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Vascular and Interventional Radiology

Jose F Condado, Vasilis Babaliaros, Travis S Henry, Brian Kaebnick, Dennis Kim, Gerald W Staton
BACKGROUND: The best treatment of patients with external pulmonary vascular compression due to advanced sarcoidosis is unknown. OBJECTIVES: To report a single-center experience of percutaneous treatment for pulmonary vascular stenosis caused by external compression due to advanced sarcoidosis. METHODS: We report a case series of 5 patients with biopsy confirmed advanced sarcoidosis, seen at our academic institution with worsening dyspnea despite increase of immunosuppressive therapy...
October 7, 2016: Sarcoidosis, Vasculitis, and Diffuse Lung Diseases: Official Journal of WASOG
Roxane Maurer, Michel Rivoire, Valéria Basso, Pierre Meeus, Patrice Peyrat, Aurélien Dupré
BACKGROUND: The portal vascularization of segment IV (S4) of the liver has not been well described. Knowledge of the portal supply to S4 is of great interest for liver surgery and for interventional radiological procedures. This study aimed to analyse the distribution of portal vein branches supplying S4. METHODS: We retrospectively analysed data from patients operated on for liver tumours between 2007 and 2016. Patients with involvement of S4 branches or the left portal vein, previous liver surgery or poor quality imaging were excluded...
October 18, 2016: Surgical and Radiologic Anatomy: SRA
Walter R Wilson, Thomas C Bower, Mark A Creager, Sepideh Amin-Hanjani, Patrick T O'Gara, Peter B Lockhart, Rabih O Darouiche, Basel Ramlawi, Colin P Derdeyn, Ann F Bolger, Matthew E Levison, Kathryn A Taubert, Robert S Baltimore, Larry M Baddour
No abstract text is available yet for this article.
October 13, 2016: Circulation
Catherine E Hansing, Joseph P Marquardt, Daniel M Sutton, John D York
Arteriovenous malformations (AVMs) are a high-flow form of a vascular malformation, which can be found anywhere in the body. While historically treated surgically, a multidisciplinary approach utilizing multiple specialties and treatment modalities is now commonly employed. In order to effectively treat an AVM, the nidus must be targeted and eradicated, which can be done via multiple approaches. We present the case of a 43-year-old male with a gastric wall AVM, which was initially incompletely treated using a percutaneous transarterial approach...
September 26, 2016: Cardiovascular and Interventional Radiology
Laura Gart, Antoine M Ferneini
Endovascular techniques are essential for controlling acute head and neck bleeding that cannot be controlled by local or systemic measures. Detailed knowledge of the head and neck vascular anatomy, advances in catheterization techniques, and the availability of new embolic materials have improved the safety, efficacy, and predictability of these procedures. To improve patient safety, the oral and maxillofacial surgeon must be familiar with these techniques.
November 2016: Oral and Maxillofacial Surgery Clinics of North America
Stacy E Croteau, Deepti Gupta
Kasposiform hemoangioendothelioma (KHE) and tufted angioma (TA) are classifed as vascular tumors with locally aggressive and benign growth potential, respectively, within the classification schema proposed by the International Society for the Study of Vascular Anomalies. A unique feature of these vascular tumors is the risk of Kasabach-Merritt phenomenon (KMP), a severe thrombocytopenia with mild to moderate coagulopathy resulting from intralesional platelet trapping. As with many vascular anomalies, accurate description of clinical course, responses to therapy, and long-term outcomes have been hindered by lesion misidentification, imprecise nomenclature, and lack of prospective, randomized clinical trials to assess therapeutic efficacy...
September 2016: Seminars in Cutaneous Medicine and Surgery
Daria Almesberger, Francesco Manna, Gianni Franco Guarneri, Andrea Marchesi, Pier Camillo Parodi
BACKGROUND AND PURPOSE: The purpose of the present study is to evaluate the vascular malformations of the head and neck. They are uncommon lesions, but some areas have a significant potential for fatality, due to their massive bleeding. The vascular anatomy of the nose carries a high recurrence rate, due to the unique characteristic of the nose, especially if deep vascular connection is present. METHODS: The present article describes 2 patients of nasal dorsum arteriovenous malformations, both using a combined procedure: preoperative selective embolization, en-bloc tumor resection, and reconstruction with a forehead flap...
September 2016: Journal of Craniofacial Surgery
Shafagh Monazzam, Parker B Goodell, Edgardo S Salcedo, Sandahl H Nelson, Philip R Wolinsky
BACKGROUND: Computed tomography Angiogram (CTA) is frequently utilized to detect vascular injuries even without exam findings indicating a vascular injury. We had the following hypotheses: 1) a CTA for lower extremity fractures with no clinical signs of a vascular injury is not indicated. 2) fracture location and pattern would correlate with the risk of a vascular injury. METHODS: A retrospective review was conducted on patients who had an acute lower extremity fracture(s) and a CTA...
September 16, 2016: Journal of Trauma and Acute Care Surgery
M Portas, E Mansilla, H Drago, D Dubner, A Radl, A Coppola, M Di Giorgio
Acute and late radiation-induced injury on skin and subcutaneous tissues are associated with substantial morbidity in radiation therapy, interventional procedures and also are of concern in the context of nuclear or radiological accidents. Pathogenesis is initiated by depletion of acutely responding epithelial tissues and damage to vascular endothelial microvessels. Efforts for medical management of severe radiation-induced lesions have been made. Nevertheless, the development of strategies to promote wound healing, including stem cell therapy, is required...
September 2016: Radiation Protection Dosimetry
Mikhail C S S Higgins, Wei-Ting Hwang, Chase Richard, Christina H Chapman, Angelique Laporte, Stefan Both, Charles R Thomas, Curtiland Deville
PURPOSE: To assess the United States interventional radiology (IR) academic physician workforce diversity and comparative specialties. METHODS: Public registries were used to assess demographic differences among 2012 IR faculty and fellows, diagnostic radiology (DR) faculty and residents, DR subspecialty fellows (pediatric, abdominal, neuroradiology, and musculoskeletal), vascular surgery and interventional cardiology trainees, and 2010 US medical school graduates and US Census using binomial tests with ...
August 25, 2016: Journal of Vascular and Interventional Radiology: JVIR
Eric J Keller, Robert L Vogelzang, Benjamin H Freed, James C Carr, Jeremy D Collins
BACKGROUND: Quality improvement efforts in cardiovascular imaging have been challenged by limited adoption of initiatives and policies. In order to better understand this limitation and inform future efforts, the range clinical values related to cardiovascular imaging at a large academic hospital was characterized. MATERIALS AND METHODS: 15 Northwestern Medicine physicians from internal medicine, cardiology, emergency medicine, cardiac/vascular surgery, and radiology were interviewed about their use of cardiovascular imaging and imaging guidelines...
2016: Journal of Cardiovascular Magnetic Resonance
Anthony J Comerota, Robert J Min, Suman W Rathbun, Neil Khilnani, Thom Rooke, Thomas W Wakefield, Teresa L Carman, Fedor Lurie, Suresh Vedantham, Steven E Zimmet
BACKGROUND: In every field of medicine, comprehensive education should be delivered at the graduate level. Currently, no single specialty routinely provides a standardized comprehensive curriculum in venous and lymphatic disease. METHOD: The American Board of Venous & Lymphatic Medicine formed a task force, made up of experts from the specialties of dermatology, family practice, interventional radiology, interventional cardiology, phlebology, vascular medicine, and vascular surgery, to develop a consensus document describing the program requirements for fellowship medical education in venous and lymphatic medicine...
August 17, 2016: Phlebology
Pasha Normahani, Nigel J Standfield, Usman Jaffer
BACKGROUND: Acute limb ischemia (ALI) continues to pose a significant challenge to clinicians and is associated with an unacceptably high rate of morbidity and mortality. Despite its time critical nature, little is known regarding the delays encountered during the patient pathway. The aim of this study was to identify sources of delay in the patient pathway at our institution. METHODS: 67 cases of ALI of the lower extremities from 66 patients, who had presented to our center between May 2003 to April 2014, were identified for retrospective analysis...
August 12, 2016: Annals of Vascular Surgery
Hyoung Won Jeon, So Young Kim, Byung Se Choi, Yun Jung Bae, Ja-Won Koo, Jae-Jin Song
OBJECTIVE: In patients with pulsatile tinnitus (PT), physical examination such as auscultation with head position change or digital compression over the ipsilateral jugular vein provides physicians with important information. However, objective diagnosis of PT is sometimes limited because 1) audible bruit is absent on auscultation in some patients, 2) abnormal vascular structures found in radiologic evaluation is not always pathognomonic because they can be found in asymptomatic subjects as well, and 3) although an objective diagnostic tool using transcanal sound recording has recently been introduced, special equipment is needed...
October 2016: Otology & Neurotology
Johannes Hensler, Ulf Jensen-Kondering, Stephan Ulmer, Olav Jansen
INTRODUCTION: Spontaneous dissections of intracranial arteries are rare, but important causes of stroke, especially in younger patients. Dissections of the anterior cerebral artery (ACA) have been reported only very rarely in the European and North American populations but might be more prevalent than previously thought. METHODS: This paper describes the presenting pattern of the disease, the clinical and imaging findings, as well as endovascular therapeutical options with respect to a meta-analysis of cases reported in the literature...
August 11, 2016: Neuroradiology
A Bauschke, A Altendorf-Hofmann, M Freesmeyer, T Winkens, C Malessa, J-H Schierz, U Teichgraeber, U Settmacher
INTRODUCTION: The role of selective internal radioembolization (SIRT) in the treatment of hepatocellular carcinoma (HCC) is currently unclear. MATERIALS AND METHODS: We investigated 52 patients with nonresectable HCC in cirrhosis who underwent SIRT at the Department of General, Visceral and Vascular Surgery in co-operation with the Department of Nuclear Medicine and the Institute of Diagnostic and Interventional Radiology between April 2011 and October 2015. RESULTS: In five patients, SIRT was employed for bridging to liver transplantation...
July 26, 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Stephen Overholser, Omer Raheem, David Zapata, Dharam Kaushik, Ronald Rodriguez, Ithaar H Derweesh, Michael A Liss
BACKGROUND: Renal cancer may invade the inferior vena cava (IVC) creating more complex surgical intervention. We investigate radiologic findings that may predict vascular reconstruction prior to surgery and future renal cancer-specific mortality. MATERIALS AND METHODS: Radiologic findings included Mayo Clinic risk factors for vascular reconstruction: Right-sided tumor, anteroposterior diameter of the IVC at the ostium of the renal vein ≥24.0 mm, and radiologic identification of complete occlusion of the IVC...
July 2016: Urology Annals
Fernando Antonio Bacchim Neto, Allan Felipe Fattori Alves, Yvone Maria Mascarenhas, Patrícia Nicolucci, Diana Rodrigues de Pina
PURPOSE: To perform a complete evaluation on radiation doses, received by primary and assistant medical staff, while performing different vascular interventional radiology procedures. MATERIALS AND METHODS: We evaluated dose received in different body regions during three categories of vascular procedures: lower limb angiography (Angiography), lower limb percutaneous transluminal angioplasty (Angioplasty) and stent graft placement for abdominal aortic aneurysm treatment (A...
August 2016: Physica Medica: PM
Deanna Menapace, Mario Mitkov, Richard Towbin, Marcia Hogeling
Infantile hemangiomas are the most common vascular tumors of infancy. A multidisciplinary approach including dermatologists, otolaryngologists, plastic surgeons, hematologists/oncologists and interventional/diagnostic radiologists is crucial for appropriate management of children with complicated infantile hemangiomas. Since its unforeseen discovery in 2008, propranolol has become the first-line treatment for infantile hemangiomas, eclipsing systemic corticosteroids and radiologic intervention. There are still, however, uncommon indications for more aggressive interventional management...
October 2016: Pediatric Radiology
Miguel Montero-Baker, Gregory J Ziomek, Luis Leon, Aaron Gonzales, Robert S Dieter, Crystal L Gadd, John P Pacanowski
BACKGROUND: The structural limitations of currently available laser-cut nitinol stents in the highly diseased arterial system of the lower extremity are well described. These devices are frequently used in long-segment occlusions, at the adductor hiatus, and across the knee into the popliteal artery and tibial-peroneal trunk despite concerns related to the high mobility of the knee joint and the potential for external stent compression, fractures, and occlusion. The Supera stent (Abbott Vascular, Santa Clara, Calif) was developed to provide superior radial strength, fracture resistance, and flexibility compared with laser-cut nitinol stents...
October 2016: Journal of Vascular Surgery
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