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Seminars in Interventional Radiology

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https://www.readbyqxmd.com/read/29872251/pediatric-portal-interventions
#1
REVIEW
Rajiv N Srinivasa, Jeffrey Forris Beecham Chick, Noah Chen, Joseph J Gemmete, Wael A Saad, Narasimham L Dasika, Ravi N Srinivasa
No abstract text is available yet for this article.
June 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29872250/chronic-thromboembolic-pulmonary-hypertension
#2
REVIEW
Stuart Jamieson, G Victor Pretorius
Chronic thromboembolic pulmonary hypertension occurs when acute thromboemboli fail to dissolve completely. The resulting fibrotic scar tissue within the pulmonary arteries is obstructive and eventually leads to right heart failure. Medical therapy for this condition is supportive, but surgery with pulmonary artery endarterectomy is curative, and carries a low mortality at experienced centers.
June 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29872249/percutaneous-pulmonary-embolism-thrombectomy-and-thrombolysis-technical-tips-and-tricks
#3
REVIEW
Zlatko Devcic, William T Kuo
Catheter-directed therapy (CDT) is now acknowledged as a treatment option for select patients with acute massive or submassive pulmonary embolism (PE), and more patients are being considered for CDT if there is available expertise. Therefore, interventionalists should be aware of the variety of catheter-based treatment options, specific pitfalls to avoid during therapy, and the appropriate treatment endpoints. This article reviews currently available techniques and protocols for treating acute massive and submassive PE, with tips to safely and successfully perform percutaneous PE interventions...
June 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29872248/catheter-directed-thrombolysis-for-submassive-pulmonary-embolism
#4
REVIEW
Matthew A Chiarello, Akhilesh K Sista
Acute pulmonary embolism (PE) is a leading cause of morbidity and mortality in the United States. PE associated with right ventricular strain, termed submassive or intermediate-risk PE, is associated with an increased rate of clinical deterioration and short-term mortality. Trials have demonstrated systemic thrombolytics may improve patient outcomes, but they carry a risk of major hemorrhage. Catheter-directed thrombolysis (CDT) may offer similar efficacy to and a lower risk of catastrophic hemorrhage than systemic thrombolysis...
June 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29872247/patient-assessment-clinical-presentation-imaging-diagnosis-risk-stratification-and-the-role-of-pulmonary-embolism-response-team
#5
REVIEW
Tamir Friedman, Ronald S Winokur, Keith B Quencer, David C Madoff
Pulmonary embolism (PE) is currently the third leading cause of death and moreover is likely underdiagnosed. PE remains the most common preventable cause of hospital deaths in the United States, which may be attributable to its diagnostic challenges. Although difficult to diagnose, patient mortality rates are time-dependent, and thus, the suspicion and diagnosis of PE in a timely manner is imperative. Diagnosis based on several criteria which may dictate imaging workup as well as laboratory tests and clinical parameters are discussed...
June 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29872246/intervention-in-massive-pulmonary-embolus-catheter-thrombectomy-thromboaspiration-versus-systemic-lysis-versus-surgical-thrombectomy
#6
REVIEW
John M Moriarty, Martin Edwards, Adam N Plotnik
Massive pulmonary embolus (PE), defined as hemodynamic shock from acute PE, is a life-threatening condition. Deaths from massive PE, especially when unsuspected, occur within minutes to hours of onset and as such prompt intervention can be lifesaving. Acute massive PE patients have traditionally been candidates for treatment with intravenous systemic thrombolysis to improve pulmonary artery pressure, arteriovenous oxygenation, and pulmonary perfusion in an effort to reduce mortality. However, patients with contraindications to systemic thrombolysis or those who have failed thrombolysis may benefit from other techniques including endovascular and surgical embolectomy...
June 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29872245/inferior-vena-cava-filters-and-prevention-of-recurrent-pulmonary-embolism
#7
REVIEW
Anuj Malhotra, Sirish Kishore, David Trost, David C Madoff, Ronald S Winokur
Although inferior vena cava (IVC) filters have a clear role in preventing recurrent pulmonary embolism (PE) in patients with venous thromboembolism who cannot be anticoagulated, the role of filters in patients who are candidates for anticoagulation is controversial. With limited and conflicting data, practitioners often have to make an educated patient-specific decision when encountering this scenario. This article reviews the available data on the efficacy and risks associated with adjunctive IVC filter use to prevent recurrent PE...
June 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29872244/hypercoagulable-states-and-thrombophilias-risks-relating-to-recurrent-venous-thromboembolism
#8
REVIEW
Marissa D Rybstein, Maria T DeSancho
Inherited and acquired thrombophilias and hypercoagulable states, such as active cancer, estrogen-induced, autoimmune disorders, major surgery, hospitalization, and trauma, are well-known risk factors for venous thromboembolism (VTE). The effect of these on recurrent VTE is different for each specific risk factor. The major risk factors affecting VTE recurrence include the presence of active cancer and an unprovoked first VTE. In addition, the use of combined female hormones in a woman with a previous history of estrogen-related VTE is a major risk factor for VTE recurrence...
June 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29872243/epidemiology-pathophysiology-and-natural-history-of-pulmonary-embolism
#9
REVIEW
Meredith Turetz, Andrew T Sideris, Oren A Friedman, Nidhi Triphathi, James M Horowitz
Pulmonary embolism (PE) is a common and potentially deadly form of venous thromboembolic disease. It is the third most common cause of cardiovascular death and is associated with multiple inherited and acquired risk factors as well as advanced age. The prognosis from PE depends on the degree of obstruction and hemodynamic effects of PE and understanding the pathophysiology helps in risk-stratifying patients and determining treatment. Though the natural history of thrombus is resolution, a subset of patients have chronic residual thrombus, contributing to the post-PE syndrome...
June 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29872242/novel-anticoagulant-treatment-for-pulmonary-embolism-with-direct-oral-anticoagulants-phase-3-trials-and-clinical-practice
#10
REVIEW
C├ęcile Tromeur, Liselotte M van der Pol, Albert T A Mairuhu, Christophe Leroyer, Francis Couturaud, Menno V Huisman, Frederikus A Klok
Anticoagulant therapy is the cornerstone of therapeutic management in acute venous thromboembolism (VTE), consisting of pulmonary embolism and deep vein thrombosis. Direct oral anticoagulants (DOACs) have become the standard of care because of their good safety profile and ease of use in clinical practice. Indeed, phase 3 randomized trials (AMPLIFY, EINSTEIN, RECOVER, and HOKUSAI studies) showed that DOACs provided a similar efficacy and a better safety than conventional treatment with parenteral heparin with overlapping loading dose of vitamin K antagonists in acute VTE therapeutic management...
June 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29872241/as-an-observer-of-interventional-radiology
#11
EDITORIAL
Charles E Ray
No abstract text is available yet for this article.
June 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29628619/intra-and-extrahepatic-collaterals-pitfalls-and-pathways-for-locoregional-therapy
#12
REVIEW
James Su, Suraj Kapoor, Daniel B Brown
No abstract text is available yet for this article.
March 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29628618/female-pelvic-vascular-malformations
#13
REVIEW
Aparna Annam
Vascular malformations are classified primarily according to their flow characteristics, slow flow (lymphatic and venous) or fast flow (arteriovenous). They can occur anywhere in the body but have a unique presentation when affecting the female pelvis. With a detailed clinical history and the proper imaging studies, the correct diagnosis can be made and the best treatment can be initiated. Lymphatic and venous malformations are often treated with sclerotherapy while arteriovenous malformations usually require embolization...
March 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29628617/varicose-veins-and-lower-extremity-venous-insufficiency
#14
REVIEW
Eric DePopas, Matthew Brown
Lower extremity venous insufficiency and varicose veins are common conditions, affecting up to 25% of women. Herein, we review the pathophysiology of lower extremity venous insufficiency and varicose veins, the epidemiology of varicose veins, clinical diagnosis, and ultrasonographic diagnosis. We also discuss treatment rationale, algorithms, and techniques, with a focus on endovenous great saphenous vein ablation.
March 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29628616/updates-on-uterine-artery-embolization
#15
REVIEW
Maureen P Kohi, James B Spies
Uterine fibroids (leiomyomas) are the most common benign neoplasm of the female pelvis and have a lifetime prevalence exceeding 80% among African American women and approaching 70% among Caucasian women. Approximately 50% of women with fibroids experience symptoms which may include menorrhagia that may result in anemia, bulk symptoms with bladder and bowel dysfunction and abdominal protrusion, dysmenorrhea, and infertility. Hysterectomy remains the most common treatment option for fibroids and concerns have been raised about the overuse of this procedure...
March 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29628615/pelvic-artery-embolization-for-treatment-of-postpartum-hemorrhage
#16
REVIEW
Jonathan D Lindquist, Robert L Vogelzang
Postpartum hemorrhage (PPH) is the leading cause of maternal perinatal morbidity and mortality worldwide. Defined as greater than 500 mL blood loss after vaginal delivery, and greater than 1,000 mL blood loss after cesarean delivery, PPH has many causes, including uterine atony, lower genital tract lacerations, coagulopathy, and placental anomalies. Correction of coagulopathy and identification of the cause of bleeding are mainstays of treatment. Medical therapies such as uterotonics, balloon tamponade, pelvic artery embolization, and uterine-sparing surgical options are available...
March 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29628614/pelvic-congestion-syndrome-systematic-review-of-treatment-success
#17
REVIEW
Candace L Brown, Magda Rizer, Ryan Alexander, Emerson E Sharpe, Paul J Rochon
Pelvic venous insufficiency is now a well-characterized etiology of pelvic congestion syndrome (PCS). The prevalence of CPP is 15% in females aged 18 to 50 years in the United States and up to 43.4% worldwide. In addition to individual physical, emotional, and quality-of-life implications of CPP, there are profound healthcare and socioeconomic expenses with estimated annual direct and indirect costs in the United States in excess of 39 billion dollars. PCS consists of clinical symptoms with concomitant anatomic and physiologic abnormalities originating in venous insufficiency...
March 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29628613/locoregional-therapies-for-the-treatment-of-hepatic-metastases-from-breast-and-gynecologic-cancers
#18
REVIEW
Samdeep K Mouli, Ramona Gupta, Neil Sheth, Andrew C Gordon, Robert J Lewandowski
Breast cancer is the most common women's malignancy in the United States and is the second leading cause of cancer death. More than half of patients with breast cancer will develop hepatic metastases; this portends a poorer prognosis. In the appropriately selected patient, there does appear to be a role for curative (surgery, ablation) or palliative (intra-arterial treatments) locoregional therapy. Gynecologic malignancies are less common and metastases to the liver are most often seen in the setting of disseminated disease...
March 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29628612/contraceptive-implant-migration-and-removal-by-interventional-radiology
#19
REVIEW
Salina Zhang, Pelin Batur, Charles Martin, Paul J Rochon
As the reversible contraceptive arm implants grow more popular, there is an increasing need to recognize the complications resulting from implant migration and removal. This review summarizes the findings of imaging and removal methods. When an implant is lost, the axillary region should be investigated first. If the implant still cannot be found, visualization though different methods have been employed for non-radiopaque implants. Real-time fluoroscopic-guided localization and removal can be accomplished for radiopaque Nexplanon...
March 2018: Seminars in Interventional Radiology
https://www.readbyqxmd.com/read/29628611/updates-on-mr-guided-focused-ultrasound-for-symptomatic-uterine-fibroids
#20
REVIEW
Divya Sridhar, Maureen P Kohi
Magnetic-resonance-guided focused ultrasound (MRgFUS), also called high-intensity focused ultrasound (HIFU) is an effective, noninvasive uterine-preserving treatment for symptomatic uterine fibroids. As the use of this therapeutic modality is not yet widespread, it may remain unfamiliar to many interventional radiologists. The purpose of this review is to discuss MRgFUS, including technology, patient selection, technique, outcomes, complications, and recent data on fertility and comparative effectiveness.
March 2018: Seminars in Interventional Radiology
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