenib), radioembolization consistently provides similar survival rates. Two indications seem particularly appealing in the boundaries of these stages for first-line radioembolization. First, the treatment of patients straddling between the intermediate and advanced stages (intermediate patients with bulky or bilobar disease that are considered poor candidates for TACE, and advanced patients with solitary tumors invading a segmental or lobar branch of the portal vein). Second, the treatment of patients that are slightly above the criteria for resection, ablation or transplantation, for which downstaging could open the door for a radical approach. Radioembolization can also be used to treat patients progressing to TACE or sorafenib. With a number of clinical trials underway, the available evidence shows that it adds a significant value to the therapeutic weaponry against HCC of tertiary care centers dealing with this major cancer problem.
OBJECTIVE. The purpose of this study was to investigate the prevalence of incidental deep venous thrombosis (DVT) in patients with clinically suspected peripheral arterial occlusive disease (PAOD) using contrast-enhanced MR angiography (MRA) with a blood pool contrast agent.
In 1960, Alfred J. Luessenhop and William T. Spence published the first article on embolization entitled “Artificial Embolization of Cerebral Arteries” in the Journal of the American Medical Association.1 It included a detailed case report of a young patient with a cerebral arteriovenous malformation that was treated by artificial embolization using “an embolus of predetermined size and configuration,” which was introduced far proximal to the malformation. This described one of the first embolization agents and techniques.
OBJECTIVE. The purpose of this study was to investigate whether changes in attenuation and size of liver metastatic lesions of colorectal cancer at MDCT 1 month after 90Y radioembolization treatment are predictive of response at FDG PET 3 months after treatment.
Use of the radial artery as the primary access vessel into the arterial system for transcatheter diagnosis and intervention is not a new concept. The first series describing diagnostic angiography of the coronary circulation using transradial access (TRA) was published in 1989 by Lucien Campeau at the Montreal Heart Institute.1 Campeau suggested percutaneous radial access as a safer alternative to percutaneous and “cutdown” brachial or axillary access. His series of 100 patients demonstrated an 88% technical success rate and a 6% asymptomatic radial artery occlusion rate, which was a significant improvement over brachial/axillary upper arm access.1 Shortly thereafter, in 1992, Kiemeneij performed the first successful transradial (TR) coronary angioplasty procedure and then, in 1993, the first TR coronary stent placement via the radial artery.2 Since then, the utilization of this technique has significantly grown worldwide.
Background—Obesity and surgery are known risk factors for venous thromboembolism (VTE), but there is limited information about the independent effects of obesity on the incidence of postoperative VTE. We linked questionnaire data from the Million Women Study with hospital admission and death records to examine the risk of VTE in relation to body mass index (BMI) both in the absence of surgery and in the first 12 weeks following an operation.
The appearance of a benign fistula between the airway and the gastrointestinal tract is a rare complication of esophagectomy. We report a patient with neo-esophago-bronchial fistula that developed 13 months after two-stage esophagectomy. Repeat thoracotomy was not deemed appropriate given the patient’s chronic sepsis and malnutrition. After unsuccessful attempts at endoscopic closure, the fistula was successfully and permanently occluded under radiological guidance with an Amplatzer® Vascular Plug 2. The patient remained asymptomatic, with a measured weight gain, 12 months after the successful fistula occlusion.
One of the most preventable causes of death in abdominal and pelvic trauma is arterial hemorrhage that goes untreated or unrecognized.1 Over the last decade, radiology has undergone many advances, particularly in noninvasive imaging and interventional angiography, such that critical arterial hemorrhage is both recognized and treated faster, often with life-preserving results. The cornerstone of arterial hemostasis is early intervention, whether via endovascular techniques, open laparotomy, or a combination of both. Early intervention requires a highly sensitive and specific diagnostic study that can be performed and interpreted quickly.
Radiofrequency ablation (RFA) is an alternative therapy for hepatocellular carcinoma and liver metastases when resection cannot be performed or, in the case of hepatocellular carcinoma, when transplant cannot be performed in a timely enough manner to avoid the risk of dropping off the transplant list. RFA has the advantage of being a relatively low-risk minimally invasive procedure used in the treatment of focal liver tumors. This review article discusses the current evidence supporting RFA of liver tumors, as well as the indications, complications, and follow-up algorithms used after RFA.
PURPOSE: We aimed to evaluate the efficacy and feasibility of ultrasonography (US)-accelerated catheter-directed thrombolysis for the treatment of deep venous thrombosis.
Purpose: To determine whether placement of marking coils at biopsy of small renal neoplasms to facilitate localization at subsequent radiofrequency (RF) ablation is safe and can reduce fluoroscopy time during the ablative procedure.
OBJECTIVE. To our knowledge there is currently no quantitative preprocedural method for predicting the distribution and selectivity of delivery of chemoembolic material during trans–arterial chemoembolization. Transcatheter intraarterial perfusion MRI has been developed as a method of quantifying hepatic arterial perfusion. The purpose of this study was to investigate whether findings at transcatheter intraarterial perfusion MRI before chemoembolization can be used to predict uptake of the chemoembolic material delivered during chemoembolization.
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