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Alain Cunqueiro, Meir H Scheinfeld
Intracranial gas is commonly detected on neuroimaging. The recognition of this finding can at first blush be unsettling. Being able to localize this gas to a specific compartment: intraarterial, intravenous, intraparenchymal, subdural, epidural, subarachnoid and intraventricular, is the first step in determining the importance of the gas. Determination of the route of entry: through the skull, extension from a paranasal sinus or the mastoid air cells, via the spine, or trans-vascular, is the other important factor in determining potential consequences...
March 15, 2018: Emergency Radiology
Pavol Sajgalik, Vaclav Kremen, Vratislav Fabian, Simon Maltais, John M Stulak, Sudhir S Kushwaha, Lyle D Joyce, John A Schirger, Bruce D Johnson
The gold standard for noninvasive blood pressure (BP) measurement, the Doppler technique, does not provide systolic blood pressure (SBP) and diastolic blood pressure (DBP) and may limit therapy outcomes. To improve patient care, we tested specifically designed experimental BP (ExpBP) monitor and the Doppler technique by comparing noninvasive measures to the intraarterial (I-A) BP in 31 patients with end-stage heart failure (4 females) 2.6 ± 3.4 days post-LVAD implantation (20 HeartMate II and 11 HeartWare)...
March 13, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
N B Perepech, I E Mikhaylova
This review is devoted to the use of antiaggregants. We consider here pathogenesis of intraarterial thrombosis, mechanism of action of antiaggregants, and recommendations on the use of drugs of this class for primary prevention of cardiovascular diseases and prevention of atherothrombotic complications of stable ischemic heart disease. Information on mechanisms of development and causes of resistance to antiaggregants is also presented. Finally we discuss the problem of safety of therapy with antiaggregants, methods of lowering the risk of bleeding, and prevention of aspirin induced gastropathy...
February 2018: Kardiologiia
Kunal Malik, R Joel Welch, Carol L Shields
PURPOSE: Retinoblastoma (Rb) is a potentially fatal intraocular malignancy in children, and hand-held optical coherence tomography (HH-OCT) can assist in submillimeter detection and monitoring after treatment of Rb. Retinoblastoma located in the macula, or those with chemoresistance, can be among the most difficult to manage. We describe HH-OCT features in a case of chemoresistant macular Rb that eventually responded to plaque radiotherapy after failing intravenous chemotherapy and intraarterial chemotherapy...
February 13, 2018: Retinal Cases & Brief Reports
Naveed Kamal, Neil Majmundar, Nitesh Damadora, Mohammad El-Ghanem, Rolla Nuoman, Irwin A Keller, Steven Schonfeld, Igor Rybinnik, Gaurav Gupta, Sudipta Roychowdry, Fawaz Al-Mufti
PURPOSE: The purpose of this study is to review the history of treatments for acute ischemic stroke, examine developments in endovascular therapy, and discuss the future of the management of acute ischemic stroke. METHODS: A selective review of recent clinical trials for the treatment of acute ischemic stroke was conducted. RESULTS: We reviewed completed trials of the management of acute ischemic stroke including intravenous thrombolytics, intraarterial thrombolytics, and thrombectomy...
February 8, 2018: British Journal of Neurosurgery
Wei-Xing Jiang, Zhi-En Zhou, Wei-Gang Yan, Jie Pan, Zhi-Gang Ji
RATIONALE: Postoperative hemorrhage is a rare complication after laparoscopic radical prostatectomy (LRP), with no case reports of bleeding from the external iliac artery in the literature. PATIENT CONCERNS: A 73-year-old man diagnosed with clinical stage 2c prostate cancer underwent LRP successfully with only approximately 200 mL of intraoperative blood loss. However, his blood pressure dropped from 135/74 to 80/49 mm Hg and his hemoglobin decreased by 66 g/L compared with the preoperative level within 5 hours...
December 2017: Medicine (Baltimore)
Young-Jin Kim, Kwang-Wook Cho, Seong-Rim Kim, Do-Sung Yoo, Hae-Kwan Park, Cheol Ji
Objective: Intraarterial thrombolysis (IA-Tx) with stent retriever is accepted as an additional treatment for selected patients and the clinical benefit is well reported. Each intravenous tissue plasminogen activator administration (IV-tPA) and perfusion diffusion mismatching (P/D-mismatching) is well known the beneficial effects for recanalization and clinical outcomes. In this report, authors analyzed the clinical outcomes of additional IA-Tx with retrieval stent device, according to the combined IV-tPA and P/D-mismatching or not...
December 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
Jenson Ma, Juan Martin Gimenez, Tyler Sandow, Daniel Devun, David Kirsch, Paul Gulotta, Patrick Gilbert, Dennis Kay
Background: Since the early 1990s, the minimally invasive image-guided therapies used in interventional oncology to treat hepatocellular carcinoma have continued to evolve. Additionally, the range of applications has been expanded to the treatment of hepatic metastases from colorectal cancer, neuroendocrine tumors, cholangiocarcinoma, breast cancer, melanoma, and sarcoma. Methods: We searched the literature to identify publications from 1990 to the present on various image-guided intraarterial therapies and their efficacy, as well as their role in the management of primary and secondary liver malignancies...
2017: Ochsner Journal
Danny Eytan, Andrew J Goodwin, Robert Greer, Anne-Marie Guerguerian, Mjaye Mazwi, Peter C Laussen
OBJECTIVES: Define the distributions of heart rate and intraarterial blood pressure in children at admission to an ICU based on admission diagnosis and examine trends in these physiologic signs over 72 hours from admission (or to discharge if earlier). DESIGN: A retrospective analysis of continuously acquired signals. SETTING: A quaternary and primary referral children's hospital with a general PICU and cardiac critical care unit. PATIENTS: One thousand two hundred eighty-nine patients less than 18 years old were analyzed...
February 2018: Pediatric Critical Care Medicine
Vera Yarovaya, Kareem Sioufi, Carol L Shields
Background: Optical coherence tomography (OCT) has become an invaluable tool in retinoblastoma management, providing submillimeter visualization of tumor control following treatment. Herein, we document OCT-detection of a subtle tumor recurrence, allowing early intervention and achieving foveal microanatomy preservation. Case presentation: A 3-week-old girl was diagnosed with bilateral familial retinoblastoma, classified as group D in the right eye (OD) and group B in the left eye (OS), and treated with intravenous chemoreduction...
2017: International Journal of Retina and Vitreous
Takashi Ando, Kazuma Date, Makoto Takeda
No abstract text is available yet for this article.
January 1, 2017: Asian Cardiovascular & Thoracic Annals
Lidija Kocbek, Mateja Rakuša
PURPOSE: The right bronchial artery usually arises from the descending thoracic aorta as a common trunk with the right intercostal artery and forms the right intercostobronchial trunk. Both, the third right posterior intercostal artery and the right intercostobronchial trunk, are described as the most constant vessels. The focus of the study was to determine the characteristics of the right intercostobronchial trunk regarding the origins of the posterior intercostal arteries from the thoracic aorta...
November 10, 2017: Surgical and Radiologic Anatomy: SRA
Ramón Iglesias-Rey, Manuel Rodríguez-Yáñez, Emilio Rodríguez-Castro, José Manuel Pumar, Susana Arias, María Santamaría, Iria López-Dequidt, Pablo Hervella, Clara Correa-Paz, Tomás Sobrino, Denis Vivien, Francisco Campos, Mar Castellanos, José Castillo
Based on preclinical studies suggesting that recombinant tissue plasminogen activator (rt-PA) may promote ischemic brain injuries, we investigated in patients the possible risk of worse clinical outcome after rt-PA treatment as a result of its inability to resolve cerebral ischemia. Here, we designed a cohort study using a retrospective analysis of patients who received treatment with intravenous (4.5-h window) or intraarterial rt-PA, without or with thrombectomy. Controls were consecutive patients who did not receive recanalization treatment, who met all inclusion criteria...
November 7, 2017: Translational Stroke Research
Hye Seon Jeong, Jong Wook Shin, Hyon-Jo Kwon, Hyeon-Song Koh, Hae-Sung Nam, Hee Seon Yu, Na Young Yoon, Jei Kim
OBJECTIVES: Thrombolytic therapy is associated with favorable clinical outcomes after successful and rapid recanalization in patients with acute ischemic stroke. This study aimed to evaluate the cost benefits and clinical outcomes at 1 year after intraarterial thrombectomy (IAT) by the rapidity of the successful recanalization. MATERIALS & METHODS: Clinical outcomes of and medical costs incurred by 230 patients with acute ischemic stroke who underwent IAT were compared by the rapidity from symptom onset to successful recanalization (2b/3 thrombolysis in cerebral infarction grade): ≤6-hr (n = 143), >6-hr (n = 31), and no-recanalization (n = 56)...
October 2017: Brain and Behavior
Hiroshi Maeda
History of the EPR (enhanced permeability and retention) effect is discussed, which goes back to the analyses of molecular pathology in bacterial infection and edema (extravasation) formation. The first mediator we found for extravasation was bradykinin. Later on, were found nitric oxide and superoxide, then formation of peroxynitrite, that activates procollagenase. In this inflammatory setting many other vascular mediators are involved that are also common to cancer vasculature. Obviously cancer vasculature is defective architechtally, and this makes macromolecular drugs more permeable through the vascular wall...
November 2017: Journal of Drug Targeting
Andrew C Leatherbarrow, Alina Bucata
We report a rare case of iatrogenic arterial cannula transection during a dressing change and migration of the distal fragment within the radial artery. The retained intraarterial fragment was successfully located using ultrasound, enabling swift surgical removal. We discuss the risk factors associated with arterial cannula transection and the efficacy of imaging modalities in locating the intraarterial fragment.
September 26, 2017: A & A Case Reports
F Edward Boas, Lisa Bodei, Constantinos T Sofocleous
Liver metastases are a major cause of death from colorectal cancer. Intraarterial therapy options for colorectal liver metastases include chemoinfusion via a hepatic arterial pump or port, irinotecan-loaded drug-eluting beads, and radioembolization using 90Y microspheres. Intraarterial therapy allows the delivery of a high dose of chemotherapy or radiation into liver tumors while minimizing the impact on liver parenchyma and avoiding systemic effects. Specificity in intraarterial therapy can be achieved both through preferential arterial flow to the tumor and through selective catheter positioning...
September 2017: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Denver Steven Pinto, V Ravi Hoisala, Pavan Gupta, Parthasarathy Sarkar
INTRODUCTION: Hemangiomas are benign tumors characterized by proliferation of blood vessels. A few hemangiomas are aggressive, characterized by bone expansion and extraosseous extension. These benign tumors may be mistaken for metatasis resulting in unnecessary biopsies, which have a high risk of hemorrhage. These hemangiomas can spread not just into the paraspinal soft tissues but also into the epidural region of the spinal canal causing cord compression and paraparesis. These clinical symptoms can be relieved by surgical decompression of the posterior elements, embolization or radiotherapy...
March 2017: Journal of Orthopaedic Case Reports
Shunji Sarukawa, Hideaki Kamochi, Tadahide Noguchi, Ataru Sunaga, Hirokazu Uda, Yoshiyuki Mori, Hiroshi Nishino, Kotaro Yoshimura
Anteromedial maxillectomy is typically performed in conjunction with low-dose radiotherapy and intraarterial chemotherapy. In doing so, the extent of surgical defects is reduced. However, nasal deviation and oral incompetence may ensue, due to cicatricial contracture of wounds, and may be distressing to these patients. Herein, we report a series of eight free perforator flap procedures (anterolateral thigh [ALT] flap, 6; thoracodorsal artery perforator [TAP] flap, 2) used to correct such deformities. The TAP flap was combined with scapular tip [ST] osseous flap in patients with added zygomatic prominence defects...
September 2017: Journal of Cranio-maxillo-facial Surgery
Beatrice Fiorucci, Giacomo Isernia, Gioele Simonte, Luca Farchioni, Basso Parente, Gianbattista Parlani, Massimo Lenti
Acute occlusion of the visceral arteries is a threatening complication following branched endovascular aortic repair (EVAR). Its prompt diagnosis and treatment are mandatory to restore renal function. Several techniques have been used to manage this complication. We report 2 clinical cases of patients, previously treated with implantation of an off-the-shelf thoracoabdominal aortic endograft, with acute bilateral occlusion of the renal arteries. Both patients were successfully treated with AngioJet rheolytic thrombectomy...
July 21, 2017: Annals of Vascular Surgery
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