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ESTUDIOS


01 agosto 2017

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. CT–Guided Bone Biopsies in Metastatic Castration-Resistant Prostate Cancer: Factors Predictive of Maximum Tumor Yield

Michael G. Holmes, MD, Erik Foss, MD, Gabby Joseph, PhD, Adam Foye, BS, Brooke Beckett, MD, Daria Motamedi, MD, Jack Youngren, PhD, George V. Thomas, MD, Jiaoti Huang, MD, PhD, Rahul Aggarwal, MD, Joshi J. Alumkal, MD, Tomasz M. Beer, MD, Eric J. Small, MD, Thomas M. Link, MD, PhD

Purpose: To evaluate the success rate of CT–guided bone biopsies in metastatic castration-resistant prostate cancer (mCRPC) and to investigate associated technical, imaging, and clinical parameters affecting diagnostic yields.

01 agosto 2017

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Case-Control Study of Intra-arterial Verapamil for Intraprostatic Anastomoses to Extraprostatic Arteries in Prostatic Artery Embolization for Benign Prostatic Hypertrophy

Simon Chun Ho Yu, MD, Carmen Cho, FRCR, Esther Hung, FRCR, Defeng Wang, PhD, Peter Chiu, FRCS, Chi Hang Yee, FRCS, Anthony Ng, FRCS

Purpose: It is hypothesized that intra-arterial administration of verapamil is a safe and effective way to reverse the flow in intraprostatic anastomoses to extraprostatic arteries without compromising treatment outcomes in prostatic artery embolization (PAE) for benign prostatic hypertrophy (BPH).

01 agosto 2017

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Short-Term Safety and Efficacy of Balloon-Occluded Retrograde Transvenous Obliteration Using Ethanolamine Oleate: Results of a Prospective, Multicenter, Single-Arm Trial

Masao Kobayakawa, MD, Shigehiro Kokubu, MD, PhD, Shozo Hirota, MD, PhD, Jun Koizumi, MD, PhD, Norifumi Nishida, MD, PhD, Taku Yasumoto, MD, PhD, Satoshi Mochida, MD, PhD, Hisashi Hidaka, MD PhD, Noriko Tanaka, MHS, PhD, Tsuyoshi Tajima, MD, PhD

Purpose: To evaluate 90-day outcomes after balloon-occluded retrograde transvenous obliteration (BRTO) with ethanolamine oleate (EO) in patients with gastric varices (GVs).

01 septiembre 2017

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Evaluation of a Device Combining an Inferior Vena Cava Filter and a Central Venous Catheter for Preventing Pulmonary Embolism Among Critically Ill Trauma Patients

Victor F. Tapson, MD, Joshua P. Hazelton, DO, John Myers, MD, Claudia Robertson, MD, Ramyar Gilani, MD, Julie A. Dunn, MD, Marko Bukur, MD, Martin A. Croce, MD, Ann Peick, MD, Sonlee West, MD, Lawrence Lottenberg, MD, Jay Doucet, MD, Preston R. Miller, MD, Bruce Crookes, MD, Rajesh R. Gandhi, MD, Chasen A. Croft, MD, Anthony Manasia, MD, Brian A. Hoey, MD, Howard Lieberman, MD, Oscar D. Guillamondegui, MD, MPH, Victor Novack, MD, Gregory Piazza, MD, Samuel Z. Goldhaber, MD

Purpose: To evaluate efficacy and safety of a novel device that combines an inferior vena cava (IVC) filter and central venous catheter (CVC) for prevention of pulmonary embolism (PE) in critically ill patients.

01 septiembre 2017

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Albumin-Bilirubin and Platelet-Albumin-Bilirubin Grades Accurately Predict Overall Survival in High-Risk Patients Undergoing Conventional Transarterial Chemoembolization for Hepatocellular Carcinoma

Jan Hansmann, MD, Maximilian J. Evers, BS, James T. Bui, MD, R. Peter Lokken, MD, MPH, Andrew J. Lipnik, MD, Ron C. Gaba, MD, Charles E. Ray Jr., MD, PhD

Purpose: To evaluate albumin-bilirubin (ALBI) and platelet-albumin-bilirubin (PALBI) grades in predicting overall survival in high-risk patients undergoing conventional transarterial chemoembolization for hepatocellular carcinoma (HCC).

01 junio 2017

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Phantom Study Investigating the Accuracy of Manual and Automatic Image Fusion with the GE Logiq E9: Implications for use in Percutaneous Liver Interventions

Mark Christiaan Burgmans, J. Michiel den Harder, Philippa Meershoek, Nynke S. van den Berg, Shaun Xavier Ju Min Chan, Fijs W. B. van Leeuwen, Arian R. van Erkel

Purpose: To determine the accuracy of automatic and manual co-registration methods for image fusion of three-dimensional computed tomography (CT) with real-time ultrasonography (US) for image-guided liver interventions.

01 junio 2017

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Successful Retrieval of an Embolized Vascular Closure Device (Angio-Seal®) After Peripheral Angioplasty

Philipp Jud, Rupert Portugaller, Dennis Bohlsen, Thomas Gary, Marianne Brodmann, Gerald Hackl, Franz Hafner

A 55-year-old male with peripheral arterial disease underwent angioplasty of the right lower limb arteries via antegrade femoral access. Angio-Seal® closure device was used to treat the puncture site, whereby the intravascular sealing anchor accidentally embolized into the malleolar region of the right posterior tibial artery. Successful retrieval of the anchor was accomplished by a SpiderFX embolic protection device. This technique may be a useful approach to retrieve embolized foreign bodies via endovascular access.

01 julio 2017

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Debulking Atherectomy in the Peripheral Arteries: Is There a Role and What is the Evidence?

Konstantinos Katsanos, Stavros Spiliopoulos, Lazaros Reppas, Dimitris Karnabatidis

Traditional percutaneous balloon angioplasty and stent placement is based on mechanical plaque disruption and displacement within the arterial wall. On the contrary, transcatheter atherectomy achieves atherosclerotic plaque clearance by means of directional plaque excision or rotational plaque removal or laser plaque ablation. Debulking atherectomy may allow for a more uniform angioplasty result at lower pressures with consequently less vessel barotrauma and improved luminal gain, thereby decreasing the risk of plaque recoil and dissection that may require permanent metal stenting. It has been also argued that atherectomy may disrupt the calcium barrier and optimize drug transfer and delivery in case of drug-coated balloon applications. The authors discuss the various types of atherectomy devices available in clinical practice to date and critically appraise their mode of action as well as relevant published data in each case. Overall, amassed randomized and observational evidence indicates that percutaneous atherectomy of the femoropopliteal and infrapopliteal arteries may achieve high technical success rates and seems to lessen the frequency of bailout stenting, however, at the expense of increased risk of peri-procedural distal embolization. Long-term clinical outcomes reported to date do not support the superiority of percutaneous atherectomy over traditional balloon angioplasty and stent placement in terms of vessel patency or limb salvage. The combination of debulking atherectomy and drug-coated balloons has shown promise in early studies, especially in the treatment of more complex lesions. Unanswered questions and future perspectives of this continuously evolving endovascular technology as part of a broader treatment algorithm are discussed.

01 agosto 2017

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Cirse Quality Assurance Document and Standards for Classification of Complications: The Cirse Classification System

D. K. Filippiadis, C. Binkert, O. Pellerin, R. T. Hoffmann, A. Krajina, P. L. Pereira

Interventional radiology provides a wide variety of vascular, nonvascular, musculoskeletal, and oncologic minimally invasive techniques aimed at therapy or palliation of a broad spectrum of pathologic conditions. Outcome data for these techniques are globally evaluated by hospitals, insurance companies, and government agencies targeting in a high-quality health care policy, including reimbursement strategies. To analyze effectively the outcome of a technique, accurate reporting of complications is necessary. Throughout the literature, numerous classification systems for complications grading and classification have been reported. Until now, there has been no method for uniform reporting of complications both in terms of definition and grading. The purpose of this CIRSE guideline is to provide a classification system of complications based on combining outcome and severity of sequelae. The ultimate challenge will be the adoption of this system by practitioners in different countries and health economies within the European Union and beyond.

01 agosto 2017

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Radiation-Induced Skin Injuries to Patients: What the Interventional Radiologist Needs to Know

Werner Jaschke, Matthias Schmuth, Annalisa Trianni, Gabriel Bartal

For a long time, radiation-induced skin injuries were only encountered in patients undergoing radiation therapy. In diagnostic radiology, radiation exposures of patients causing skin injuries were extremely rare. The introduction of fast multislice CT scanners and fluoroscopically guided interventions (FGI) changed the situation. Both methods carry the risk of excessive high doses to the skin of patients resulting in skin injuries. In the early nineties, several reports of epilation and skin injuries following CT brain perfusion studies were published. During the same time, several papers reported skin injuries following FGI, especially after percutaneous coronary interventions and neuroembolisations. Thus, CT and FGI are of major concern regarding radiation safety since both methods can apply doses to patients exceeding 5 Gy (National Council on Radiation Protection and Measurements threshold for substantial radiation dose level). This paper reviews the problem of skin injuries observed after FGI. Also, some practical advices are given how to effectively avoid skin injuries. In addition, guidelines are discussed how to deal with patients who were exposed to a potentially dangerous radiation skin dose during medically justified interventional procedures.

01 agosto 2017

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Continuously Grooved Stent Struts for Enhanced Endothelial Cell Seeding

Marja ter Meer, Willeke F. Daamen, Yvonne L. Hoogeveen, Gijs J. F. van Son, Jeremy E. Schaffer, J. Adam van der Vliet, Leo J. Schultze Kool, Lambertus P. van den Heuvel

Purpose: Implantation of pre-endothelialized stents could enhance cellular recovery of a damaged vessel wall provided attached cells remain viable, functional and are present in sufficient numbers after deployment. The purpose of this study was to evaluate the feasibility of grooved stainless steel (SS) stents as a primary endothelial cell (EC) carrier with potentially enhanced EC protection upon stent deployment.

01 agosto 2017

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Prospective Clinical and Pharmacological Evaluation of the Delcath System’s Second-Generation (GEN2) Hemofiltration System in Patients Undergoing Percutaneous Hepatic Perfusion with Melphalan

Eleonora M. de Leede, Mark C. Burgmans, T. Susanna Meijer, Christian H. Martini, Fred G. J. Tijl, Jaap Vuyk, Arian R. van Erkel, Cornelis J. H. van der Velde, Ellen Kapiteijn, Alexander L. Vahrmeijer

Introduction: Percutaneous hepatic perfusion (PHP) with melphalan is an effective treatment for patients with hepatic metastases, but associated with high rates of bone marrow depression. To reduce systemic toxicity, improvements have been made to the filtration system. In pre-clinical studies, the Delcath System’s GEN2 filter was superior to the first-generation filters. In this clinical study, we analysed the pharmacokinetics and toxicity of PHP using the new GEN2 filter.

01 septiembre 2017

CARDIOVASCULAR AND INTERVENTIONAL RADIOLOGY. Uterine Artery Embolization for Symptomatic Adenomyosis: 7-Year Clinical Follow-up Using UFS-Qol Questionnaire

Annefleur M. de Bruijn, Marieke Smink, Wouter J. K. Hehenkamp, Robbert J. Nijenhuis, Albert J. Smeets, Focco Boekkooi, Paul J. H. M. Reuwer, Willem J. Van Rooij, Paul N. M. Lohle

Purpose: The purpose of this study was to assess clinical outcomes 7 years after uterine artery embolization (UAE) in the treatment of symptomatic adenomyosis.

28 agosto 2017

WORLD JOURNAL OF GASTROENTEROLOGY. Postoperative inflammation as a possible cause of portal vein thrombosis after irreversible electroporation for locally advanced pancreatic cancer

Jun-Jun Su, Ming Su, Kai Xu, Peng-Fei Wang, Li Yan, Shi-Chun Lu, Wan-Qing Gu, Yong-Liang Chen

Portal vein thrombosis (PVT) is a rare but serious postoperative complication associated with irreversible electroporation (IRE). We report a case of postoperative PVT in a 54-year-old woman who underwent IRE for locally advanced pancreatic cancer. Drain removal and discharge of the patient from the hospital were scheduled on postoperative day (POD) 7; however, a magnetic resonance imaging scan revealed the presence of PVT. We suspected postoperative inflammation in the pancreas as the main cause of PVT. However, the patient did not undergo any medical treatment because she did not have any clinical symptoms, and she was discharged on POD 8.

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