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https://www.readbyqxmd.com/read/29166330/hepatic-falciform-artery-demonstrating-maa-uptake-in-the-anterior-abdomen-prior-to-embolization
#1
Dhruv Patel, Ken Le, Joga Chaganti, Robert Mansberg
A 58-year-old man was referred for selective internal radiation therapy for locally advanced unresectable hepatocellular carcinoma. Intra-arterial particle perfusion scintigraphy was performed with SPECT/CT following intra-arterial injection of Tc macroaggregated albumin. Angiography demonstrated a hepatic falciform artery, a feeding artery of the ligamentum teres, whereas scintigraphy demonstrated tracer uptake in the mid-anterior abdominal wall. The hepatic falciform artery was subsequently embolized and the repeat angiogram confirmed successful occlusion...
November 22, 2017: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29163743/comparison-of-endovascular-treatment-with-intravenous-thrombolysis-for-isolated-m2-segment-of-middle-cerebral-artery-occlusion-in-acute-ischemic-stroke
#2
Adnan I Qureshi, Muhammad A Saleem, Emrah Aytac
Background: The benefit of endovascular treatment for distal large artery ischemic occlusions such as M2 segment of middle cerebral artery is not clear. Methods: We retrospectively analyzed data from 51 subjects who had an isolated M2 segment occlusion on baseline computed tomographic (CT) angiogram who were randomized to either intravenous (IV) recombinant tissue plasminogen activator (rt-PA) followed by endovascular treatment or IV rt-PA alone in a multicenter trial...
October 2017: Journal of Vascular and Interventional Neurology
https://www.readbyqxmd.com/read/29153027/annals-express-large-abnormal-peak-on-capillary-zone-electrophoresis-due-to-contrast-agent
#3
Rachel D Wheeler, Liqun Zhang, Joanna Sheldon
BACKGROUND: Some iodinated radio-contrast media absorb UV light and can therefore be detected by capillary zone electrophoresis (CZE). If seen, these peaks are typically small with "quantifications" of below 5g/L. Here we describe detection of a large peak on CZE that was due to the radio-contrast agent, Omnipaque(T)(M). METHODS: Serum from a patient was analysed by CZE, and the IgG, IgA, IgM and total protein concentrations were measured. The serum sample was further analysed by gel electrophoresis and immunofixation...
January 1, 2017: Annals of Clinical Biochemistry
https://www.readbyqxmd.com/read/29135347/relative-cerebral-blood-volume-is-associated-with-collateral-status-and-infarct-growth-in-stroke-patients-in-swift-prime
#4
Juan F Arenillas, Elisa Cortijo, Pablo García-Bermejo, Elad I Levy, Reza Jahan, Mayank Goyal, Jeffrey L Saver, Gregory W Albers
We aimed to evaluate how predefined candidate cerebral perfusion parameters correlate with collateral circulation status and to assess their capacity to predict infarct growth in patients with acute ischemic stroke (AIS) eligible for endovascular therapy. Patients enrolled in the SWIFT PRIME trial with baseline computed tomography perfusion (CTP) scans were included. RAPID software was used to calculate mean relative cerebral blood volume (rCBV) in hypoperfused regions, and hypoperfusion index ratio (HIR). Blind assessments of collaterals were performed using CT angiography in the whole sample and cerebral angiogram in the endovascular group...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29131773/update-on-cardiovascular-applications-of-multienergy-ct
#5
Kevin Kalisz, Sandra Halliburton, Suhny Abbara, Jonathon A Leipsic, Moritz H Albrecht, U Joseph Schoepf, Prabhakar Rajiah
Advances in scanner technology enabling shorter scan times, improvements in spatial and temporal resolution, and more dose-efficient data reconstruction coupled with rapidly growing evidence from clinical trials have established computed tomography (CT) as an important imaging modality in the evaluation of cardiovascular disorders. Multienergy (or spectral or dual-energy) CT is a relatively recent advance in which attenuation data from different energies are used to characterize materials beyond what is possible at conventional CT...
November 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/29130956/ischemic-stroke-histological-thrombus-composition-and-pre-interventional-ct-attenuation-are-associated-with-intervention-time-and-rate-of-secondary-embolism
#6
Peter B Sporns, Uta Hanning, Wolfram Schwindt, Aglae Velasco, Boris Buerke, Christian Cnyrim, Jens Minnerup, Walter Heindel, Astrid Jeibmann, Thomas Niederstadt
BACKGROUND AND PURPOSE: The introduction of stent retrievers has made the complete extraction and histological analysis of human thrombi possible. A number of large randomized trials have proven the efficacy of thrombectomy for ischemic stroke; however, thrombus composition could have an impact on the efficacy and risk of the intervention. We therefore investigated the impact of histologic thrombus features on interventional outcome and procedure-related embolisms. For a pre-interventional estimation of histologic features and outcome parameters, we assessed the pre-interventional CT attenuation of the thrombi...
October 31, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29127251/looking-beyond-the-indication-bone-scan-for-trauma-providing-unsuspected-initial-diagnosis-of-acute-critical-lower-limb-arterial-compromise
#7
Fathima Fijula Palot Manzil, Samuel E Almodovar, Pradeep Bhambhvani
We report a case of rare incidental initial detection of unsuspected arterial supply compromise to the right lower extremity on a bone scan done to rule out fracture in a patient with right hip pain following a fall. Follow up CT angiogram confirmed near complete occlusion of right lower extremity arteries for which patient underwent above knee amputation.
November 10, 2017: Journal of Nuclear Medicine Technology
https://www.readbyqxmd.com/read/29122894/dyspnoea-in-lupus
#8
Jeremy Fleri Soler, Andrew Borg, Cecilia Mercieca
A 32-year-old woman suffering from systemic lupus erythematosus presented with a 6-week history of progressive dyspnoea and pleuritic chest pain. Examination was normal apart from reduced air entry at the lung bases.Arterial blood gases showed hypoxaemia and chest X-ray revealed raised hemidiaphragms without any pleural effusions. Lung function showed a restrictive pathology while high-resolution chest CT and CT pulmonary angiogram were negative. Echocardiography showed normal ventricular diameters and no pericardial effusion...
November 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29101266/a-59-year-old-woman-with-visible-precordial-pulsations
#9
Alastair J Moss, Renzo Pessotto, Andrew D Flapan
CLINICAL INTRODUCTION: A retired 59-year-old woman presented to the cardiology clinic concerned with cardiac pulsations that were visible on her chest wall. These were not associated with dyspnoea, syncope or chest discomfort.Of note, 8 years previously, she complained of recurrent nocturnal diaphoresis and 5 kg weight loss. Blood sampling at that time revealed a microcytic anaemia, reactive thrombocytosis and raised inflammatory markers (erythrocyte sedimentation rate 99 mm/hour, C-reactive protein 161 mg/L)...
November 3, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29075546/a-rare-report-of-infectious-emphysematous-aortitis-secondary-to-clostridium-septicum-without-prior-vascular-intervention
#10
Ciel Harris, Joseph Geffen, Keyrillos Rizg, Stuart Shah, Aaron Richardson, Cherisse Baldeo, Avinash Ramdass
The term "mycotic aneurysm" was first used by Osler in 1882 to describe a mushroom-shaped aneurysm in subacute bacterial endocarditis. Mycotic aneurysms account for only 2.6% of all aneurysms of the aorta. Rarer still are anaerobic infections secondary to organisms such as Clostridium septicum, which results in emphysematous aortitis. The vast majority of emphysematous aortic infections occur as a result of instrumentation; however, in this case we present an infection de novo. A 75-year-old male presented with a 2-week history of progressive fatigue and chest pain that then developed into constitutional symptoms...
2017: Case Reports in Vascular Medicine
https://www.readbyqxmd.com/read/29073499/management-of-major-vascular-injury-during-pedicle-screw-instrumentation-of-thoracolumbar-spine
#11
Aleem K Mirza, Mohammed Ali Alvi, Ryan M Naylor, Panagiotis Kerezoudis, William E Krauss, Michelle J Clarke, Daniel L Shepherd, Ahmad Nassr, Randall R DeMartino, Mohamad Bydon
OBJECTIVES: Vascular injury is a rare complication of spinal instrumentation. Presentation can vary from immediate hemorrhage to pseudoaneurysm formation. In the literature, surgical approach to repair has varied based on anatomy, acuity of diagnosis, infection, and available technology. In this manuscript, we aim to describe our institutional experience with vascular injuries in thoraco-lumbar spine surgery. PATIENTS AND METHODS: We report our institutional experience of three cases of vascular injury secondary to pedicle screw misplacement and their management, as well as a review of the literature...
October 16, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29066647/buttock-wounds-beware-what-lies-beneath
#12
Stephanie Clark, Suzanne Westley, Alexander Coupland, Mohamad Hamady, Alun H Davies
A 25-year-old man presented to a major trauma centre with multiple stab wounds, most significantly to the right buttock. Triple-phase CT revealed no acute bleeding and his wounds were closed. In the month following injury, he re-presented seven times to the emergency department (ED) complaining of bleeding and wound breakdown. After his seventh ED attendance, he was examined under general anaesthesia. Intraoperatively, profuse arterial bleeding was encountered and the local major haemorrhage protocol was activated...
October 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29056401/outcomes-of-transcatheter-arterial-embolization-with-a-modified-n-butyl-cyanoacrylate-glue-for-spontaneous-iliopsoas-and-rectus-sheath-hematomas-in-anticoagulated-patients
#13
Rany Jawhari, Olivier Chevallier, Nicolas Falvo, Philippe d'Athis, Sophie Gehin, Pierre-Emmanuel Charles, Marco Midulla, Romaric Loffroy
PURPOSE: To assess the efficacy and safety of n-butyl cyanoacrylate methacryloxy sulfolane (NBCA-MS) transcatheter arterial embolization for anticoagulation-related soft-tissue bleeding and to evaluate predictive factors of clinical success and 30-day mortality. MATERIALS AND METHODS: A retrospective review of 50 anticoagulated patients (25 male; mean age, 71.7 y ± 14.2; range, 19-87 y) who underwent emergent Glubran 2 NBCA-MS embolization for iliopsoas hematomas (IPHs; n = 38), rectus sheath hematomas (n = 11), or both (n = 1) between 2011 and 2016 was performed...
October 19, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/29054946/management-challenges-of-late-presentation-dacron-patch-infection-after-carotid-endarterectomy
#14
Jie Hua Xu, Nishath Altaf, Patrik Tosenovsky, Bibombe Patrice Mwipatayi
An 83-year-old man presented 4 years after right carotid endarterectomy (CEA) with an infection of his prosthetic Dacron patch. Initial scans (CT angiogram and whole body labelled white cell scan) were clear with no infection or collection noted. Systemically, the patient presented well with no recorded fevers. With an occluded left internal carotid artery and severely stenosed vertebral arteries, surgery presented a high risk of major stroke due to the lack collateral supply and this was discussed extensively...
October 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29054943/non-infectious-aortitis-in-an-immunosuppressed-renal-transplant-recipient-with-iga-nephropathy
#15
Charlotte M Snead, Stephen C Crockett, Phillippa K Bailey
A 54-year-old woman presented with atypical chest pain, fever and malaise. She was immunosuppressed with three agents following a living-donor kidney transplant 1 year previously. Her native kidney failure was secondary to biopsy-demonstrated crescentic IgA nephropathy, with systemic involvement. A CT pulmonary angiogram revealed an inflammatory cuff of soft tissue around the descending thoracic aorta suggesting aortitis. Inflammatory markers were elevated. Given her immunosuppression, the patient was screened extensively for infective causes and was empirically commenced on intravenous meropenem...
October 19, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29046469/-a-rare-case-of-ruptured-unruptured-miniature-aneurysms-originating-from-the-infundibular-dilatation-of-the-callosomarginal-artery-branching-from-the-infracallosal-a2-segment-of-the-azygos-anterior-cerebral-artery
#16
Shota Yoshimura, Chika Somagawa, Kei Satoh, Yutaka Fukuda, Takeshi Hiu, Tomonori Ono, Ryujiro Ushijima, Keisuke Toda, Keisuke Tsutsumi
We report the first case of two de novo miniature aneurysms(ruptured/unruptured)emerging from the infundibular dilatation(ID)of the callosomarginal artery, which branches from the infracallosal(A2)segment of the azygos anterior cerebral artery(AACA), in a 36-year-old woman. The patient had previously been diagnosed with a miniature, unruptured aneurysm, occurring in the A2 segment of the AACA, detected by CT angiography(CTA)at another hospital two years ago, and had been followed up with MR angiography(MRA)every 6 months...
October 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29046468/-a-case-of-dural-arteriovenous-fistula-that-developed-21-months-after-cerebral-venous-sinus-thrombosis
#17
Motonori Ishii, Takashi Yamanouchi, Ryosuke Oshima, Masaki Sato, Tomoyuki Noda, Hideki Maki, Akira Kito
A 56-year-old man experienced a sudden onset of left hemiparesis. The computed tomography(CT)scan revealed a lobar hemorrhage in the right fronto-parietal lobe. After his admission, deep vein thrombosis was detected in his left lower limb, and angiograms taken on the 36th day of hospitalization revealed cerebral venous sinus thrombosis. Anticoagulant treatment was induced. After 21 months, he experienced a sudden onset of left hemiparesis again. The CT scan revealed a new lobar hemorrhage in the right frontal lobe, and angiograms revealed that two dural arteriovenous fistulas(dAVF)developed in the superior sagittal sinus(SSS)and the left transverse-sigmoid sinus...
October 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/29040038/ferumoxytol-enhanced-mr-angiography-for-vascular-access-mapping-before-transcatheter-aortic-valve-replacement-in-patients-with-renal-impairment-a-step-toward-patient-specific-care
#18
Kim-Lien Nguyen, John M Moriarty, Adam N Plotnik, Olcay Aksoy, Takegawa Yoshida, Richard J Shemin, William M Suh, J Paul Finn
Purpose To assess the technical feasibility of the use of ferumoxytol-enhanced (FE) magnetic resonance (MR) angiography for vascular mapping before transcatheter aortic valve replacement in patients with renal impairment. Materials and Methods This was an institutional review board-approved and HIPAA-compliant study. FE MR angiography was performed at 3.0 T or 1.5 T. Unenhanced computed tomographic (CT) images were used to overlay vascular calcification on FE MR angiographic images as composite fused three-dimensional data...
October 16, 2017: Radiology
https://www.readbyqxmd.com/read/29026365/incidental-finding-of-bronchopulmonary-sequestration-in-a-64-year-old-female
#19
Pichapong Tunsupon, Ayesha Arshad, Sumit Patel, M Jeffery Mador
BACKGROUND: Bronchopulmonary sequestration is a congenital abnormality of the primitive foregut. In adults, the typical age at presentation is 20-25 years. CASE REPORT: A 64-year-old female was referred for evaluation of an 8 × 6-cm right lower lobe cystic lesion. Her medical history was significant for recurrent right lower lobe pneumonia requiring multiple hospitalizations. Her physical examination was significant for crackles at the right lung base. Computed tomography (CT) of the chest with contrast showed cystic changes with thickened septation of the medial segment of the right lower lobe lacking distinct visceral pleura and with arterial supply from the anomalous branch of the thoracic aorta arising near the celiac trunk...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29025777/oesophageal-ischaemia-an-uncommon-cause-of-chest-pain
#20
Ayodele Sasegbon, Akram Algieder, Bashir Rameh
A 79-year-old woman with a history of ischaemic heart disease and atrial fibrillation presented to hospital with severe chest pain. Blood tests showed an elevated D-dimer and a rise in troponin I. ECG showed right bundle branch block pattern and T wave inversion in leads V1 to V3, although these changes were present in old ECGs. A chest X-ray was done which was normal. Due to the nature and severity of her pain a CT aortic angiogram was done. This did not show any evidence of aortic dissection or a pulmonary embolism...
October 11, 2017: BMJ Case Reports
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