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Patel DM, Di Capua JF, Rouhezamin MR, Uppot RN, Kalva SP. Retrieval of a Greenfield Inferior Vena Cava Filter Indwelling for 29 Years. Vasc Endovascular Surg 2024:15385744241231134. [PMID: 38279905 DOI: 10.1177/15385744241231134] [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: 01/29/2024]
Abstract
Inferior vena cava (IVC) filters are used to prevent fatal and nonfatal pulmonary embolism in patients who otherwise cannot receive anticoagulation for venous thrombosis. While generally safe and effective, complications can arise, especially after prolonged implantation. Timely retrieval is essential once the indication for insertion has resolved. However, encountering patients with long-standing embedded filters is not uncommon. This case report discusses the successful retrieval of a permanent Greenfield IVC filter after 29 years.
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Affiliation(s)
- Dipesh M Patel
- Division of Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - John F Di Capua
- Division of Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Mohammad Reza Rouhezamin
- Division of Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Raul N Uppot
- Division of Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sanjeeva P Kalva
- Division of Interventional Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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2
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Ghaemi O, Mehrabi Nejad MM, Rouhezamin MR, Ayoobi Yazdi N, Pourghorban R, Rokni Yazdi H. A technical review of percutaneous sclerotherapy with bleomycin for giant hepatic venous malformation. CVIR Endovasc 2023; 6:46. [PMID: 37755623 PMCID: PMC10533756 DOI: 10.1186/s42155-023-00394-7] [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] [Received: 06/27/2023] [Accepted: 09/14/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Hepatic venous malformation (HVM), traditionally called liver haemangioma, is considered the most common benign hepatic lesion. Treatment might be indicated in large and symptomatic HVMs. We aim to describe stepwise technical aspects of trans-hepatic percutaneous sclerotherapy of hepatic venous malformation (HVM). MAIN TEXT Patients with symptomatic HVM larger than 5 cm are selected after discussion in hepatobiliary multidisciplinary team. After prophylactic antibiotic and corticosteroid administration, local anaesthesia and conscious sedation are applied. A 22-gauge spinal or Chiba needle is used to obtain percutaneous access to the HVM through normal liver parenchyma under ultrasound guidance. To ensure proper needle placement and to prevent accidental delivery of sclerosant into unintended areas, about 5-10 mL iodine contrast is injected under fluoroscopy. Then, 45-60 IU bleomycin is mixed with 10 mL distilled water and 10 mL lipiodol and is slowly injected under fluoroscopy over a period of 20-30 s. After the needle is removed, manual pressure is applied over the puncture site for a period of 5 min followed by placement of a sandbag. Patients are monitored for 6-8 h post-procedure. CONCLUSION In this technical review, we described our institutional technique of percutaneous sclerotherapy, which could be regarded as an alternative to TAE in the management of HVM.
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Affiliation(s)
- Omid Ghaemi
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital, Tehran University of Medical Sciences (TUMS), Qarib St, Keshavarz Blvd, Tehran, 1419733141, Iran
| | - Mohammad-Mehdi Mehrabi Nejad
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital, Tehran University of Medical Sciences (TUMS), Qarib St, Keshavarz Blvd, Tehran, 1419733141, Iran
| | | | - Niloofar Ayoobi Yazdi
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital, Tehran University of Medical Sciences (TUMS), Qarib St, Keshavarz Blvd, Tehran, 1419733141, Iran
| | - Ramin Pourghorban
- Department of Radiology, Sina Hospital, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Department of Medical Imaging, Nepean Hospital, Kingswood, NSW, Australia
| | - Hadi Rokni Yazdi
- Department of Radiology, Advanced Diagnostic and Interventional Radiology Research Center (ADIR), Medical Imaging Center, Imam Khomeini Hospital, Tehran University of Medical Sciences (TUMS), Qarib St, Keshavarz Blvd, Tehran, 1419733141, Iran.
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Bagheri Lankarani K, Honarvar B, Shafi Pour F, Bagherpour M, Erjaee A, Rouhezamin MR, Khorrami M, Amiri Zadeh Fard S, Seifi V, Geramizadeh B, Salahi H, Nikeghbalian S, Shamsaeefar A, Malek-Hosseini SA, Shirzadi S. Predictors of Death in the Liver Transplantation Adult Candidates: An Artificial Neural Networks and Support Vector Machine Hybrid-Based Cohort Study. J Biomed Phys Eng 2022; 12:591-598. [PMID: 36569570 PMCID: PMC9759643 DOI: 10.31661/jbpe.v0i0.2010-1212] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2020] [Accepted: 12/13/2020] [Indexed: 06/17/2023]
Abstract
BACKGROUND Model for end-stage liver disease (MELD) is currently used for liver transplantation (LT) allocation, however, it is not a sufficient criterion. OBJECTIVE This current study aims to perform a hybrid neural network analysis of different data, make a decision tree and finally design a decision support system for improving LT prioritization. MATERIAL AND METHODS In this cohort follow-up-based study, baseline characteristics of 1947 adult patients, who were candidates for LT in Shiraz Organ Transplant Center, Iran, were assessed and followed for two years and those who died before LT due to the end-stage liver disease were considered as dead cases, while others considered as alive cases. A well-organized checklist was filled for each patient. Analysis of the data was performed using artificial neural networks (ANN) and support vector machines (SVM). Finally, a decision tree was illustrated and a user friendly decision support system was designed to assist physicians in LT prioritization. RESULTS Between all MELD types, MELD-Na was a stronger determinant of LT candidates' survival. Both ANN and SVM showed that besides MELD-Na, age and ALP (alkaline phosphatase) are the most important factors, resulting in death in LT candidates. It was cleared that MELD-Na <23, age <53 and ALP <257 IU/L were the best predictors of survival in LT candidates. An applicable decision support system was designed in this study using the above three factors. CONCLUSION Therefore, Meld-Na, age and ALP should be used for LT allocation. The presented decision support system in this study will be helpful in LT prioritization by LT allocators.
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Affiliation(s)
- Kamran Bagheri Lankarani
- MD, Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Behnam Honarvar
- MD, Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Farshad Shafi Pour
- PhD, Department of Industrial Engineering, Iran University of Science and Technology, Tehran, Iran
| | - Morteza Bagherpour
- PhD, Department of Industrial Engineering, Iran University of Science and Technology, Tehran, Iran
| | - Asma Erjaee
- MD, Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Rouhezamin
- MD, Trauma Research Center, Rajaei Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mojdeh Khorrami
- MD, Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Saeid Amiri Zadeh Fard
- MD, Department of Internal Medicine, Gastroenterology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Seifi
- MD, Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bita Geramizadeh
- MD, Department of Pathology, Transplant Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Heshmatollah Salahi
- MD, Shiraz Organ Transplant Center, Shiraz University of Medical Sciences Shiraz, Iran
| | - Saman Nikeghbalian
- MD, Shiraz Organ Transplant Center, Shiraz University of Medical Sciences Shiraz, Iran
| | - Alireza Shamsaeefar
- MD, Shiraz Organ Transplant Center, Shiraz University of Medical Sciences Shiraz, Iran
| | | | - Saeedreza Shirzadi
- MD, Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
- MD, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
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Affiliation(s)
| | - Shahram Paydar
- Trauma Research Center, Rajaee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sara Haseli
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Rouhezamin MR, Haseli S. Diagnosing Pulmonary Thromboembolism in COVID-19: A Stepwise Clinical and Imaging Approach. Acad Radiol 2020; 27:896-897. [PMID: 32331965 PMCID: PMC7164893 DOI: 10.1016/j.acra.2020.04.023] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 04/13/2020] [Accepted: 04/13/2020] [Indexed: 01/01/2023]
Affiliation(s)
| | - Sara Haseli
- Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Rouhezamin MR, Shekarchi B, Taheri Akerdi A, Paydar S. Internal Jugular Vein Waveform; A New Insight to Detect Early Stage of Hemorrhagic Shock. Bull Emerg Trauma 2019; 7:263-268. [PMID: 31392226 PMCID: PMC6681873 DOI: 10.29252/beat-070309] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Revised: 05/19/2019] [Accepted: 06/19/2019] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVE To evaluate the accuracy of internal jugular vein waveform to detect early stage of hemorrhagic shock. METHODS Forty-three volunteers enrolled in our study between November and December 2018. After blood donation of 450cc, the blood donors in the case group underwent color Doppler sonography of internal Jugular Vein. Besides, the clinical and laboratory indicators of shock were evaluated. The same clinical, laboratory and sonographic data was also obtained from the volunteers in the control group, then Chi-square and Student t-test were applied to make comparison between mentioned groups. RESULTS After excluding five volunteers, eighteen subjects were included in the blood donor group (mean of age: 35.81±8.05) and 20 healthy volunteers enrolled in the control group (mean of age: 34.95± 6.86). The Jugular pulsatility index was significantly smaller in the case group (0.47 ± 0.27 vs. 0.77 ± 0.52). The jugular pulsatility index above 0.91 excluded blood loss (sensitivity=100%). The combination of clinical, laboratory and sonographic data were also represented as two other indices; Jugular Pulsatility-Shock index and Jugular Pulsatility-Shock-Base Deficit index (JPSBDI). These indices were also accurate enough to detect early blood loss (p=0.011 and <0.001, respectively). JPSBDI below 0.38 was highly accurate to rule out blood loss. (Area under the curve: 0.868, sensitivity=95% and specificity=76.47%). CONCLUSION The internal Jugular vein waveform is accurate to detect early stages of shock. The combination of clinical, laboratory and sonographic data is more promising than each of them, separately.
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Affiliation(s)
| | - Babak Shekarchi
- Department of Radiology, School of Medicine, AJA University of Medical Sciences, Tehran, Iran
| | - Ali Taheri Akerdi
- Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Shahram Paydar
- Trauma Research Center, Rajaee (Emtiaz) Trauma Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
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Lotfi M, Beheshti R, Rouhezamin MR, Rezaianzadeh A, Farhadi P, Daneshi Z. A Ten-Year Study of Prostate Cancer: A Southern Iranian Experience. Iran J Med Sci 2018; 43:372-379. [PMID: 30046205 PMCID: PMC6055215] [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] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Prostate cancer is the most common malignancy among the male population in the United States and the 3rd most common non-skin cancer among men in Iran. Its prevalence has shown a rising trend in recent decades. The aim of this study was to report the epidemiological features of prostate cancer in patients referred for prostate biopsy in the south of Iran and to evaluate the accuracy of the levels of the prostate-specific antigen (PSA) and the PSA-density (PSAD) as well as the extension of the disease in the prediction of the biological behavior of prostate cancer. METHODS This is a retrospective study on the medical records of 1982 consecutive patients who underwent transrectal ultrasound-guided biopsy due to an abnormal digital rectal examination and/or an elevated PSA level following referral from the Urology Ward to the Radiology Department of Shahid Faghihi Hospital in Shiraz, southern Iran, between December 2003 and July 2014. RESULTS The overall cancer detection rate was 33.1%. Although the cancer was more prevalent among the elderly patients, a significant fraction (7%) of the patients were aged < 55 years. The sensitivity and specificity of the PSA were 97.4% and 8.7% and those of the PSAD were 82.9% and 52%, respectively. Of the 637 patients with prostate cancer, 250 (39.2%) had unilateral disease, 378 (59.4%) had bilateral disease, and 9 (1.4%) had inner-gland involvement. Most of the patients with bilateral involvement had high-grade Gleason scores. CONCLUSION Our study underlines the relationship between age and the frequency of cancer; the levels of the PSA and the PSAD and the Gleason score; and the extent of tumor involvement and the grade of prostate cancer and also highlights the significance of screening, especially in younger patients.
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Affiliation(s)
- Mehrzad Lotfi
- Medical Imaging Research Center, Department of Radiology, Nemazee Hospital, Shiraz University of Medical Sciences , Shiraz, Iran
| | - Reza Beheshti
- Medical Imaging Research Center, Department of Radiology, Nemazee Hospital, Shiraz University of Medical Sciences , Shiraz, Iran
| | - Mohammad Reza Rouhezamin
- Medical Imaging Research Center, Department of Radiology, Nemazee Hospital, Shiraz University of Medical Sciences , Shiraz, Iran
| | - Abbas Rezaianzadeh
- Research Center for Health Sciences, Department of Epidemiology, Shiraz University of Medical Sciences. Shiraz Medical School, Shiraz, Iran
| | - Pouya Farhadi
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zeinab Daneshi
- Medical Imaging Research Center, Department of Radiology, Nemazee Hospital, Shiraz University of Medical Sciences , Shiraz, Iran
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Rouhezamin MR, Paydar S, Hasirbaf M, Bolandparvaz S, Abbasi HR. The Spatiotemporal Pattern of Trauma in Victims of Violence Visited in Emergency Room of Rajaei Hospital, Shiraz, Iran. Bull Emerg Trauma 2013; 1:141-146. [PMID: 27162846 PMCID: PMC4789448] [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] [Received: 08/03/2013] [Revised: 09/04/2013] [Accepted: 09/28/2013] [Indexed: 06/05/2023] Open
Abstract
OBJECTIVE To explain an important aspect of violence, the spatiotemporal pattern of trauma in victims of violence visited in emergency room of Rajaei hospital, Shiraz, Iran. METHODS This cross-sectional prospective study comprised 109 randomly selected victims of violence visited in emergency room of Rajaei hospital, a tertiary referral hospital affiliated to Shiraz University of Medical Sciences in winter 2013. We recorded the demographic information as well as data regarding the type and time of the injuries. The data collected for each victim was then entered in a data gathering form. RESULTS The study included 88% males with mean age 27.8 ± 8.8 years, which encompassed more than 60% young adults. Our study showed a temporal pattern with triple peaks. Moreover, 64% of assault trauma occurred at night. Furthermore, our study showed the majority of our patients suffered from stab wounds and about 57% of patients studied lacked high school diploma. Moreover it was revealed that violence was more common in downtown Shiraz, especially in the Fifth city district with simultaneous presence of many risk factors for violence. CONCLUSION The result of this study showed that age, gender, educational status and temporal peak of violence were shown to be similar to other investigations conducted in other countries. Despite these similarities, stabbing were more prevalent in our study. Additionally, the Fifth city district of Shiraz seems to be the main city district where preventive intervention is needed to reduce violence- related injuries.
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Affiliation(s)
| | - Shahram Paydar
- Trauma Research Center, Shiraz University of Medical Science, Shiraz, Iran
| | - Maryam Hasirbaf
- Trauma Research Center, Shahid Rajaee Trauma Hospital, Shiraz, Iran
| | | | - Hamid Reza Abbasi
- Trauma Research Center, Shiraz University of Medical Science, Shiraz, Iran
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Ebrahimi S, Tahmasebi S, Rouhezamin MR, Mousavi SM, Abbasi HR, Bolandparvaz S, Paydar S. Modified Perihepatic Packing; A Creative and Beneficial Method for Management of High Grade Liver Injury. Bull Emerg Trauma 2013; 1:22-27. [PMID: 27162817 PMCID: PMC4771238] [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] [Received: 08/13/2012] [Revised: 09/21/2012] [Accepted: 10/03/2012] [Indexed: 06/05/2023] Open
Abstract
OBJECTIVE To evaluate the efficacy of modified perihepatic packing (MPHP) in reducing the rate of re-bleeding rate after packing removal. METHODS This was an experimental study being performed in Shiraz animal laboratory. High grade liver parenchymal injury was induced in 30 transgenic Australian rabbits which were then divided into two groups. Group A (control) included 14 and group B (experimental) comprised 16 rabbits. The animals in group A underwent standard perihepatic packing (SPHP) and those in group B were subjected to MPHP. Re-bleeding was assessed and compared between the two groups, after removal of perihepatic packings. RESULTS There was no significant difference between two study groups regarding baseline and perioperative characteristics. Rabbits in group A had significantly lower rate of postoperative re-bleeding compared to those in group A (57.1% vs. 12.5%; p=0.019). The mean bleeding volume was also significantly lower in group B compared to group A (76.88 ± 22.12 vs. 98.93 ± 33.8 mL; p<001). Although the survival rate was higher in group A compared to group B (93.8% vs. 78.6%) but the difference was not statistically significant (p=0.315). CONCLUSION MPHP is a simple and safe procedure for surgical management of high grade liver parenchymal injury concomitant with severe loss of glisson's capsule. This procedure significantly decreases re-bleeding after packing removal in comparison with SPHP.
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Affiliation(s)
- Sajjad Ebrahimi
- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Sedigheh Tahmasebi
- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Mohammad Reza Rouhezamin
- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Seyed Mohsen Mousavi
- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Hamid Reza Abbasi
- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Shahram Bolandparvaz
- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Shahram Paydar
- Trauma Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
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