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Techniques in Vascular and Interventional Radiology

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https://www.readbyqxmd.com/read/29784127/endovascular-iliocaval-reconstruction-for-chronic-iliocaval-thrombosis-the-data-where-we-are-and-how-it-is-done
#1
Jeffrey Forris Beecham Chick, Ravi N Srinivasa, Kyle J Cooper, Neil Jairath, Anthony N Hage, Brooke Spencer, Steven D Abramowitz
Iliocaval thrombosis, or thrombosis of the inferior vena cava and iliac veins, is associated with significant morbidity in the form of limb-threatening compromise from phlegmasia cerulean dolens, development of post-thrombotic syndrome, and death secondary to pulmonary embolism. Endovascular iliocaval reconstruction is an effective treatment for iliocaval thrombosis with high levels of technical success, favorable clinical outcomes and stent patency rates, and few complications. It is often able to relieve the debilitating symptoms experienced by affected patients and is a viable option for patients who fail conservative management...
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29784126/endobronchial-forceps-assisted-and-excimer-laser-assisted-inferior-vena-cava-filter-removal-the-data-where-we-are-and-how-it-is-done
#2
James X Chen, Jennifer Montgomery, Gordon McLennan, S William Stavropoulos
The recognition of inferior vena cava filter related complications has motivated increased attentiveness in clinical follow-up of patients with inferior vena cava filters and has led to development of multiple approaches for retrieving filters that are challenging or impossible to remove using conventional techniques. Endobronchial forceps and excimer lasers are tools for designed to aid in complex inferior vena cava filter removals. This article discusses endobronchial forceps-assisted and excimer laser-assisted inferior vena cava filter retrievals...
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29784125/catheter-directed-thrombolysis-for-pulmonary-embolism-the-state-of-practice
#3
Xi Xue, Akhilesh K Sista
Acute pulmonary embolism (PE) is a major public health problem. It is the third most common cause of death in hospitalized patients. In the United States, there are up to 600,000 cases diagnosed per year with 100,000-180,000 acute PE-related deaths. Common risk factors include underlying genetic conditions, acquired conditions, and acquired hypercoagulable states. Acute PE increases the pulmonary vascular resistance and the load on the right ventricle (RV). Increased RV loading causes compensatory RV dilation, impaired contractility, tachycardia, and sympathetic activation...
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29784124/caval-thrombus-management-the-data-where-we-are-and-how-it-is-done
#4
Brittany Harrison, Frank Hao, Nii Koney, Justin McWilliams, John M Moriarty
Thromboses of the superior and inferior vena cava, either isolated or associated with distal deep venous thrombosis, are uncommon, but confer potentially serious morbidity and mortality. Incidence is increasing, especially with the prominence of intravascular devices. The range of treatment options is also expanding to include medical management, surgery, and endovascular techniques which are now frequently considered first line therapy due to lower reintervention rates and decreased periprocedural morbidity...
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29784123/endovascular-interventions-for-venous-disease
#5
REVIEW
Paul O'Connor, Robert Lookstein
Venous thromboembolism, including deep vein thrombosis and pulmonary embolism, occur in up to 900,000 people per year in the United States. Current first-line therapy consists of systemic anticoagulation with a goal to prevent additional thrombus formation. Treatment with anticoagulation alone provides less than satisfactory results with some studies showing propagation of thrombus in almost 40% of cases. Current first-line therapy does not include active removal of thrombus and does little to alleviate acute symptoms and the damaging inflammatory response that may result in postthrombotic syndrome...
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29784122/treatment-of-venous-malformations-the-data-where-we-are-and-how-it-is-done
#6
Anthony N Hage, Jeffrey Forris Beecham Chick, Ravi N Srinivasa, Jacob J Bundy, Nikunj R Chauhan, Michael Acord, Joseph J Gemmete
Venous malformations are the most common type of congenital vascular malformation. The diagnosis and management of venous malformations may be challenging, as venous malformations may be located anywhere in the body and range from small and superficial to large and extensive lesions. There are many treatment options for venous malformations including systemic targeted drugs, open surgery, sclerotherapy, cryoablation, and laser photocoagulation. This article reviews the natural history, clinical evaluation, imaging diagnosis, and treatment modalities of venous malformations...
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29784121/prelude-to-venous-disease-past-present-and-future
#7
EDITORIAL
Jeffrey Forris Beecham Chick, Steven D Abramowitz
No abstract text is available yet for this article.
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29784120/open-surgical-management-of-deep-venous-occlusive-disease
#8
Misaki M Kiguchi, Steven D Abramowitz
Endovascular techniques have revolutionized the management of deep venous occlusive disease. Open surgery, however, is still required for cases that prove refractory to endovascular interventions. The surgical management of deep venous occlusive disease typically involves venous bypass. Preoperative planning before open venous surgery relies upon dynamic imaging to clarify the location and severity of venous obstruction, the assessment of infrainguinal reflux, and the delineation of bypass origination and target vessels...
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29784119/venous-stents-current-status-and-future-directions
#9
Susan M Shamimi-Noori, Timothy W I Clark
Venous outflow obstruction is a dominant contributor to chronic venous disease. Treatment of venous disease has historically been limited by available vascular stent technology not specifically designed for the venous system. The ideal venous stent must provide requisite flexibility, strength, and accurate deployment for the anatomical and pathophysiological conditions of chronic venous disease. Venous stent technology is advancing with multiple dedicated venous stents currently available in Europe and with investigational device exemption studies ongoing in the United States...
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29784118/acute-lower-extremity-deep-venous-thrombosis-the-data-where-we-are-and-how-it-is-done
#10
Raja S Ramaswamy, Olaguoke Akinwande, Joseph D Giardina, Pavan K Kavali, Christina G Marks
The incidence of venous thromboembolism, including both deep vein thrombosis and pulmonary embolism, is estimated at 300,000-600,000 per year. Although thrombosis may occur anywhere, it is thrombosis of the deep veins of the lower extremities that is of interest as this is where thrombosis occurs most often within the venous system. This article discusses the evaluation and interventions, including endovascular catheter-direct treatments, for patients with acute deep venous thrombosis.
June 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29472000/get-the-lead-off-our-backs
#11
Chet R Rees, Barrett W C Duncan
Many interventionalists face physical challenges almost daily for years or decades. The burden of assuming awkward positions while carrying extra weight can take its toll on the musculoskeletal system to such an extent that the career is ended or modified to exclude procedural aspects. The proliferation of lighter aprons has unfortunately resulted in reduced protection with poor correlation of protection to labeling due to the inadequacies of testing methods for nonlead materials. The protective quality of the non-leads is not superior to lead-containing composites on a weight basis, and the user no longer knows how well they are protected unless buying aprons containing lead...
March 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29471999/make-radiation-protection-a-habit
#12
Donald L Miller
This review describes the basic concepts and methods for optimization of occupational dose in the interventional suite. In fluoroscopy, the source of virtually all radiation exposure to the operator is scattered radiation from the patient. All other things being equal, reducing patient radiation dose will reduce operator and staff dose. Most tools and methods of occupational radiation protection are entirely operator dependent. These methods must be used routinely and properly to be effective. Your occupational dose depends on how well you follow good radiation protection practices and on the kinds of procedures you do...
March 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29471998/baby-on-board-managing-occupational-radiation-exposure-during-pregnancy
#13
M Victoria Marx
This article reviews the issue of occupational radiation exposure as a deterrent to recruitment of women into the field of interventional radiology and provides the reader with three strategies to optimize radiation protection during fluoroscopically guided procedures. These include personal protective shielding, use of ancillary shielding, and techniques that limit fluoroscopy x-ray tube output. When optimal radiation safety practices are implemented as the norm in the IR suite, very little extra needs to be done to ensure that fetal dose of a pregnant interventionalist is negligible...
March 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29471997/always-on-my-mind
#14
Stephen Balter
This article is focused on occupational radiogenic brain tumors and some radioprotective techniques used to manage this risk. Published case reports have stimulated concern among operators. The anatomical pattern of tumor locations is not consistent with measured radiation dose distributions at operators' heads. In addition, the lack of statistically positive findings in these reports, and a recently published survey on radiologist's mortality both indicate that the current level of fluoroscopists' radiation safety practices is likely to be adequate...
March 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29471996/the-eyes-have-it
#15
Lindsay Machan
The ocular lens is one of the most susceptible structures in the body to radiation damage. Unfortunately, much of the traditional academic and regulatory thinking on thresholds to develop radiation-induced opacities or cataracts has proven to be false. Individual vulnerability to the effects of radiation is extremely variable, largely because each individual is variably genetically equipped to repair the damage caused by radiation. Therefore many people, including some unsuspecting interventional radiologists may have no, or almost no, threshold at all for cataract development after radiation injury...
March 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29471995/should-we-keep-the-lead-in-the-aprons
#16
Gabriel Bartal, Anna M Sailer, Eliseo Vano
Medical staff should not be exposed to the primary X-ray beam during fluoroscopy-guided interventional procedures (FGIP). The main source of staff exposure is scatter radiation from the patient, which can be significant. Although many aspects of X-ray exposure to the patient as well as occupational exposure to interventional radiologists and other staff are strongly regulated and monitored in most countries, it is surprising how loosely the labeling and testing of the protective aprons is regulated. Interventional radiologists (IRs) have to be experts in interventional radiology as well as in basic facts regarding ways to provide a satisfactory level of protection from occupational exposure...
March 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29471994/ergonomics-in-the-development-and-prevention-of-musculoskeletal-injury-in-interventional-radiologists
#17
Jamaal L Benjamin, Quinn C Meisinger
Interventional radiology is a constantly evolving specialty overlapping with multiple other specialties, including cardiology, vascular surgery, orthopedic surgery, urology, and minimally invasive surgery. Unique ergonomic considerations for interventional radiology include utilization of intraoperative viewing monitors and personal radiation protection equipment. Work-related injuries are common in interventional radiologists,1 often leading to pain while performing procedures or during time away from work...
March 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29471993/live-without-regret
#18
EDITORIAL
M Victoria Marx
No abstract text is available yet for this article.
March 2018: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29224663/obstruction-of-the-biliary-and-urinary-system
#19
REVIEW
William O'Connell, Jay Shah, Jason Mitchell, J David Prologo, Louis Martin, Michael J Miller, Jonathan G Martin
Biliary and urinary obstructions can be managed endoscopically or cystoscopically, surgically or by percutansous intervention or drainage. If the obtructed system is infected, emergent decompression is needed. Early recognition and treatment is paramount in both conditions. Acute cholangitis can present many different ways, from mild symptoms to fulminant sepsis. It is usually a result of ascending bacterial colonization and biliary obstruction resulting in bacterial overgrowth. Therefore, those patients with recent biliary instrumentation or previous biliary modification are at higher risk...
December 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29224662/managing-venous-thromboembolic-disease-on-call
#20
REVIEW
Jason W Mitchell, William G O Connell, Charles A Gilliland, Irwin M Best
Managing venous thromboembolic disease on-call requires the interventional radiologist consider not only potential risk and benefit to the patient but also available resources in the IR suite as well as throughout the hospital, such as intensive care monitoring during treatment. We demonstrate how our practice manages these on-call cases ranging from deep venous thrombosis to acute pulmonary embolism and decide which patients need emergent treatment and which can undergo delayed intervention during working hours...
December 2017: Techniques in Vascular and Interventional Radiology
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