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Vascular and Interventional Radiology

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https://www.readbyqxmd.com/read/28777415/repositioning-of-central-venous-access-devices-using-a-high-flow-flush-technique-a-clinical-practice-and-cost-review
#1
Timothy R Spencer
BACKGROUND: Malpositioned central venous access device (CVAD) tip locations can cause significant mechanical and chemical vessel-related injuries and complications if left in inappropriate positions.The aim of this study is to determine the use of a high-flow flush technique (HFFT) in successful correction of malpositioned catheters into the lower superior vena cava or cavoatrial junction and provide a cost comparison to interventional/fluoroscopic-based repositioning. METHODS: This is a Retrospective chart and radiographic review of all inserted CVADs found malpositioned between 1996-2014 in a multi-specialty 1000-bed tertiary trauma center in Sydney, Australia...
August 2, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28767031/microsurgical-vascular-manipulation-in-aneurysm-surgery-and-delayed-ischemic-injury
#2
Muhammad Omar Chohan, Andrew P Carlson, Cristina Murray-Krezan, Christopher L Taylor, Howard Yonas
BACKGROUND: The role of aggressive surgical manipulation with clot evacuation, arachnoid dissection, and papaverine-guided adventitial dissection of large vessels during ruptured aneurysm surgery in reducing vasospasm is controversial. Here we describe a single-institution experience in aneurysm surgery outcomes with and without aggressive surgery. METHODS: We performed retrospective analysis of all patients >18 years of age with subarachnoid hemorrhage (SAH) from anterior circulation aneurysms between 2008 and 2013 at the University of New Mexico Hospital...
July 2017: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/28761800/pancreatic-kaposiform-hemangioendothelioma-not-responding-to-sirolimus
#3
Paloma Junco Triana, Mariela Dore, Vanesa Cerezo Nuñez, Javier Gomez Jimenez, Miriam Ferrero Miguel, Mercedes González Díaz, Joan Novo Ricardo, Ane Andres, Manuel Lopez Santamaria, Juan Carlos Lopez-Gutierrez
Background  Kaposiform hemangioendothelioma (KHE) is a vascular tumor frequently associated with Kasabach-Merritt phenomenon (KMP), characterized by severe thrombocytopenia and consumptive coagulopathy. Visceral involvement in KHE is rare. In our recent experience, sirolimus has shown to be an effective treatment in cutaneous KHE, becoming indeed the treatment of choice in KMP. We report a case of pancreatic KHE associated with KMP and refractory to sirolimus. Case Report  A 4-month-old infant is referred for obstructive jaundice (10 mg/dL conjugated bilirubin) secondary to vascular pancreatic tumor...
January 2017: European Journal of Pediatric Surgery Reports
https://www.readbyqxmd.com/read/28756055/efficacy-of-over-the-scope-clips-in-management-of-high-risk-gastrointestinal-bleeding
#4
Justin Brandler, Navtej Buttar, Anushka Baruah, Muhammad Zeb, Ayesha Mehfooz, Prachi Pophali, Louis Wong Kee Song, Barham AbuDayyeh, Christopher Gostout, Kristin Mara, Ross Dierkhising
BACKGROUND & AIMS: Standard endoscopic therapies do not control bleeding or produce complications in as many as 20% of patients with non-variceal gastrointestinal bleeding. Most bleeding comes from ulcers with characteristics such as high-risk vascular territories and/or large vessels. We evaluated the efficacy of using over the scope clips (OTSCs) as primary or rescue therapy for patients with bleeding from lesions that have a high-risk for adverse outcomes. METHODS: We performed a retrospective analysis of data from 67 patients with gastrointestinal bleeding from high-risk lesions who were treated with OTSC as primary (n=49) or rescue therapy (n=18) at a quaternary center, from December 2011 through February 2015...
July 26, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28742731/endoscopic-ultrasound-guided-portal-venous-access-diagnostic-and-therapeutic-implications
#5
Rajat Garg, Tarun Rustagi
Endoscopic ultrasound (EUS) has evolved from a purely diagnostic to an interventional modality offering minimally invasive alternatives to surgical and radiologic interventions. This has led to a rapidly growing interest in EUS-guided vascular interventions. EUS-guided portal venous access is an emerging technique which opens a new arena for interventional vascular EUS. Portal vein can be accessed under EUS guidance with high precision and low risk of complications thus expanding its application for both benign and malignant conditions...
July 24, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28706116/training-standards-in-neuroendovascular-surgery-program-accreditation-and-practitioner-certification
#6
REVIEW
Arthur L Day, Adnan H Siddiqui, Philip M Meyers, Tudor G Jovin, Colin P Derdeyn, Brian L Hoh, Howard Riina, Italo Linfante, Osama Zaidat, Aquilla Turk, Jay U Howington, J Mocco, Andrew J Ringer, Erol Veznedaroglu, Alexander A Khalessi, Elad I Levy, Henry Woo, Robert Harbaugh, Steven Giannotta
BACKGROUND AND PURPOSE: Neuroendovascular surgery is a medical subspecialty that uses minimally invasive catheter-based technology and radiological imaging to diagnose and treat diseases of the central nervous system, head, neck, spine, and their vasculature. To perform these procedures, the practitioner needs an extensive knowledge of the anatomy of the nervous system, vasculature, and pathological conditions that affect their physiology. A working knowledge of radiation biology and safety is essential...
July 13, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28704746/a-case-report-of-an-anterior-tibial-artery-pseudo-aneurysm-open-surgical-management-a-rare-complication-post-total-knee-arthroplasty
#7
Kang Lie Darius Aw, Choon Chieh Tan, Jack Kian Ch'ng, Siew Ping Chng
INTRODUCTION: Complications involving injury to neurological and vascular structures are infrequently reported after total knee arthroplasty (TKA). They are associated with significant morbidity and can be limb threatening. PRESENTATION OF CASE: We present a patient with an anterior tibial artery (ATA) aneurysm post total knee arthroplasty. A 69-year-old female was referred for a swelling over her left antero-lateral aspect of her leg 4 years post TKA. Radiological investigations showed an ATA pseudo aneurysm...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28696854/ct-angiography-in-the-emergency-department-maximizing-contrast-enhancement-and-image-quality-while-minimizing-radiation-dose-and-contrast-material-volume-vascular-interventional-radiology
#8
Toshimasa J Clark, Martin L Gunn
No abstract text is available yet for this article.
July 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
https://www.readbyqxmd.com/read/28694612/cerebral-and-coronary-vasculature-in-disease-associations-and-dissociations-in-the-south-indian-population
#9
Krishnan Srinivasan, Srinivasan Ravikumar, Sadanandavalli Retnaswami Chandra, Selva Ganapathy, G S Ravi
INTRODUCTION: Cerebrovascular accidents constitute the most common cause of disability all over the world. In India prevalence rate is 545 per 100000 and mortality rate is around 7.5 per thousand. Therefore the authors undertook a study on patients who underwent coronary artery bypass surgery (CABG). They were investigated for clinical and/or radiological evidence of cerebrovascular disease (CVD) with the aim to decide on early neurological intervention. PATIENTS AND METHODS: 210 patients who had undergone CABG were evaluated with neck vessel Doppler using high resolution duplex scanner system and computed tomography (CT) scan as well as MR angiogram (MRA) in addition to assessment of co morbid risk factors...
July 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28665467/single-center-comparison-of-the-efficacy-and-complications-of-arterial-vascular-closure-devices-in-interventional-radiology
#10
Matthew A Elmasri, Stephen T Kee, John M Moriarty, Antoinette Gomes, Edward W Lee, Justin P McWilliams
INTRODUCTION: Vascular closure devices (VCDs) are commonly used to achieve hemostasis of arterial access sites, but there is little comparative data on the variety of VCDs currently in clinical use. We reviewed the VCD experience at our institution to determine the safest and most effective VCD. MATERIALS AND METHODS: Retrospective analysis of 907 consecutive arterial procedures in interventional radiology from June 2012 to June 2014 was performed. Five VCDs were used: Angio-Seal (n = 478), FISH (n = 56), Mynx (n = 56), Perclose (n = 61), and Starclose (n = 68)...
June 20, 2017: Journal of Vascular Access
https://www.readbyqxmd.com/read/28646803/effects-of-balneotherapy-on-serum-levels-of-shingosine-1-phosphate-in-patients-with-osteoarthritis
#11
Esra Aycan Ustyol, Fatih Karaarslan, Seldag Bekpinar, Kagan Ozkuk, Nergis Erdogan
Context • Balneotherapy is one of the most commonly used nonpharmacological interventions for osteoarthritis (OA), but its mechanism of action in relieving pain and stiffness and in improving physical function is not well understood. Studies have found that therapy provokes a series of neuroendocrinal reactions with anti-inflammatory and analgesic effects. Sphingosine-1-phosphate (S1P), a bioactive lipid, has been implicated as an important mediator in the maintenance of physiological processes (eg, vascular barrier integrity) and in pathophysiologic processes such as inflammatory conditions...
June 23, 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28616205/appearance-and-rapid-evolution-of-thoraco-abdominal-intramural-hematoma-after-tevar
#12
Edoardo Cervi, Franco Nodari, Emanuele Botteri, Girolomina Mazzeo, Bonardelli Stefano
Some studies consider the different physical properties of the stent graft when compared with the blood vessel on the basis of vascular lesions that may require further intervention. We present a case in which a patient developed an intramural hematoma at the distal landing of previous thoracic endovascular aortic repair (TEVAR) that required the relining with a flared prosthesis. During follow-up, we observed the appearance of more caudal hematoma. We decided to observe this lesion with close radiological controls...
January 2017: JRSM Cardiovascular Disease
https://www.readbyqxmd.com/read/28600218/systematic-review-of-patient-specific-surgical-simulation-toward-advancing-medical-education-%C3%A2
#13
Won Hyung A Ryu, Navjit Dharampal, Ahmed E Mostafa, Ehud Sharlin, Gail Kopp, William Bradley Jacobs, Robin John Hurlbert, Sonny Chan, Garnette R Sutherland
OBJECTIVE: Simulation-based education has been shown to be an effective tool to teach foundational technical skills in various surgical specialties. However, most of the current simulations are limited to generic scenarios and do not allow continuation of the learning curve beyond basic technical skills to prepare for more advanced expertise, such as patient-specific surgical planning. The objective of this study was to evaluate the current medical literature with respect to the utilization and educational value of patient-specific simulations for surgical training...
June 6, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28596990/magnetic-resonance-imaging-of-cerebral-malaria-patients-reveals-distinct-pathogenetic-processes-in-different-parts-of-the-brain
#14
Sanjib Mohanty, Laura A Benjamin, Megharay Majhi, Premanand Panda, Sam Kampondeni, Praveen K Sahu, Akshaya Mohanty, Kishore C Mahanta, Rajyabardhan Pattnaik, Rashmi R Mohanty, Sonia Joshi, Anita Mohanty, Ian W Turnbull, Arjen M Dondorp, Terrie E Taylor, Samuel C Wassmer
The mechanisms underlying the rapidly reversible brain swelling described in patients with cerebral malaria (CM) are unknown. Using a 1.5-Tesla (T) magnetic resonance imaging (MRI) scanner, we undertook an observational study in Rourkela, India, of 11 Indian patients hospitalized with CM and increased brain volume. Among the 11 cases, there were 5 adults and 6 children. All patients had reduced consciousness and various degrees of cortical swelling at baseline. The latter was predominately posterior in distribution...
May 2017: MSphere
https://www.readbyqxmd.com/read/28584946/post-procedural-care-in-interventional-radiology-what-every-interventional-radiologist-should-know-part-ii-catheter-care-and-management-of-common-systemic-post-procedural-complications
#15
Bedros Taslakian, Divya Sridhar
Interventional radiology (IR) has evolved into a full-fledged clinical specialty with attendant comprehensive patient care responsibilities. Providing excellent and thorough clinical care is as essential to the practice of IR as achieving technical success in procedures. Basic clinical skills that every interventional radiologist should learn include routine management of percutaneously inserted drainage and vascular catheters and rapid effective management of common systemic post-procedural complications. A structured approach to post-procedural care, including routine follow-up and early identification and management of complications, facilitates efficient and thorough management with an emphasis on quality and patient safety...
June 5, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28584945/cirse-quality-assurance-document-and-standards-for-classification-of-complications-the-cirse-classification-system
#16
D K Filippiadis, C Binkert, O Pellerin, R T Hoffmann, A Krajina, P L Pereira
Interventional radiology provides a wide variety of vascular, nonvascular, musculoskeletal, and oncologic minimally invasive techniques aimed at therapy or palliation of a broad spectrum of pathologic conditions. Outcome data for these techniques are globally evaluated by hospitals, insurance companies, and government agencies targeting in a high-quality health care policy, including reimbursement strategies. To analyze effectively the outcome of a technique, accurate reporting of complications is necessary...
June 5, 2017: Cardiovascular and Interventional Radiology
https://www.readbyqxmd.com/read/28583728/conical-neck-is-strongly-associated-with-proximal-failure-in-standard-endovascular-aneurysm-repair
#17
Georgios A Pitoulias, Andrés Reyes Valdivia, Suteekhanit Hahtapornsawan, Giovanni Torsello, Apostolos G Pitoulias, Martin Austermann, Claudio Gandarias, Konstantinos P Donas
OBJECTIVE: Hostile proximal aortic neck (HN) challenges the suitability for standard endovascular aneurysm repair (EVAR) of patients at high risk for "open" repair. However, there has been little if any focus placed on the individual role of the "nonlength" HN features in EVAR outcomes. The aim of this study was to evaluate their individual and potentially predictive role in outcomes of EVAR under HN conditions. METHODS: Data of 156 consecutive EVAR patients with short (<15 mm) HN, treated with the Endurant device (Medtronic Cardiovascular, Santa Rosa, Calif) at three European academic vascular centers between 2007 and 2015, were collected and retrospectively analyzed...
June 2, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28580065/lateral-thoracic-artery-pseudoaneurysm-as-a-result-of-penetrating-chest-trauma
#18
Matthew Pontell, Dane Scantling, Jessica Babcock, Alexander Trebelev, Alberto Nunez
Pseudoaneurysms are potentially fatal complications of vascular trauma; however, they are rarely seen as the sole complication of penetrating injury. We present a case of a pseudoaneurysm with an associated arteriovenous fistula of the left lateral thoracic artery as a result of direct trauma from a knife stab. The patient presented only with a painful, swollen left pectoralis muscle. Upon diagnosis, he was taken to the interventional radiology suite and treated successfully with fluoroscopic guided coil embolization...
January 2017: Journal of Radiology Case Reports
https://www.readbyqxmd.com/read/28571227/ultrasound-guided-percutaneous-injection-of-thrombin-effective-technique-for-treatment-of-iatrogenic-femoral-pseudoaneurysms
#19
Atul Mishra, Akhilesh Rao, Yayati Pimpalwar
INTRODUCTION: Arterial pseudoaneurysms are well known iatrogenic complication of percutaneous angiographic or interventional vascular procedures. In the past, the definitive treatment option was open surgical repair which is a relatively invasive procedure. In the last few years, Ultrasound (US) guided percutaneous thrombin injection has been gaining popularity as definitive treatment of pseudoaneurysms. AIM: To evaluate efficacy and safety of US guided percutaneous injection of thrombin for treatment of iatrogenic femoral pseudoanurysms at a tertiary care interventional radiological and cardiology centre...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28552373/surgical-treatment-of-complications-after-high-dose-chemoradiotherapy-for-lung-cancer
#20
Chris Dickhoff, Max Dahele, Sayed M Hashemi, Suresh Senan, Egbert F Smit, Koen J Hartemink, Marinus A Paul
BACKGROUND: There are limited published reports on the indications for, and outcomes of, a surgical intervention for complications arising after high-dose chemoradiotherapy (CRT) for locally advanced non-small cell lung cancer (NSCLC). We report on our institutional experience with such cases. METHODS: Patients who underwent operations for any complication after CRT (≥60 Gy) for NSCLC between 2009 and 2015 were identified. All operations were performed at a tertiary referral center...
August 2017: Annals of Thoracic Surgery
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