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Richardson AJ, Kumar J, Richardson K, Bhatia A, Pennix T, Shah K, Maini A, Jalaeian H, Bhatia S. Safety of Prostatic Artery Embolization via Transradial Access versus Transfemoral Access. J Vasc Interv Radiol 2024; 35:541-547. [PMID: 38103863 DOI: 10.1016/j.jvir.2023.09.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 08/31/2023] [Accepted: 09/02/2023] [Indexed: 12/19/2023] Open
Abstract
PURPOSE To compare prostatic artery embolization (PAE) via transradial access (TRA-PAE) versus transfemoral access (TFA-PAE) to assist access selection. MATERIAL AND METHODS Procedural outcomes and adverse events were evaluated in 998 patients who underwent PAE at a single center from April 2014 to August 2022; 821 (82%) underwent TRA-PAE (Group R) and 177 (18%) underwent TFA-PAE (Group F). Mean age and prostate size of Groups R and F were 69.2 years (SD ± 8.4) and 117.4 g (SD ± 63.1) and 75.2 years (SD ± 12.1) and 127.2 g (SD ± 83.6), respectively (P < .01 and P = .16; postpropensity matching: P = .38 and P = .35, respectively). Indications for PAE included lower urinary tract symptoms, acute or chronic urinary retention, and hematuria. Procedural and patient-specific metrics were reviewed. Technical success was defined as bilateral PAE. Adverse events were recorded according to the Society of Interventional Radiology (SIR) adverse events classification. Statistical significance was defined as P < .05. RESULTS Technical success was achieved in 798 (97.2%) patients in Group R and 165 (93.2%) patients in Group F. Mean procedural time, single- and continuous-rotation fluoroscopy time, dose area product, and air kerma were significantly lower in Group R than in Group F (P < .001). Moreover, 6 (0.7%) patients in Group R and 9 (5.5%) patients in Group F had access site ecchymoses, whereas 5 (0.6%) patients in Group R and 6 (3.6%) in Group F had access site hematomas. Two patients experienced transient ischemic attacks (TIAs) after TRA-PAE and recovered without intervention. Two occult radial artery occlusions were noted, but no patient experienced hand ischemia. CONCLUSIONS In a large single interventional radiologist cohort, TRA-PAE demonstrated similar technical success to that of TFA-PAE with lower access site hemorrhagic complications and radiation requirements; however, TIA and occult radial artery occlusions remain a concern.
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Affiliation(s)
- Andrew J Richardson
- Department of Interventional Radiology, Jackson Memorial Hospital, Miami, Florida.
| | - Jessica Kumar
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Kenneth Richardson
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Ansh Bhatia
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Thomas Pennix
- Department of Interventional Radiology, Jackson Memorial Hospital, Miami, Florida
| | - Khushi Shah
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Aneesha Maini
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Hamed Jalaeian
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Shivank Bhatia
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
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Kozlowski KM, Jalaeian H, Travis LM, Zikria JF. A comparative analysis of infection and complication rates between single- and double-lumen ports. Infect Control Hosp Epidemiol 2024:1-5. [PMID: 38272652 DOI: 10.1017/ice.2024.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2024]
Abstract
OBJECTIVE Port-a-caths are implanted intravascular chest ports that enable venous access. With more port placements performed by interventional radiologists, it is important to discern differences in infection and complication rates between double- and single-lumen ports. METHODS We retrospectively reviewed 1,385 port placements over 2 years at the University of Miami. Patients were grouped by single- or double-lumen ports. Data on duration of catheter stay, bloodstream infections, malfunctions, and other complications (fibrin sheath, thrombosis, catheter malposition) were collected. Multivariate Cox regression was performed to identify variables predicting port infection. RESULTS The mean patient age was 58.8 years; the mean BMI was 26.9 kg/m2; and 61.5% of these patients were female. Our search revealed 791 double-lumen ports (57.1%) and 594 single-lumen ports (42.9%). The median follow-up was 668 days (range, 2-1,297). Double-lumen ports were associated with significantly higher rates of bacteremia (2.78% vs 0.84%; P = .02), port malfunction (8.3% vs 2.0%; P < .001), fibrin sheath formation (2.2% vs 0.5%; P < .02), catheter tip malposition (1.0% vs 0; P = .01), and catheter-associated thrombosis (1.4% vs 0; P = .003). Multivariate Cox regression analysis, after adjusting for other variables, showed that double-lumen chest ports had 2.98 times (95% confidence interval, 1.12-7.94) the hazard rate of single-lumen ports for developing bloodstream infection (P = .029). CONCLUSIONS Double-lumen chest ports are associated with increased risk for bloodstream infection, malfunction, fibrin sheath formation, catheter tip malposition, and catheter-associated thrombosis. Interventional radiologists may consider placing single-lumen ports if clinically feasible; however, future studies are needed to determine clinical significance. The study limitations included the retrospective study design and the potential loss of patient follow-up.
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Affiliation(s)
- Konrad M Kozlowski
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Hamed Jalaeian
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Levi M Travis
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
| | - Joseph F Zikria
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida
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Lee EW, Eghtesad B, Garcia-Tsao G, Haskal ZJ, Hernandez-Gea V, Jalaeian H, Kalva SP, Mohanty A, Thabut D, Abraldes JG. AASLD Practice Guidance on the use of TIPS, variceal embolization, and retrograde transvenous obliteration in the management of variceal hemorrhage. Hepatology 2024; 79:224-250. [PMID: 37390489 DOI: 10.1097/hep.0000000000000530] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 06/22/2023] [Indexed: 07/02/2023]
Affiliation(s)
- Edward Wolfgang Lee
- Department of Radiology and Surgery, Ronald Reagan UCLA Medical Center, Los Angeles, California, USA
| | - Bijan Eghtesad
- Department of General Surgery, Digestive Disease and Surgery Institute Cleveland Clinic, Cleveland, Ohio, USA
| | - Guadalupe Garcia-Tsao
- Yale University School of Medicine, Department of Internal Medicine, Section of Digestive Diseases, New Haven, Connecticut, USA
- VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Ziv J Haskal
- Department of Radiology and Medical Imaging/Interventional Radiology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Virginia Hernandez-Gea
- Barcelona Hepatic Hemodynamic Laboratory, Liver Unit, Hospital Clínic, Institut D'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS). Universitat de Barcelona (UB). CIBEREHD (Centro de Investigación Biomédica en Red Enfermedades Hepáticas y Digestivas). Health Care Provider of the European Reference Network on Rare Liver Disorders (ERN-Liver), Barcelona, Spain
| | - Hamed Jalaeian
- Department of Interventional Radiology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | | | - Arpan Mohanty
- Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Dominique Thabut
- AP-HP Sorbonne Université, Hôpital Universitaire Pitié-Salpêtrière, Service d'Hépato-gastroentérologie, Paris, France
| | - Juan G Abraldes
- Division of Gastroenterology (Liver Unit), University of Alberta, Edmonton, Canada
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Jalaeian H, Field DH, Cohen EI. Transplant Renal Interventions. Tech Vasc Interv Radiol 2023; 26:100925. [PMID: 38123287 DOI: 10.1016/j.tvir.2023.100925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2023]
Abstract
Renal transplantation is the most commonly performed solid-organ allograft surgery; in 2021, 25487 kidneys were transplanted in the United States, and nearly 42,000 adult patients were listed for transplant. As the treatment of choice for patients with end-stage renal disease, transplantation is performed at more than 250 centers. Despite a high rate of success, renal transplantation is not without complication, and the interventional radiologist plays a crucial role in the management of the postoperative patient. Knowledge of postsurgical anatomy, imaging findings, and technical challenges unique to these patients is important for the safe and effective treatment of transplant-related conditions. We offer a guide to the most common interventions in the renal transplant population, including biopsy, vascular interventions, and the management of urinary obstruction.
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Affiliation(s)
- Hamed Jalaeian
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, FL.
| | - David H Field
- Division of Interventional Radiology, MedStar Georgetown University Hospital, Washington, DC
| | - Emil I Cohen
- Division of Interventional Radiology, MedStar Georgetown University Hospital, Washington, DC
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Torkian P, Jalaeian H, Wallace S, Shrestha P, Talaie R, Golzarian J. Post-Embolization Hemoglobin Changes: When to Consider Re-intervention. Cardiovasc Intervent Radiol 2023; 46:617-625. [PMID: 36869220 DOI: 10.1007/s00270-023-03386-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 02/05/2023] [Indexed: 03/05/2023]
Abstract
PURPOSE Decline in hemoglobin (Hgb) levels is common post-embolization, but there is no consensus on the classification of patients based on risk for re-bleeding or re-intervention. The current study evaluated post-embolization Hgb level trends with the goal of understanding the factors predictive of re-bleeding and re-intervention. MATERIALS AND METHODS All patients who underwent embolization for gastrointestinal (GI), genitourinary, peripheral, or thoracic arterial hemorrhage from 01/2017 to 01/2022 were reviewed. Data included demographics, periprocedural pRBC transfusion (TF) or pressor requirements, and outcome. Lab data consisted of Hgb values pre-embolization, immediately post-embolization, and daily values on days 1-10 after embolization. Hgb trends were compared between patients across TF and re-bleeding outcomes. Regression model was used to examine factors predictive of re-bleeding and magnitude of Hgb reduction post-embolization. RESULTS A total of 199 patients were embolized for active arterial hemorrhage. Perioperative Hgb level trends were similar for all sites and between TF + and TF- patients, showing a decline reaching a nadir within 6 days post-embolization followed by an upward trend. Maximum Hgb drift was predicted by GI embolization (p = 0.018), TF before embolization (p = 0.001), and use of vasopressor (p = 0.000). Patients with Hgb drop > 15% within the first two days post-embolization had a higher chance of having a re-bleeding episode (p = 0.04). CONCLUSION Perioperative Hgb trends showed a consistent downward drift followed by an upward shift, irrespective of TF requirement status or site of embolization. Using a cut-off value of 15% Hgb reduction within the first two days post-embolization may be helpful to assess re-bleeding risk.
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Affiliation(s)
- Pooya Torkian
- Vascular and Interventional Radiology, Department of Radiology, University of Minnesota, B-228 Mayo Memorial Building, MMC 292420 Delaware Street S.E., Minneapolis, MN, 55455, USA.
| | - Hamed Jalaeian
- Department of Interventional Radiology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Stephanie Wallace
- Vascular and Interventional Radiology, Department of Radiology, University of Minnesota, B-228 Mayo Memorial Building, MMC 292420 Delaware Street S.E., Minneapolis, MN, 55455, USA
| | - Prashant Shrestha
- Vascular and Interventional Radiology, Department of Radiology, University of Minnesota, B-228 Mayo Memorial Building, MMC 292420 Delaware Street S.E., Minneapolis, MN, 55455, USA
| | - Reza Talaie
- Vascular and Interventional Radiology, Department of Radiology, University of Minnesota, B-228 Mayo Memorial Building, MMC 292420 Delaware Street S.E., Minneapolis, MN, 55455, USA
| | - Jafar Golzarian
- Vascular and Interventional Radiology, Department of Radiology, University of Minnesota, B-228 Mayo Memorial Building, MMC 292420 Delaware Street S.E., Minneapolis, MN, 55455, USA
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Patel A, Kozlowski K, Richardson K, Jalaeian H, Venkat S. Abstract No. 225 Comparison of Outcome of CT-Guided Lung Biopsy Using a 17-Gauge vs. 19-Gauge Biopsy Gun System. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Richardson A, Maini A, Richardson K, Shah K, Brent H, Boateng J, Bokhari A, Kumar J, Jalaeian H, Bhatia S. Abstract No. 288 Prostate Artery Embolization in Prostate Glands Greater than 80 g: A Single Center Experience. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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Richardson A, Richardson K, Shah K, Maini A, Aldajani M, Romeus L, Hall D, Bhatia A, Kumar J, Jalaeian H, Bhatia S. Abstract No. 284 Comparison of PAE for BPH on Prostate Gland Size <80 g versus >80 g: Retrospective Review of Short-Term to Mid-Term Outcomes in a Single Center. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Richardson A, Shah K, Maini A, Richardson K, Aldajani M, Boateng J, Bhatia A, Sanan A, Jalaeian H, Bhatia S. Abstract No. 599 Comparison of Safety and Feasibility of Prostate Artery Embolization via Transradial Access versus Transfemoral Access: A Single-Center Experience. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/26/2023] Open
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10
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Richardson A, Maini A, Richardson K, Shah K, Bhatia A, Reddy R, Sanan A, Kumar J, Jalaeian H, Bhatia S. Abstract No. 3 ▪ ABSTRACT OF THE YEAR Prostate Artery Embolization—Single-Center Experience of 1,000 Patients with Short-, Mid- and Long-Term Follow-Up. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2023] Open
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Calmet F, Mohan P, Jalaeian H, Martin P. Management of Patients With Gastric Varices. Gastroenterol Hepatol (N Y) 2022; 18:574-585. [PMID: 36397927 PMCID: PMC9666800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Management of patients with gastric varices represents a unique challenge for clinicians. The broad range of endoscopic and endovascular techniques currently available is in stark contrast with the limited evidence available to inform the optimal management of these patients. This article describes the classification, pathophysiology, and natural history of gastric varices; summarizes the available evidence regarding medical, endoscopic, and endovascular management of gastric varices; and provides recommendations on how to integrate these options. Management of these patients ultimately requires a multidisciplinary approach involving hepatologists, therapeutic endoscopists, and interventional radiologists, with consideration given to patient characteristics and local expertise.
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Affiliation(s)
- Fernando Calmet
- Department of Medicine, Division of Gastroenterology, Newton-Wellesley Hospital, Newton, Massachusetts
- Department of Medicine, Division of Gastroenterology, Tufts University School of Medicine, Boston, Massachusetts
| | - Prasoon Mohan
- Department of Interventional Radiology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Hamed Jalaeian
- Department of Interventional Radiology, Miller School of Medicine, University of Miami, Miami, Florida
| | - Paul Martin
- Department of Medicine, Division of Hepatology, Miller School of Medicine, University of Miami, Miami, Florida
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Acharya V, Jalaeian H, Tummala S, Shah K, Kumar J, Kably I, Bhatia S. Cone Beam CT with Automatic vessel Detection Software versus Conventional 2D Fluoroscopy with Overlay for Prostate Artery Embolization: A Comparison of Prostatic Artery Catheterization Time and Radiation Exposure. Journal of Clinical Interventional Radiology ISVIR 2022. [DOI: 10.1055/s-0041-1740575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Abstract
Purpose To evaluate the effect of cone-beam computed tomography (CT) with automatic vessel detection software on prostate artery catheterization and fluoroscopy time in prostate artery embolization (PAE).
Methods Fifty patients undergoing PAE for BPH were enrolled in this prospective study. Twenty-five PAEs were performed using automatic vessel detection software with syngo embolization guidance (study) and were compared with 25 PAEs performed using conventional two-dimensional (2D) fluoroscopy with overlay (control). PAE was performed using 300–500 μm trisacryl gelatin spherical particles. The primary outcome parameters were prostatic artery catheterization time and fluoroscopy time.
Results Bilateral PAE was achieved in 24/25 cases in both groups. The median right and left prostatic artery catheterization times were similar between the two groups, (p = 0.473 and p = 0.659, respectively). The median fluoroscopy time (28.0 and 42.0 minutes, p = 0.046) and total procedure time (70.0 and 118.0 minutes, p < 0.001) were shorter in the study group. The median total dose area product (DAP) was not significantly different. However, the median CBCT DAP (11406 vs. 6248, p < 0.001) was higher in the study group, while median fluoroscopy DAP (7371 vs. 8426, p < .049) was higher in the control group. Median digital subtraction angiography (DSA), CBCT, and fluoroscopy DAP accounted for 27%, 45%, and 29% of the total DAP in the study group and 32%, 29%, and 39% in the control group (p < 0.001), respectively. All complications were Clavien–Dindo Grade 1.
Conclusion Although CBCT with automatic vessel detection software had no significant effect on time-to-prostatic artery catheterization and total radiation exposure, it reduced the fluoroscopy time and procedure time.
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Affiliation(s)
- Vedant Acharya
- University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Hamed Jalaeian
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Srinivas Tummala
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Kush Shah
- Department of Interventional Radiology, Jackson Memorial Hospital, Miami, Florida, United States
| | - Jessica Kumar
- Department of Interventional Radiology, Jackson Memorial Hospital, Miami, Florida, United States
| | - Issam Kably
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida, United States
| | - Shivank Bhatia
- Department of Interventional Radiology, University of Miami Miller School of Medicine, Miami, Florida, United States
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Mohan P, Chang D, Deo S, Liu Z, Kaneku H, Jalaeian H, Dikici E, Zeynaloo E, Velazquez O, Bhatia S, Daunert S. Abstract No. 358 Liver regeneration following thermal ablation using targeted nanocarrier mediated stem cell therapy. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Richardson A, Kumar J, Pennix T, Richardson K, Esses E, Bysani K, Amin A, Sandhu J, Jalaeian H, Bhatia S. Abstract No. 65 Prostate artery embolization: single-center experience of 807 patients with 6 years of follow-up. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Richardson K, Hernandez A, Venkat S, Jalaeian H, Bhatia S. Abstract No. 548 Does body habitus affect the outcome of CT-guided lung biopsies? J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kumar J, Richardson A, Pennix T, Amin A, Bokhari A, Esses E, Aldajani M, Richardson K, Jalaeian H, Bhatia S. Abstract No. 67 Prostate artery embolization in patients with prostate glands greater than 80 g: a single-center experience with 5 years of follow-up. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Kumar J, Richardson A, Pennix T, Aldajani M, Amin A, Sandhu J, Bysani K, Richardson K, Jalaeian H, Bhatia S. Abstract No. 64 Prostate artery embolization in prostate size less than 80 g: a single-center experience with 5 years of follow-up. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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18
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Kumar J, Richardson A, Richardson K, Sandhu J, Bysani K, Aldajani M, Esses E, Bokhari A, Jalaeian H, Bhatia S. Abstract No. 68 Comparison of prostate artery embolization for benign prostatic hyperplasia on prostate gland size less than 80 g versus greater than 80 g: retrospective review of short and mid-term outcomes. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Richardson A, Kumar J, Pennix T, Richardson K, Bokhari A, Aldajani M, Bysani K, Esses E, Jalaeian H, Bhatia S. Abstract No. 63 Effect of prostatic artery embolization on reduction or cessation of preprocedural benign prostatic hypertrophy medication: single-center experience. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Pennix T, Richardson A, Richardson K, Kumar J, Bokhari A, Aldajani M, Amin A, Sandhu J, Jalaeian H, Bhatia S. Abstract No. 70 Radiation exposure reduction with operator experience in prostatic artery embolization: a single-institution study. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Pennix T, Jalaeian H, Sanan A, Bokhari A, Leichter J. Abstract No. 48 Does radiofrequency ablation and kyphoplasty in combination with radiation treatment have additive effect for the treatment of painful spine metastases? J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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22
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Talaie R, Torkian P, Amili O, Aboufirass Y, Rostambeigi N, Jalaeian H, Golzarian J. Particle Distribution in Embolotherapy, How Do They Get There? A Critical Review of the Factors Affecting Arterial Distribution of Embolic Particles. Ann Biomed Eng 2022; 50:885-897. [PMID: 35524027 DOI: 10.1007/s10439-022-02965-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 04/05/2022] [Indexed: 11/26/2022]
Abstract
Embolization has tremendously evolved in recent years and has expanded to treatment of a variety of pathologic processes. There has been emerging evidence that the level of arterial occlusion and the distribution of embolic particles may play an important role in the clinical outcome. This is a comprehensive literature review to identify variables that play important role in determination of level of occlusion of blood vessels and distribution of embolic particles. The literature searches between 1996 to 2020 through PubMed and Ovid-MEDLINE yielded over 1030 articles of which 30 studies providing details on the level of occlusion are reviewed here. We divided the playing factors into characteristics of the particles, solution/injection and vascular bed. Accordingly, particle size, type and aggregation, compressibility/deformability, and biodegradability are categorized as the factors involving particles' behavioral nature. Infusion rate and concentration/dilution of the medium are related to the carrying solution. Hemodynamics and the arterial resistance are characteristics of the vascular bed that also play an important role in the distribution of embolic particles. Understanding and predicting the level of embolization is a complex multi-factor problem that requires more evidence, warranting further randomized controlled trials, and powered human and animal studies.
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Affiliation(s)
- Reza Talaie
- Department of Vascular and Interventional Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Pooya Torkian
- Department of Vascular and Interventional Radiology, University of Minnesota, Minneapolis, MN, USA.
| | - Omid Amili
- Department of Mechanical, Industrial and Manufacturing Engineering (MIME), University of Toledo, Toledo, OH, USA
| | | | - Nassir Rostambeigi
- Mallinckrodt Institute of Radiology, Washington University School of Medicine in St. Louis, St. Louis, MO, USA
| | - Hamed Jalaeian
- Department of Interventional Radiology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Jafar Golzarian
- Department of Vascular and Interventional Radiology, University of Minnesota, Minneapolis, MN, USA
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Bhatia S, Acharya V, Jalaeian H, Kumar J, Bryant E, Richardson A, Malkova K, Harward S, Sinha V, Kably I, Kava BR. Effect of Prostate Artery Embolization on Erectile Function - A Single Center Experience of 167 Patients. J Sex Med 2022; 19:594-602. [PMID: 35184995 DOI: 10.1016/j.jsxm.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 01/03/2022] [Accepted: 01/10/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Prostate artery embolization (PAE) is an emerging therapy for lower urinary tract symptoms (LUTS) associated with benign prostatic hyperplasia (BPH). AIM This retrospective study was conducted to assess the effect of prostate artery embolization (PAE) on erectile function in a cohort of patients with LUTS attributable to BPH at 3-months after the procedure. METHODS A retrospective review was performed on 167 patients who underwent PAE. Data collected included Sexual Health Inventory in Men (SHIM) scores at 3, 6, and 12 months post-PAE, in conjunction with the International Prostate Symptom Scores (IPSS), Quality of Life (QoL) scores, and prostate volumes. Primary outcome was erectile function as assessed by SHIM scores at 3 months after PAE. An analysis was performed to identify patients with a ±5-point SHIM change to group them according to this minimum clinically significant difference in erectile function. Adverse events were recorded using the Clavien-Dindo (CD) classification. OUTCOMES At 3 months following PAE, median IPSS decreased by 16.0 [IQR, 9.0-22.0] points, median QOL decreased by 4.0 [IQR, 2.0-5.0] points, and median prostate volume decreased by 33 g [IQR, 14-55]. RESULTS Median SHIM score was 17.0 [IQR, 12.0-22.0] at baseline, 18.0 [IQR, 14.0-23.0] at 3 months [P = .031], 19.0 [IQR, 14.5-21.5] at 6 months [P = .106] and 20 [IQR, 16.0-24.0] at 12 months [P = .010] following PAE. In patients with no erectile dysfunction (ED) at baseline, 21% (n = 9) reported some degree of decline in erectile function post-PAE. However, 38% (n = 40) of patients who presented with mild-to-moderate ED reported improvement in their erectile function 3 months following PAE. Overall, the changes in baseline SHIM score were relatively small; 82% (n = 137) of patients did not have more than 5 points of change in their SHIM scores at 3 months following PAE. CLINICAL IMPLICATIONS Our findings suggest PAE has no adverse impact on erectile function for most patients. STRENGTHS & LIMITATIONS The study was performed at a single center with 1 operator's experience, and is retrospective with no control group. CONCLUSION Findings suggest that prostate artery embolization has no adverse effect on erectile function in the majority of patients with LUTS attributable to BPH at 3 months after the procedure. Bhatia S, Acharya V, Jalaeian H, et al., Effect of Prostate Artery Embolization on Erectile Function - A Single Center Experience of 167 Patients. J Sex Med 2022;19:594-602.
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Affiliation(s)
- Shivank Bhatia
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Vedant Acharya
- University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Hamed Jalaeian
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Jessica Kumar
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA.
| | - Evan Bryant
- University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Andrew Richardson
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Kseniia Malkova
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Sardis Harward
- University of Massachusetts Medical School, Worcester, MA, USA
| | - Vishal Sinha
- Weill Cornell Department of Radiology, New York, NY, USA
| | - Issam Kably
- Department of Interventional Radiology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | - Bruce R Kava
- Department of Urology, University of Miami, Miller School of Medicine, Miami, FL, USA
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Jalaeian H, Acharya V, Shibuya M, Okuna Y, Bhatia S. Abstract No. 15 Two-year outcomes of comparing Embosphere microspheres versus imipenem–cilastatin for genicular artery embolization in patients with knee osteoarthritis. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Richardson A, Acharya V, Kumar J, Jalaeian H, Kably I, Bhatia S. Abstract No. 59 Prostate artery embolization in prostate size larger than 80 g: a single-center experience with 5-year follow up. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Richardson A, Acharya V, Kumar J, Jalaeian H, Kably I, Bhatia S. Abstract No. 57 ▪ FEATURED ABSTRACT Prostate artery embolization: single-center experience of 576 patients with 5 years’ follow-up. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Bokhari A, Leichter J, Jalaeian H, Chaitowitz I, Bhatia S. Abstract No. 165 Radiofrequency ablation in combination with kyphoplasty for the treatment of painful spine metastases: evaluation of VAS pain scale. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Acharya V, Pennix T, Clode H, Shah K, Jalaeian H, Bhatia S. Abstract No. 455 Radiation doses with increased experience in prostatic artery embolization for benign prostatic hypertrophy: a single-institution series. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Richardson A, Acharya V, Kumar J, Jalaeian H, Kably I, Bhatia S. Abstract No. 62 Safety and feasibility of prostate artery embolization via transradial access: a single-center experience. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Talaie R, Jalaeian H, Rostambeigi N, Spano A, Golzarian J. Recanalization and Reconstruction of a Chronically Occluded Inferior Vena Cava Through an Existing Transjugular Intrahepatic Portosystemic Shunt in the Setting of Budd-Chiari Syndrome. Vasc Endovascular Surg 2021; 55:529-533. [PMID: 33739196 DOI: 10.1177/15385744211002026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Budd-Chiari syndrome (BCS) results from the occlusion or flow reduction in the hepatic veins or inferior vena cava and can be treated with transjugular intrahepatic portosystemic shunt when hepatic vein recanalization fails.1-3 Hypercoagulable patients with primary BCS are predisposed to development of new areas of thrombosis within the TIPS shunt or IVC. This case details a patient with BCS, pre-existing TIPS extending to the right atrium, and chronic retrohepatic IVC thrombosis who underwent sharp recanalization of the IVC with stenting into the TIPS stent bridging the patient until his subsequent hepatic transplantation.
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Affiliation(s)
- Reza Talaie
- Division of Vascular and Interventional Radiology, Department of Radiology, 5635University of Minneapolis, MN, USA
| | - Hamed Jalaeian
- Department of Interventional Radiology, 5635Miller School of Medicine, University of Miami, Coral Gables, FL, USA
| | - Nassir Rostambeigi
- Division of Vascular and Interventional Radiology, Washington University, Mallinckrodt Institute of Radiology, St. Louis, MO, USA
| | - Anthony Spano
- Division of Vascular and Interventional Radiology, Department of Radiology, 5635University of Minneapolis, MN, USA
| | - Jafar Golzarian
- Division of Vascular and Interventional Radiology, Department of Radiology, 5635University of Minneapolis, MN, USA
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Bhatia S, Kumar J, Acharya V, Jalaeian H, Bryant E, Harward S, Sinha V, Kably I, Kava B. 108 Erectile Function Following Prostate Artery Embolization in Patients with Larger Prostate Glands: A Large Single Center Experience. J Sex Med 2021. [DOI: 10.1016/j.jsxm.2021.01.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Young S, Gasparetto A, Jalaeian H, Golzarian J. Biomarkers in the setting of benign prostatic hyperplasia-induced lower urinary tract symptoms: what an interventional radiologist needs to know. Br J Radiol 2020; 93:20200484. [PMID: 32706988 DOI: 10.1259/bjr.20200484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
With increasing evidence to support prostate artery embolization (PAE) in the treatment of benign prostatic hyperplasia (BPH)-induced lower urinary tract symptoms (LUTS), Interventional Radiologists have begun to play an important role in the management of these patients. One area of knowledge needed when developing a PAE practice is knowledge of prostate-specific antigen (PSA) and other biomarkers utilized to detect prostate cancer in this population and what role they should play in the work up and follow-up of patients presenting with presumed BPH-induced LUTS. Furthermore, understanding how to evaluate presumed BPH-induced LUTS and stratify the risk of prostate cancer is an important skill to develop. The goal of this review is to provide Interventional Radiologists who have begun or aim to begin a PAE practice with the information they need to know regarding PSA levels and prostate cancer risk stratification for this patient population.
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Affiliation(s)
- Shamar Young
- Department of Radiology, University of Minnesota. 420 Delaware ST SE MMC 292, Minneapolis, MN 55455, United States
| | - Alessandro Gasparetto
- Department of Radiology, University of Minnesota. 420 Delaware ST SE MMC 292, Minneapolis, MN 55455, United States
| | - Hamed Jalaeian
- Department of Interventional Radiology, University of Miami 1115 NW 14 St, Miami, FL, 33136, United States
| | - Jafar Golzarian
- Department of Radiology, University of Minnesota. 420 Delaware ST SE MMC 292, Minneapolis, MN 55455, United States
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Talaie R, Jalaeian H, D'Souza D, Aboufirass Y, Golzarian J. Successful Percutaneous Transcatheter Closure of a Common Femoral Artery Pseudoaneurysm With Use of MicroVascular Plug Despite Continued Catheter-Directed Thrombolysis. Vasc Endovascular Surg 2020; 54:458-462. [PMID: 32338189 DOI: 10.1177/1538574420921276] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Common femoral artery pseudoaneurysm is a known complication of percutaneous vascular access. Treatment options include surgical repair of the pseudoaneurysm or endovascular methods such as ultrasound-guided compression and direct thrombin injection into the pseudoaneurysm sac. Treatment of pseudoaneurysm is more challenging when a patient is undergoing concurrent catheter-directed or systemic thrombolytic therapy. This is a case report of endovascular treatment of an iatrogenic pseudoaneurysm of common femoral artery in a patient receiving concurrent catheter-directed thrombolytic therapy. This was performed successfully by precise deployment of a MicroVascular Plug into the pseudoaneurysm neck with immediate closure of pseudoaneurysm. Midterm follow-up confirmed sustained exclusion of the pseudoaneurysm sac with continued patency of the treated femoral artery.
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Affiliation(s)
- Reza Talaie
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Hamed Jalaeian
- Department of Interventional Radiology, Miller School of Medicine, University of Miami, FL, USA
| | - Donna D'Souza
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | | | - Jafar Golzarian
- Division of Vascular and Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
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Jalaeian H, Talaie R, Hunter DW, Golzarian J, Rosenberg MS. Comparison of tandem ureteral stents, cryoplasty, and cutting balloon ureteroplasty in treatment of refractory transplant ureteral strictures. Clin Transplant 2020; 34:e13859. [PMID: 32196747 DOI: 10.1111/ctr.13859] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2019] [Revised: 02/28/2020] [Accepted: 03/13/2020] [Indexed: 11/30/2022]
Abstract
The objective of study was to compare clinical outcome of cryoplasty, tandem stents, and cutting balloon ureteroplasty as "bailout procedures" to prevent surgical intervention or stent dependency in renal transplant patients with refractory ureteral stricture. All patients who underwent a bailout procedure from June 11, 2003, to August 8, 2015, at a single institution were reviewed retrospectively. Refractory ureteral stricture was defined as ureteral stenosis not responding to at least two prior percutaneous plain balloon ureteroplasties. Primary patency was defined as stable allograft function following the procedure with unobstructed urine outflow, not requiring indwelling ureteral stent, repeat ureteroplasty, or surgical revision. Sixty-one procedures were performed on 51 patients. Patients were followed up for a median of 286 days. Overall primary patency rate was 26.1%. Primary patency rate by method was 38.1%, 23.1%, and 14.3% after cryoplasty, tandem stent placement, and cutting balloon dilatation, respectively (P = .260). Primary patency rate was higher in early (<3 months post-transplant) ureteral strictures (35.7% vs 13.3%; P = .047). More complications identified in patients who had tandem ureteral stents (P = .00754). As some renal transplant patients may not be good operative candidates for ureteral revision, it would be reasonable to attempt one of these "bailout" interventions as long as the clinical team and patient are aware of overall low potential for achieving primary patency.
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Affiliation(s)
- Hamed Jalaeian
- Department of Interventional Radiology, Miller School of Medicine, University of Miami, Miami, FL, USA
| | - Reza Talaie
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - David W Hunter
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Jafar Golzarian
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
| | - Michael S Rosenberg
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Minneapolis, MN, USA
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Gawande R, Jalaeian H, Niendorf E, Olgun D, Krystosek L, Rubin N, Spilseth B. MRI in differentiating malignant versus benign portal vein thrombosis in patients with hepatocellular carcinoma: Value of post contrast imaging with subtraction. Eur J Radiol 2019; 118:88-95. [PMID: 31439264 PMCID: PMC6915965 DOI: 10.1016/j.ejrad.2019.07.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2019] [Revised: 07/03/2019] [Accepted: 07/05/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To evaluate MR imaging parameters including quantitative multiphasic post-contrast enhancement with subtraction and qualitative diffusion weighted imaging (DWI) in differentiating benign versus malignant portal venous thrombosis (PVT) in patients with hepatocellular carcinoma (HCC). METHOD Radiology reports over a 6-year period ending February 2016 were searched for key words indicating presence of both HCC and PVT on abdominal MRI. 39 patients were identified with PVT characterized as benign or malignant based on pathologic data or serial imaging growth criteria. Image review was performed by two subspecialized radiologists blinded to the diagnosis and medical chart. Signal intensity for regions of interest were recorded within the portal vein thrombus as well as the portal vein on pre-contrast and dynamic post-contrast phases without and with subtraction. Qualitative parameters for DWI and presence of PV expansion were also evaluated. RESULTS Percent enhancement generated high area under the curve (AUC) for both readers on all non-subtraction phases: arterial (0.95/0.98), portal venous (0.97/0.97) and delayed phase (0.96/0.99) and subtraction phases: arterial (0.91/0.96), portal venous (0.94/0.99) and delayed phases (0.96/0.97). Statistically significant differences were observed between benign and malignant PVT for both readers for PV expansion (p= <0.001/0.006). No qualitative DWI parameter reached statistical significance for both readers. CONCLUSIONS Post-contrast and subtraction MRI can reliably distinguish malignant from benign PVT in patients with HCC using subtracted or non-subtracted images and at arterial, portal venous, or delayed phase timing.
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Affiliation(s)
- Rakhee Gawande
- Johns Hopkins University, 601 N Caroline Street, Radiology, JHOC 3235-A, Baltimore, MD, 21287-0010, United States.
| | - Hamed Jalaeian
- Baystate Medical Center, 759 Chestnut Street, Springfield, MA, 01199, United States.
| | - Eric Niendorf
- Mayo Healthcare System, Department of Radiology, 1221 Whipple St., Eau Claire, WI, 54703, United States.
| | - Deniz Olgun
- Istanbul University Cerrahpasa Medical Faculty, Radiology Department, Cerrahpasa Mahallesi Kocamustafapasa, Fatih, İstanbul, 34098, Turkey.
| | - Luke Krystosek
- University of Minnesota Radiology Department, MMC 292, 420 Delaware St. SE, Minneapolis, MN, 55455, United States.
| | - Nathan Rubin
- Biostatistics Core, Masonic Cancer Center, University of Minnesota, 717 Delaware Street SE Rm 140-08, Minneapolis, MN, 55414, United States.
| | - Benjamin Spilseth
- University of Minnesota, 420 Delaware Street S.E. B234, Mayo Memorial Building MMC 292, Minneapolis, MN, 55455, United States.
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Eshraghian A, Rasekhi A, Nikeghbalian S, Muhammad S, Kazemi K, Jalaeian H, Shamsaeefar A, Geramizadeh B, Malek-Hosseini SA. Hepatic Computed Tomography Volumetry for Noninvasive Detection of Hepatic Steatosis and Steatohepatitis in Living Liver Donors. EXP CLIN TRANSPLANT 2019; 20:388-394. [PMID: 31266439 DOI: 10.6002/ect.2019.0089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVES Detection of hepatic steatosis in donors is an important step for selection of a suitable liver allograft in living-donor transplant. This study aimed to investigate the role of hepatic computed tomography volumetry as a noninvasive method for detection of hepatic steatosis in living liver donors. MATERIALS AND METHODS In a cross-sectional study, individuals who had undergone liver biopsy as a pretransplant checkup before living-donor liver transplant were included. The segmental liver volumes were measured by computed tomography scan with intravenous contrast enhancement. RESULTS Our study included 179 individuals. Mean total volume of the liver was 1705.2 ± 256.5 cm³ in those with steatohepatitis and 1419.4 ± 241.2 cm³ in those without steatohepatitis (P < .001). Higher total volume of the liver (odds ratio of 1.005; 95% confidence interval, 1.001-1.010; P = .012) and total liver volume-to-standard liver volume ratio (odds ratio of 1.090; 95% confidence interval, 1.021-1.163; P = .009) were independent predictors of steatohepatitis. A cutoff value of 1531 cm³ for total liver volume was a predictor of presence of steatohepatitis in liver biopsies of donors (sensitivity = 83%; specificity = 71%; area under the curve = 0.809; P < .001). CONCLUSIONS Computed tomography volumetry may be considered as an auxiliary noninvasive method for estimation of hepatic steatosis/steatohepatitis and may be used as a guide to select donor candidates for liver biopsy.
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Affiliation(s)
- Ahad Eshraghian
- From the Avicenna Transplant Hospital, Avicenna Center for Medicine and Organ Transplant, Shiraz, Iran
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Taleb S, Jalaeian H, Frank N, Golzarian J, D'Souza D. Is a Routine Chest X-ray Necessary in Every Patient After Percutaneous CT-Guided Lung Biopsy? A Retrospective Review of 278 Cases. Cardiovasc Intervent Radiol 2017; 40:1415-1420. [PMID: 28432386 DOI: 10.1007/s00270-017-1632-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 03/21/2017] [Indexed: 01/05/2023]
Abstract
PURPOSE To determine the rate, clinical significance, and predictors of delayed pneumothorax after CT-guided lung biopsy. METHODS Medical and imaging records of all patients who underwent CT-guided lung biopsy between January 1, 2012, and January 9, 2015, were reviewed. "Early pneumothorax" was defined as one visualized on CT scan at the time of biopsy, "delayed pneumothorax" as one discovered on the first follow-up chest X-ray (CXR), and "clinically significant pneumothorax" as one requiring chest tube placement. RESULTS Three hundred fifty-seven lung biopsies were performed; 79 patients did not have follow-up CXR and were excluded. Out of 278 cases included in the study, early pneumothorax occurred in 109 patients. Follow-up CXRs were available in the remaining 169 patients without early pneumothorax and were obtained 3.1 ± 2.9 h after biopsy. The rate of delayed pneumothorax was 8.6% (24/278). Clinically significant pneumothorax occurred in 10/24 (41.7%) patients with delayed pneumothorax, including one case of tension pneumothorax. Patients with delayed pneumothorax (n = 24) had smaller lesion long axial diameter (18.58 ± 9.84 vs 25.83 ± 17.69 mm, p = 0.005), longer intrapulmonary needle tract (23.45 ± 14.98 vs 14.17 ± 14.49, p = 0.004), and lower FEV1/FVC ratio (53.30 ± 22.47 vs 71.15 ± 13.77, p = 0.015), compared to those without delayed pneumothorax (n = 145). The length of intrapulmonary needle tract was the only independent predictor of delayed pneumothorax (p = 0.008) and symptomatic delayed pneumothorax (p = 0.019). CONCLUSION Obtaining a routine follow-up CXR in all patients after CT-guided lung biopsy appears warranted, given the high rate of delayed pneumothorax and large percentage of patients who will require a chest tube. The only independent predictor of (symptomatic) delayed pneumothorax was the length of intrapulmonary needle tract.
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Affiliation(s)
- Shayandokht Taleb
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Mayo B229, 420 Delaware St. SE/MMC 292, Minneapolis, MN, 55455, USA
| | - Hamed Jalaeian
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Mayo B229, 420 Delaware St. SE/MMC 292, Minneapolis, MN, 55455, USA
| | - Nickolas Frank
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Mayo B229, 420 Delaware St. SE/MMC 292, Minneapolis, MN, 55455, USA
| | - Jafar Golzarian
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Mayo B229, 420 Delaware St. SE/MMC 292, Minneapolis, MN, 55455, USA
| | - Donna D'Souza
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Mayo B229, 420 Delaware St. SE/MMC 292, Minneapolis, MN, 55455, USA.
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Jalaeian H, Talaie R, D'Souza D, Taleb S, Noorbaloochi S, Flanagan S, Hunter D, Golzarian J. Minilaparotomy-Assisted Transmesenteric-Transjugular Intrahepatic Portosystemic Shunt: Comparison with Conventional Transjugular Approach. Cardiovasc Intervent Radiol 2016; 39:1413-9. [PMID: 27272888 DOI: 10.1007/s00270-016-1385-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Accepted: 05/23/2016] [Indexed: 12/13/2022]
Abstract
PURPOSE This study was performed to compare the intrahepatic shunt function outcome and procedural complications of minilaparotomy-assisted transmesenteric (MAT)-transjugular intrahepatic portosystemic shunt (TIPS) placement with the conventional transjugular method. METHODS This is a retrospective review of all patients who had a MAT or conventional TIPS procedure over a 6-year period at our institute. The primary patency rate, fluoroscopy time, technical success, major procedure-related complications, and mortality data were compared between two treatment groups. RESULTS We included 49 patients with MAT-TIPS, and 63 with conventional TIPS, with an average follow-up of 21.43 months. The primary patency rates at 6 and 12 months were 82.9 and 66.7 % in the conventional TIPS group, and 81.0 and 76.5 % in the MAT-TIPS group (p = 1.000, and 0.529), respectively. There was no significant difference in technical success rate, post-procedure portosystemic pressure gradient, fluoroscopy time, and peri-procedural mortality rate between treatment groups. Major procedural-related complications were seen more frequently among MAT-TIPS patients (p = 0.012). In the MAT-TIPS group, 5 (10.2 %) patients developed post-procedure minilaparotomy, wound-related complications, and 5 (10.2 %) developed bacterial peritonitis; whereas, none of patients with conventional TIPS had either of these complications (p = 0.014). CONCLUSION While both MAT-TIPS and conventional TIPS had similar shunt primary patency rate and technical success rate, the MAT approach was associated with a significantly higher rate of minilaparotomy-related wound complications or infectious complications. These complications maybe prevented by a change in post-procedure monitoring and therapy.
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Affiliation(s)
- Hamed Jalaeian
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Mayo B228, 420 Delaware Street SE, Minneapolis, MN, 55455, USA.
| | - Reza Talaie
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Mayo B228, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
| | - Donna D'Souza
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Mayo B228, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
| | - Shayandokht Taleb
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Mayo B228, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
| | | | - Siobhan Flanagan
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Mayo B228, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
| | - David Hunter
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Mayo B228, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
| | - Jafar Golzarian
- Division of Interventional Radiology, Department of Radiology, University of Minnesota, Mayo B228, 420 Delaware Street SE, Minneapolis, MN, 55455, USA
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Jalaeian H, Taleb S, Jalaeian H, D’Souza D. Is a routine chest radiograph still necessary in every patient after percutaneous lung biopsy? J Vasc Interv Radiol 2016. [DOI: 10.1016/j.jvir.2015.12.456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Jalaeian H, Misselt A. Anaphylactic reaction to bovine thrombin in ultrasound-guided treatment of femoral pseudoaneurysm. J Vasc Interv Radiol 2016; 26:915-6. [PMID: 26003458 DOI: 10.1016/j.jvir.2015.02.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 02/21/2015] [Accepted: 02/21/2015] [Indexed: 11/19/2022] Open
Affiliation(s)
- Hamed Jalaeian
- Department of Interventional Radiology, University of Minnesota, 420 Delaware Street SE, MMC 292 B-212 Mayo, Minneapolis, MN 55455
| | - Andrew Misselt
- Department of Interventional Radiology, University of Minnesota, 420 Delaware Street SE, MMC 292 B-212 Mayo, Minneapolis, MN 55455
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Jalaeian H, Talaie R, D’Souza D, Noorbaloochi S, Kowalik K, Hunter D, Golzarian J. Intrahepatic portosystemic shunting: is minilaparotomy-assisted transmesenteric-transjugular approach still relevant? J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.12.608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Talaie R, Jalaeian H, Rosenberg M, Golzarian J. Review of the literature on commercially available coils, their clinical use, physical properties, and available level of evidence for outcome measures. J Vasc Interv Radiol 2015. [DOI: 10.1016/j.jvir.2014.12.415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Derakhshan N, Derakhshan D, Derakhshan A, Hashemi G, Fallahzadeh MH, Basiratnia M, Bazargani Z, Jalaeian H, Malek-Hosseini SA. Hyperlipidemia in children with normal allograft function. Saudi J Kidney Dis Transpl 2011; 22:339-340. [PMID: 21422639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023] Open
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Roozbeh J, Hedayati P, Sagheb MM, Sharifian M, Jahromi AH, Shaabani S, Jalaeian H, Raeisjalali GA, Behzadi S. Effect of Zinc Supplementation on Triglyceride, Cholesterol, LDL, and HDL Levels in Zinc-Deficient Hemodialysis Patients. Ren Fail 2009; 31:798-801. [DOI: 10.3109/08860220903216055] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Hamidian Jahromi A, Roozbeh J, Raiss-Jalali GA, Dabaghmanesh A, Jalaeian H, Bahador A, Nikeghbalian S, Salehipour M, Salahi H, Malek-Hosseini A. Risk factors of post renal transplant hyperparathyroidism. Saudi J Kidney Dis Transpl 2009; 20:573-576. [PMID: 19587496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
It is well recognized that patients with end stage renal diseases (ESRD) have hyper-plastic parathyroid glands. In most patients, a decrease in parathyroid hormone (PTH) occurs by about 1 year after renal transplantation. However, some renal transplant recipients continue to have elevated level of PTH. We prospectively evaluated 121 patients undergoing renal transplantation between August 2000 and 2002. The duration of dialysis, calcium (Ca), phosphorus (P), albumin, creatinine and iPTH levels were recorded prior to transplantation and three months and one year after transplantation. These 121 patients were on dialysis for an average period of 17.4 months prior to transplantation. An increase in the serum Ca and a decrease in serum P and iPTH level was seen in the patients after transplantation (P< 0.001). Hyperparathyroidism was in 12 (9.9%) and 7 (5.7%) patients three months and one year after transplantation respectively. Elderly patients and patients with longer duration on dialysis had an increased risk of developing post transplant hyperpara-thyroidism and hypercalcemia in the first year post transplant (P< 0.05). In conclusion age and duration on dialysis before transplantation seems to be important risk factors for post transplant hyperparathyroidism.
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Salehipour M, Salahi H, Jalaeian H, Bahador A, Nikeghbalian S, Barzideh E, Ariafar A, Malek-Hosseini SA. Vascular complications following 1500 consecutive living and cadaveric donor renal transplantations: a single center study. Saudi J Kidney Dis Transpl 2009; 20:570-572. [PMID: 19587495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023] Open
Abstract
The aim of this study was to document vascular complications that occurred following cadaveric and living donor kidney transplants in order to assess the overall incidence of these complications at our center as well as to identify possible risk factors. In a retrospective cohort study, 1500 consecutive renal transplant recipients who received a living or cadaveric donor kidney between December 1988 and July 2006 were evaluated. The study was performed at the Nemazee Hospital, Shiraz, Iran. The assessment of the anatomy and number of renal arteries as well as the incidence of vascular complications was made by color doppler ultrasonography, angiography, and/or surgical exploration. Clinically apparent vascular complications were seen in 8.86% of all study patients (n = 133) with the most frequent being hemorrhage (n = 91; 6.1%) followed by allo-graft renal artery stenosis (n = 26; 1.7%), renal artery thrombosis (n = 9; 0.6%), and renal vein thrombosis (n = 7; 0.5%). Vascular complications were more frequent in recipients of cadaveric organs than recipients of allografts from living donors (12.5% vs. 7.97%; P= 0.017). The occurrence of vascular complications was significantly more frequent among recipients of renal allografts with multiple arteries when compared with recipients of kidneys with single artery (12.3% vs. 8.2%; P= 0.033). The same was true to venous complications as well (25.4% vs. 8.2%; P< 0.001). Our study shows that vascular complications were more frequent in allografts with multiple renal blood vessels. Also, the complications were much less frequent in recipients of living donor transplants.
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Affiliation(s)
- Mehdi Salehipour
- Shiraz Organ Transplantation Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
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Dehghani SM, Taghavi SAR, Imanieh MH, Gholami S, Eshraghian A, Jalaeian H, Malek-Hosseini SA. Diabetes mellitus after liver transplantation in Iranian patients. Indian J Gastroenterol 2008; 27:83-4. [PMID: 18695312 DOI: pmid/18695312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Dehghani SM, Derakhshan A, Taghavi SAR, Gholami S, Jalaeian H, Malek-Hosseini SA. Prevalence and risk factors of renal dysfunction after liver transplant: a single-center experience. EXPERIMENTAL AND CLINICAL TRANSPLANTATION : OFFICIAL JOURNAL OF THE MIDDLE EAST SOCIETY FOR ORGAN TRANSPLANTATION 2008; 6:25-9. [PMID: 18405241 DOI: pmid/18405241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVES Renal dysfunction is one of the most significant complications after liver transplant. It is attributed mainly to nephrotoxicity caused by calcineurin inhibitors. We evaluated the renal functioning in liver transplant recipients alive for at least 6 months after liver transplant. MATERIALS AND METHODS One hundred seventy patients (108 male [63.5%], 62 female [36.5%]; mean age, 31.4 +/- 13.3 years; age range, 13-61 years) were included in this study. Patients who had undergone a liver transplant between 1994 and 2006 at the Organ Transplantation Center of the Shiraz University of Medical Sciences in Shiraz, Iran, and had been alive for at least 6 months after surgery were included. Data were collected regarding age, sex, body mass index, underlying liver disease, graft type, immunosuppressive medications, serum creatinine levels, and glomerular filtration rate before, 1, and 6 months after liver transplant. Renal dysfunction was defined as a serum creatinine level above 132.6 micromol/L or a glomerular filtration rate less than 60 mL/min/1.73 m2, based on our reference range. Glomerular filtration rate was calculated using the Schwartz formula (glomerular filtration rate mL/min/1.73 m2 = K x Ht (cm) / Cr mg/dL). Data were analyzed with SPSS software. RESULTS The mean follow-up was 25.9 +/- 23.5 months (range, 6-156 months). The main indications for liver transplant were cryptogenic cirrhosis (n=42), hepatitis B infection (n=34), autoimmune cirrhosis (n=30), Wilson's disease (n=21), and primary sclerosing cholangitis (n=18). The mean pretransplant glomerular filtration rate was 93.7 +/- 35.6 mL/min/1.73 m2. The mean glomerular filtration rates in the first and sixth months after liver transplant were 81.6 +/- 29.3 mL/min/1.73 m2 and 83.6 +/- 32.9 mL/min/1.73 m2. Sex, body mass index, type of immunosuppressive medication, and underlying liver disease were not predictors of renal dysfunction (P > .05). Posttransplant renal dysfunction was significantly more common in older patients (ie, those aged 38.8 years and older) (P = .0001) and those with a family history of renal disease (P < .05). CONCLUSIONS Renal dysfunction may be a significant problem for patients after liver transplant, and early detection of renal dysfunction in patients after liver transplant is important. Of all the risk factors studied here, only older age and family history of renal disease were correlated with development of renal dysfunction after liver transplant.
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Affiliation(s)
- Seyed Mohsen Dehghani
- Shiraz Organ Transplantation Center, Departments of Pediatric Gastroenterology, and Gastroenterohepatology Research Center, Nemazee Hospital Shiraz University of Medical Sciences, Shiraz, Iran.
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Salehipour M, Jalaeian H, Shirazi M, Rajabi MJ. Extravesical seromuscular ureteroneocystostomy: an effective and simple operation for treatment of vesicoureteral reflux. Urol Int 2008; 80:208-11. [PMID: 18362494 DOI: 10.1159/000112615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2007] [Accepted: 07/10/2007] [Indexed: 11/19/2022]
Abstract
PURPOSE To evaluate the success rate of extravesical seromuscular ureteroneocystostomy in the treatment of children with vesicoureteral reflux (VUR). PATIENTS AND METHODS In a prospective study from August 2005 to January of 2006, 15 patients (11 girls, 4 boys), median age of 9.5 years (range: 1-24 years), with high-grade VUR underwent operation. Urinary tract ultrasonography and voiding cystoureterography (VCUG) were the main diagnostic tools to detect VUR before the operation and at 3 months after the operation. RESULTS No VUR was detected at evaluation of 3-month postoperative VCUGs (14 cases, 93%). However, one child (7%) still had persistent VUR. This patient underwent reoperation and the length of the seromuscular tunnel was increased more with a favorable result. The overall success rate of this technique was about 93%. CONCLUSION Extravesical seromuscular ureteroneocystostomy is simple and effective method for the treatment of VUR in children.
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Affiliation(s)
- Mehdi Salehipour
- Division of Urology, Department of Surgery, Faghihi Hospital, University of Medical Sciences, Shiraz, Iran.
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