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Vascular and Interventional Radiology

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https://www.readbyqxmd.com/read/28529680/-beyond-saving-lives-current-perspectives-of-interventional-radiology-in-trauma
#1
REVIEW
Anuradha Singh, Atin Kumar, Pawan Kumar, Subodh Kumar, Shivanand Gamanagatti
Interventional radiology (IR) has become an integral part in the management of traumatic injuries. There is an ever-increasing role of IR in traumatic injuries of solid abdominal organs, pelvic and peripheral arteries to control active bleeding by therapeutic embolization or vascular reconstruction using stent grafts. Traditionally, these endovascular treatments have been offered to hemodynamically stable patients. However, in recent times endovascular approach has become preferable to surgery even in hemodynamically unstable patients with injury of surgically difficult-to-access sites...
April 28, 2017: World Journal of Radiology
https://www.readbyqxmd.com/read/28516004/endoscopic-ultrasound-reaching-where-others-can-t
#2
Fady G Haddad, Magda Daoud, Ying Liu, Sherif Andrawes
Endoscopic ultrasound (EUS) has been increasingly used for the diagnosis and staging of pancreatic cancer. It has recently become the modality of choice in assessing pancreatic lesions overcoming other traditional modalities. Typically lesions located at the tail of the pancreas are best accessed through the stomach. We present a patient with pancreatic tail mass occurring in the setting of a large hiatal hernia, intrathoracic stomach, and severe lumbar levoscoliosis. Due to altered anatomy and extensive vascular connections of the mass, any surgical or radiological intervention was considered high risk for the patient...
April 15, 2017: Curēus
https://www.readbyqxmd.com/read/28503558/management-of-unresectable-intrahepatic-cholangiocarcinoma-how-do-we-decide-among-the-various-liver-directed-treatments
#3
REVIEW
Eugene J Koay, Bruno C Odisio, Milind Javle, Jean-Nicolas Vauthey, Christopher H Crane
Intrahepatic cholangiocarcinoma often causes death due to obstruction of the biliary system or interruption of the vascular supply of the liver. This fact emphasizes the critical need for local tumor control in this disease. Successful local tumor control has traditionally been achievable through surgical resection for the small proportion of patients with operable tumors. Technological advances in radiation oncology and in interventional radiology have enabled the delivery of ablative radiation doses or other cytotoxic therapies for tumors in the liver...
April 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/28491182/aortoenteric-fistulae-temporization-and-treatment-lessons-learned-from-a-multidisciplinary-approach-to-3-patients
#4
Jeffrey Forris Beecham Chick, Jordan C Castle, Kyle J Cooper, Ravi N Srinivasa, Jonathan L Eliason, Nicholas H Osborne, Karen M Kim, Wael E Saad, Minhaj S Khaja
Aortoenteric fistulae are life-threatening conditions characterized by abnormal communications between the aorta and gastrointestinal tract. Aortoenteric fistulae may be characterized by the triad of bleeding, abdominal pain, or a pulsatile abdominal mass. Although hemorrhage is the most common presentation, it does not always occur; thus, patients may present with nonspecific symptoms. Computed tomography angiography findings suggestive of aortoenteric fistulae include ectopic gas within or adjacent to the aorta, discontinuity of the aortic wall, bowel wall thickening, and extravasation of contrast into the bowel...
June 2017: Radiology case reports
https://www.readbyqxmd.com/read/28489644/an-open-source-ultrasound-software-for-diagnosis-of-fistula-maturation
#5
Barry Belmont, Dae Woo Park, William F Weitzel, Albert J Shih
Vascular access is essential for hemodialysis patients. The mature native arteriovenous fistula has been the preferred vascular access for hemodialysis, because it has greater longevity than synthetic grafts. However, once surgically created, fistulas often fail to develop (mature) into viable points of vascular access, requiring surgical or radiologic interventions before their use. Because maturation depends on vascular mechanics (e.g., distensibility and wall shear), we developed open-source ultrasound software to investigate these metrics clinically...
May 8, 2017: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
https://www.readbyqxmd.com/read/28473094/acr-appropriateness-criteria-%C3%A2-vascular-claudication-assessment-for-revascularization
#6
Osmanuddin Ahmed, Michael Hanley, Shelby J Bennett, Ankur Chandra, Benoit Desjardins, Kenneth L Gage, Marie D Gerhard-Herman, Michael Ginsburg, Heather L Gornik, Isabel B Oliva, Michael L Steigner, Richard Strax, Nupur Verma, Frank J Rybicki, Karin E Dill
Vascular claudication is a symptom complex characterized by reproducible pain and weakness in an active muscle group due to peripheral arterial disease. Noninvasive hemodynamic tests such as the ankle brachial index, toe brachial index, segmental pressures, and pulse volume recordings are considered the first imaging modalities necessary to reliably establish the presence and severity of arterial obstructions. Vascular imaging is consequently used for diagnosing individual lesions and triaging patients for medical, percutaneous, or surgical intervention...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473084/acr-appropriateness-criteria-%C3%A2-renal-transplant%C3%A2-dysfunction
#7
Myles T Taffel, Paul Nikolaidis, Michael D Beland, M Donald Blaufox, Vikram S Dogra, Stanley Goldfarb, John L Gore, Howard J Harvin, Marta E Heilbrun, Matthew T Heller, Gaurav Khatri, Glenn M Preminger, Andrei S Purysko, Andrew D Smith, Zhen J Wang, Robert M Weinfeld, Jade J Wong-You-Cheong, Erick M Remer, Mark E Lockhart
Renal transplantation is the treatment of choice in patients with end-stage renal disease because the 5-year survival rates range from 72% to 99%. Although graft survival has improved secondary to the introduction of newer immunosuppression drugs and the advancements in surgical technique, various complications still occur. Ultrasound is the first-line imaging modality for the evaluation of renal transplants in the immediate postoperative period and for long-term follow-up. In addition to depicting many of the potential complications of renal transplantation, ultrasound can also guide therapeutic interventions...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473083/acr-appropriateness-criteria-%C3%A2-radiologic-management-of-mesenteric-ischemia
#8
Nicholas Fidelman, Ali F AbuRahma, Brooks D Cash, Baljendra S Kapoor, M-Grace Knuttinen, Jeet Minocha, Paul J Rochon, Colette M Shaw, Charles E Ray, Jonathan M Lorenz
Mesenteric vascular insufficiency is a serious medical condition that may lead to bowel infarction, morbidity, and mortality that may approach 50%. Recommended therapy for acute mesenteric ischemia includes aspiration embolectomy, transcatheter thrombolysis, and angioplasty with or without stenting for the treatment of underlying arterial stenosis. Nonocclusive mesenteric ischemia may respond to transarterial infusion of vasodilators such as nitroglycerin, papaverine, glucagon, and prostaglandin E1. Recommended therapy for chronic mesenteric ischemia includes angioplasty with or without stent placement and, if an endovascular approach is not possible, surgical bypass or endarterectomy...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28473067/acr-appropriateness-criteria-%C3%A2-chylothorax-treatment-planning
#9
Bill S Majdalany, Douglas A Murrey, Baljendra S Kapoor, Thomas R Cain, Suvranu Ganguli, Michael S Kent, Fabien Maldonado, Joseph J McBride, Jeet Minocha, Stephen P Reis, Jonathan M Lorenz, Sanjeeva P Kalva
Chylothorax is an uncommon but serious medical condition, which arises when intestinal lymphatic fluid leaks into the pleural space. Treatment strategies depend on the daily output and underlying etiology, which may be due to direct injury to lymphatic vessels or a nontraumatic disorder. Chest radiographs confirm the presence of pleural fluid and lateralize the process. In the setting of direct injury, lymphangiography can often be both diagnostic and facilitate a minimally invasive attempt at therapy. CT and MRI in this setting may be appropriate for cases when lymphangiography is not diagnostic...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28471523/laparoscopic-surgery-for-elective-abdominal-aortic-aneurysm-repair
#10
REVIEW
Lindsay Robertson, Sandip Nandhra
BACKGROUND: Abdominal aortic aneurysm (AAA) is an abnormal dilatation of the infradiaphragmatic aorta that is equal to or greater than 30 mm or a local dilatation of equal to or greater than 50% compared to the expected normal diameter of the artery. AAAs rarely occur in individuals under 50 years of age, but thereafter the prevalence dramatically increases with age, with men at a six-fold greater risk of developing an AAA than women. Prevalence of AAA has been reported to range from 1...
May 4, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28461180/giant-symptomatic-aneurysm-secondary-to-hereditary-hemorrhagic-telangiectasia-of-a-main-hepatic-artery-with-aberrant-origin-in-superior-mesenteric-artery
#11
Francisco Javier Peinado Cebria N, Santiago Este Banez Seco, A Ngel Flores-Herrero, Ricardo Montoya Ching, Benito Mendez Feria, Diego Soto Valdés, Maria Pilar Lamarca Mendoza, Antonio Orgaz Pe Rez-Grueso
INTRODUCTION: Hereditary Hemorragic Telangiectasia (HHT) is a rare disease consistent in vascular dysplasias affecting different organs. Liver involvement includes telangiectases, arteriovenous shunting, and ischemic cholangitis, and its prevalence ranges from 8 to 31%. Spontaneous pseudo aneurysms have never been reported associated to HHT. Several variations in the origin of the main hepatic artery (MHA) have been described in large radiological series, and can be found in around 4% of general population...
April 28, 2017: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/28451716/-interventional-radiology-in-the-head-and-neck-region
#12
C Mayer, E Hattingen, H Schild, F Bootz, A Schröck
In interventional neuroradiology, endovascular embolization represents an important and helpful tool in the treatment of multiple head and neck diseases. These interventional procedures may be performed with curative intent, to reduce the surgical risk within a multimodal treatment concept, or to improve or at least maintain a good quality of life within a palliative therapy concept. In addition to a good understanding of disease pathology, knowledge of vascular anatomy, including collateral vessels and dangerous extracranial-intracranial anastomoses, is essential for successful treatment, as is implementation of an established technique using appropriate material...
April 27, 2017: HNO
https://www.readbyqxmd.com/read/28438186/mortality-and-infectious-complications-of-therapeutic-endovascular-interventional-radiology-a-systematic-and-meta-analysis-protocol
#13
Kaoutar Mellouk Aid, Hervé Tchala Vignon Zomahoun, Abdelmajid Soulaymani, Karin Lebascle, Stephane Silvera, Pascal Astagneau, Benoit Misset
BACKGROUND: Endovascular interventional radiology (EIR) is an increasingly popular, mini invasive treatment option for patient with symptomatic vascular disease. The EIR practiced by qualified hands is an effective, well-tolerated procedure that offers relief of patient's symptoms with a low risk of complications. During acute post procedural period, immediate complications may relate to vascular access, restenosis, thromboembolic events, uterine ischemia, infection, necrosis, sepsis, ICU stay, surgical recovery, pain management, treatment failure, and death...
April 24, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28436152/multispecialty-involvement-in-the-management-of-type-b-aortic-dissections-in-the-endovascular-era-implications-for-training-cardiothoracic-residents
#14
Corbin Muetterties, Rohan Menon, William Moser, Nels Carroll, Kathleen Marulanda, Myunghan Choi, Grayson H Wheatley
PURPOSE: Involvement of qualified specialists with proficiency in endovascular therapies has created flux regarding the role of cardiothoracic surgeons, vascular surgeons, and other catheter-skilled specialists in the management of type B aortic dissections. We used manuscript authorship trends and recent match data in order to study how multi-specialty involvement in treating aortic dissections has changed in the endovascular era. METHODS: A PubMed review of published literature between 1998 and 2015 was performed with "aortic dissection" in the title...
April 23, 2017: Journal of Cardiac Surgery
https://www.readbyqxmd.com/read/28434845/abr-subspecialty-certifications-in-hospice-and-palliative-medicine-and-pain-medicine
#15
Paul E Wallner, Kay H Vydareny, Anne C Roberts
The ACGME currently approves fellowship training in 11 subspecialties of radiology, and the ABR currently offers six subspecialty certificates (vascular interventional radiology will be phased out in 2017) to its primary certificate holders. Four of the ABR-sponsored or co-sponsored subspecialties have been available to ABR diplomates for more than 18 years, but two-hospice and palliative medicine and pain medicine-are relatively new. The nature of specialty and subspecialty certificate development and details related to these two specific programs will be considered...
April 20, 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28397010/corona-mortis-anastomosis-a-three-dimensional-computerized-tomographic-angiographic-study
#16
Ely L Steinberg, Tomer Ben-Tov, Galit Aviram, Yohai Steinberg, Ehud Rath, Galia Rosen
PURPOSE: We evaluated the corona mortis (CM) anatomy by means of three-dimensional computerized tomography angiographic (CTA). METHODS: Patient demographic, anastomosis incidence, artery diameter, artery distance from the symphysis pubis, and pelvic size (distance between both acetabular upper labrum) parameters were assessed. The 100 patients included 66 males and 34 females (average age of 67.8 years). RESULTS: There were 66 (33%) arterial anastomoses in the 200 evaluated arteries, 30 in the right side and 36 in the left side, 36 unilaterally and 15 bilaterally...
April 10, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28384956/haemostasis-with-the-fish-vascular-closure-device-after-6-french-transfemoral-accesses-in-interventional-radiology-clinical-results
#17
Peter C Kamusella, Christopher W Lüdtke, Fabian Scheer, Reimer Andresen, Christian Wissgott
INTRODUCTION: Endovascular procedures have increased for different indications over the recent years. To achieve a safe haemostasis after arterial puncture and for more comfort for the patients different vascular closure devices have been developed. AIM: To evaluate the effectiveness and safety of a percutaneous closure system based on a matrix patch for achieving haemostasis. MATERIALS AND METHODS: In this study from 2014 to 2015 a percutaneous vascular closure system Femoral Introducer Sheath and Haemostasis (FISH) was used in 54 patients (mean age 69...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28384848/surgical-implications-of-portal-vein-variations-and-liver-segmentations-a-recent-update
#18
REVIEW
Showkathali Iqbal, Raiz Iqbal, Faiz Iqbal
The Couinaud's liver segmentation is based on the identification of portal vein bifurcation and origin of hepatic veins. It is widely used clinically, because it is better suited for surgery and is more accurate in localizing and monitoring various intra parenchymal lesions. According to standard anatomy, the portal vein bifurcates into right and left branches; the left vein drains segment II, III and IV and the right vein divides into two secondary branches - the anterior portal vein drains segments V and VIII, and the posterior drains segments VI and VII...
February 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28372492/prenatally-diagnosed-congenital-portosystemic-shunts
#19
Bérengère Francois, Alain Lachaux, Fréderic Gottrand, Stéphanie De Smet
AIM: Congenital portosystemic shunts (CPSS) are rare, congenital malformations that are increasingly often discovered during the fetal period, and for which, the manifestations and evolution are poorly understood. The objective of this review is to describe the phenotype and evolution of forms diagnosed in the antenatal period. MATERIALS AND METHODS: We performed a systematic review of the literature cited in Pubmed between 1982 and 2016 for CPSS cases diagnosed during the fetal period...
April 20, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28345682/-occupational-exposure-in-orthopedic-procedures-under-fluoroscopic-control
#20
Edyta Owsiak, Renata Kopeć, Maciej Budzanowski, Maria A Staniszewska
BACKGROUND: In interventional radiology the highest radiation doses are usually recorded for both the medical staff and the patients. Interventional procedures with X-rays are implemented in a number of medical specializations. This paper concerns the exposure of interventional teams performing orthopedic procedures under X-rays control. MATERIAL AND METHODS: Doses for interventional teams were measured in the 3 Łódź hospitals. Thermoluminescent dosemeters were applied to measure the following dose equivalents: Hp(3) for eye lens, Hp(0...
March 24, 2017: Medycyna Pracy
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