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ESTUDIOS


01 abril 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Percutaneous Angioplasty Using a Paclitaxel-Coated Balloon Improves Target Lesion Restenosis on Inflow Lesions of Autogenous Radiocephalic Fistulas: A Pilot Study

Chi-Cheng Lai, MD , Hua-Chang Fang, MD , Ching-Jiunn Tseng, MD, PhD , Chun-Peng Liu, MD , Guang-Yuan Mar, MD

Purpose: To determine whether the use of a paclitaxel-coated balloon (PCB) improves patency in patients undergoing percutaneous transluminal angioplasty (PTA) for recurrent juxtaanastomotic stenosis of radiocephalic arteriovenous fistulas (RCAVFs).

01 marzo 2013

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Prognostic Capability of Different Liver Disease Scoring Systems for Prediction of Early Mortality after Transjugular Intrahepatic Portosystemic Shunt Creation

Ron C. Gaba, MDemail address , Patrick M. Couture, BS , James T. Bui, MD , M. Grace Knuttinen, MD, PhD , Natasha M. Walzer, MD , Eric R. Kallwitz, MD , Jamie L. Berkes, MD , Scott J. Cotler, MD

Purpose: To compare the performance of various liver disease scoring systems in predicting early mortality after transjugular intrahepatic portosystemic shunt (TIPS) creation.

01 marzo 2014

JOURNAL OF VASCULAR AND INTERVENTIONAL RADIOLOGY. Short-Term Rebleeding Rates for Isolated Gastric Varices Managed by Transjugular Intrahepatic Portosystemic Shunt versus Balloon-Occluded Retrograde Transvenous Obliteration

Saher S. Sabri, MD , Nadine Abi-Jaoudeh, MD , Warren Swee, MD , Wael E. Saad, MD , Ulku C. Turba, MD , Stephen H. Caldwell, MD , John F. Angle, MD , Alan H. Matsumoto, MD

Purpose: To assess the short-term rebleeding rate associated with the use of a transjugular intrahepatic portosystemic shunt (TIPS) compared with balloon-occluded retrograde transvenous obliteration (BRTO) for management of gastric varices (GV).

28 febrero 2014

WORLD JOURNAL OF RADIOLOGY. Treatment of metastatic liver tumors using stereotactic ablative radiotherapy

Vimoj J Nair and Jason R Pantarotto.

The prognosis of patients with metastatic liver disease remains dismal with a median survival of only 6-12 mo. As 80%-90% of patients are not candidates for surgical therapy, there is a need for effective non-surgical therapies that would improve outcomes in these patients. The body of evidence related to the use of stereotactic ablative radiotherapy (SABR) in metastatic liver disease has substantially grown and evolved over the past decade. This review summarizes the current evidence supporting liver SABR with particular attention given to patient selection, target delineation, organ at risk dose volume constraints, response evaluation imaging and the various SABR techniques for delivering ablative radiotherapy to the liver. Even though it is unclear what dose-fractionation scheme, delivery system, concomitant therapy or patient selection strategy yields the optimum liver SABR outcomes, clear and growing evidence is available that SABR is a safe and effective therapy for the treatment of oligometastatic liver disease.

28 febrero 2014

WORLD JOUNAL OF GASTROENTEROLOGY. Colorectal cancer surveillance: What s new and what s next?

Johnie Rose, Knut Magne Augestad and Gregory S Cooper.

The accumulated evidence from two decades of randomized controlled trials has not yet resolved the question of how best to monitor colorectal cancer (CRC) survivors for early detection of recurrent and metachronous disease or even whether doing so has its intended effect. A new wave of trial data in the coming years and an evolving knowledge of relevant biomarkers may bring us closer to understanding what surveillance strategies are most effective for a given subset of patients. To best apply these insights, a number of important research questions need to be addressed, and new decision making tools must be developed. In this review, we summarize available randomized controlled trial evidence comparing alternative surveillance testing strategies, describe ongoing trials in the area, and compare professional society recommendations for surveillance. In addition, we discuss innovations relevant to CRC surveillance and outline a research agenda which will inform a more risk-stratified and personalized approach to follow-up.

07 marzo 2013

WORLD JOUNAL OF GASTROENTEROLOGY. Biodegradable stents in gastrointestinal endoscopy

Vicente Lorenzo-Zúñiga, Vicente Moreno-de-Vega, Ingrid Marín and Jaume Boix.

Biodegradable stents (BDSs) are an attractive option to avoid ongoing dilation or surgery in patients with benign stenoses of the small and large intestines. The experience with the currently the only BDS for endoscopic placement, made of Poly-dioxanone, have shown promising results. However some aspects should be improved as are the fact that BDSs lose their radial force over time due to the degradable material, and that can cause stent-induced mucosal or parenchymal injury. This complication rate and modest clinical efficacy has to be carefully considered in individual patients prior to placement of BDSs. Otherwise, the price of these stents therefore it is nowadays an important limitation.

07 marzo 2014

WORLD JOUNAL OF GASTROENTEROLOGY. Systematic review of novel ablative methods in locally advanced pancreatic cancer

Margaret G Keane, Konstantinos Bramis, Stephen P Pereira and Giuseppe K Fusai.

Unresectable locally advanced pancreatic cancer with or without metastatic disease is associated with a very poor prognosis. Current standard therapy is limited to chemotherapy or chemoradiotherapy. Few regimens have been shown to have a substantial survival advantage and novel treatment strategies are urgently needed. Thermal and laser based ablative techniques are widely used in many solid organ malignancies. Initial studies in the pancreas were associated with significant morbidity and mortality, which limited widespread adoption. Modifications to the various applications, in particular combining the techniques with high quality imaging such as computed tomography and intraoperative or endoscopic ultrasound has enabled real time treatment monitoring and significant improvements in safety. We conducted a systematic review of the literature up to October 2013. Initial studies suggest that ablative therapies may confer an additional survival benefit over best supportive care but randomised studies are required to validate these findings.

21 enero 2014

WORLD JOUNAL OF GASTROENTEROLOGY. Transarterial chemoembolization in Barcelona Clinic Liver Cancer Stage 0/A hepatocellular carcinoma

Heung Cheol Kim, Ki Tae Suk, Dong Joon Kim, Jai Hoon Yoon, Yeon Soo Kim, Gwang Ho Baik, Jin Bong Kim, Chang Hoon Kim, Hotaik Sung, Jong Young Choi, Kwang Hyub Han and Seung Ha Park.

AIM: To evaluate the clinical characteristics of patients with Barcelona Clinic Liver Cancer (BCLC) stage 0 and A hepatocellular carcinoma (HCC) after transarterial chemoembolization (TACE).

21 enero 2014

WORLD JOUNAL OF GASTROENTEROLOGY. Shunting branch of portal vein and stent position predict survival after transjugular intrahepatic portosystemic shunt

Ming Bai, Chuang-Ye He, Xing-Shun Qi, Zhan-Xin Yin, Jian-Hong Wang, Wen-Gang Guo, Jing Niu, Jie-Lai Xia, Zhuo-Li Zhang, Andrew C Larson, Kai-Chun Wu, Dai-Ming Fan and Guo-Hong Han.

AIM: To evaluate the effect of the shunting branch of the portal vein (PV) (left or right) and the initial stent position (optimal or suboptimal) of a transjugular intrahepatic portosystemic shunt (TIPS).

28 enero 2014

WORLD JOUNAL OF GASTROENTEROLOGY. Radiofrequency ablation as treatment for pulmonary metastasis of colorectal cancer

Takao Hiraki, Hideo Gobara, Toshihiro Iguchi, Hiroyasu Fujiwara, Yusuke Matsui and Susumu Kanazawa.

Radiofrequency ablation (RFA) causes focal coagulation necrosis in tissue. Its first clinical application was reported in 2000, and RFA has since been commonly used in both primary and metastatic lung cancer. The procedure is typically performed using computed tomography guidance, and the techniques for introducing the electrode to the tumor are simple and resemble those used in percutaneous lung biopsy. The most common complication is pneumothorax, which occurs in up to 50% of procedures; chest tube placement for pneumothorax is required in up to 25% of procedures. Other severe complications, such as pleural effusion requiring chest tube placement, infection, and nerve injury, are rare. The local efficacy depends on tumor size, and local progression after RFA is not rare, occurring in 10% or more of patients. The local progression rate is particularly high for tumors > 3 cm. Repeat RFA may be used to treat local progression. Short- to mid-term survival after RFA appears promising and is approximately 85%-95% at 1 year and 45%-55% at 3 years. Long-term survival data are sparse. Better survival may be expected for patients with small metastasis, low carcinoembryonic antigen levels, and/or no extrapulmonary metastasis. The notable advantages of RFA are that it is simple and minimally invasive; preserves pulmonary function; can be repeated; and is applicable regardless of previous treatments. Its most substantial limitation is limited local efficacy. Although surgery is still the method of choice for treatment with curative intent, the ultimate application of RFA may be to replace metastasectomy for small metastases. Randomized trials comparing RFA with surgery are needed.

01 marzo 2013

AMERICAN JOURNAL OF ROENTGENOLOGY. Gelfoam-Assisted Amplatzer Vascular Plug Technique for Rapid Occlusion in Proximal Splenic Artery Embolization

Weiping Wang, Matthew D. Tam, James Spain and Cristiano Quintini

OBJECTIVE. The objective of this study was to prospectively investigate the role of rapid Gelfoam-assisted occlusion of the splenic artery with an Amplatzer Vascular Plug (AVP). Ten consecutive proximal splenic artery embolizations were performed with AVP as the primary embolic agent and Gelfoam slurry as an adjunct. These cases were then compared with 10 retrospective cases of splenic artery embolization performed with AVP and augmented with coils or additional AVPs, or both, in patients with similar indications.

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