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Rais A, Benabderrazik B, El Bouardi N, Akammar A, Haloua M, Alami B, Alaoui MYL, Boubou M, Maaroufi M. Cholecystitis-related cystic artery pseudoaneurysm: Case report. Radiol Case Rep 2024; 19:2156-2159. [PMID: 38515769 PMCID: PMC10950602 DOI: 10.1016/j.radcr.2024.02.049] [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: 02/11/2024] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 03/23/2024] Open
Abstract
The pseudoaneurysms of the cystic artery (CAP) are very uncommon. They usually develop as a result of an acute cholecystitis or after a cholecystectomy. Among the complications, we can find hemorrhaging, biliary blockage, and haemobilia. Limited understanding of the illness makes managing specific cases difficult. We describe a case of a cystic artery pseudoaneurysm complicating an acute cholecystitis that was successfully treated by transcatheter arterial embolization.
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Affiliation(s)
- Asmae Rais
- Department of radiology of specialities, CHU Hassan II, university Sidi Mohammed Benabdellah, Fes, Morocco
| | - Btissam Benabderrazik
- Department of radiology of specialities, CHU Hassan II, university Sidi Mohammed Benabdellah, Fes, Morocco
| | - Nizar El Bouardi
- Department of radiology of specialities, CHU Hassan II, university Sidi Mohammed Benabdellah, Fes, Morocco
| | - Amal Akammar
- Department of radiology mother and child, CHU Hassan II, university Sidi Mohammed Benabdellah, Fes, Morocco
| | - Meriem Haloua
- Department of radiology mother and child, CHU Hassan II, university Sidi Mohammed Benabdellah, Fes, Morocco
| | - Babdreddine Alami
- Department of radiology of specialities, CHU Hassan II, university Sidi Mohammed Benabdellah, Fes, Morocco
| | | | - Meryem Boubou
- Department of radiology mother and child, CHU Hassan II, university Sidi Mohammed Benabdellah, Fes, Morocco
| | - Mustapha Maaroufi
- Department of radiology of specialities, CHU Hassan II, university Sidi Mohammed Benabdellah, Fes, Morocco
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Motii Y, Chahrour H, Harb A. Image guided preoperative abdominal wall botox injection for large ventral hernia repair: A case series. Radiol Case Rep 2024; 19:2315-2322. [PMID: 38559652 PMCID: PMC10978449 DOI: 10.1016/j.radcr.2024.02.079] [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: 11/18/2023] [Revised: 02/20/2024] [Accepted: 02/22/2024] [Indexed: 04/04/2024] Open
Abstract
This case series aims to explore the application of preoperative CT guided Botox injections in three different cases of abdominal wall reconstructions. Each of the three cases highlights the role of chemical component separation in achieving myofascial release and contributing to a successful surgical repair. The use of Botox in the preoperative planning of abdominal wall repair aims at creating a tension-free environment for midline closure and promoting an overall positive postoperative course for the patient. This case series presents as a valuable contribution to the different surgical approaches in abdominal wall reconstruction and the collaboration between Interventional Radiology and Surgery in treating such patients.
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Affiliation(s)
- Younes Motii
- Wayne State University School of Medicine, 540 E Canfield St, Detroit, MI 48201, USA
| | - Hussein Chahrour
- Detroit Medical Center/Wayne State University, Diagnostic Radiology, 4100 John R St, Detroit, MI 48201, USA
| | - Ali Harb
- Detroit Medical Center/Wayne State University, Diagnostic Radiology, 4100 John R St, Detroit, MI 48201, USA
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3
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Kastler A, Carneiro I, Perolat R, Rudel A, Pialat JB, Lazard A, Isnard S, Krainik A, Amoretti N, Grand S, Stacoffe N. Combined vertebroplasty and pedicle screw insertion for vertebral consolidation: feasibility and technical considerations. Neuroradiology 2024; 66:855-863. [PMID: 38453715 DOI: 10.1007/s00234-024-03325-y] [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: 11/15/2023] [Accepted: 02/24/2024] [Indexed: 03/09/2024]
Abstract
PURPOSE To assess the feasibility and technical accuracy of performing pedicular screw placement combined with vertebroplasty in the radiological setting. METHODS Patients who underwent combined vertebroplasty and pedicle screw insertion under combined computed tomography and fluoroscopic guidance in 4 interventional radiology centers from 2018 to 2023 were retrospectively assessed. Patient demographics, vertebral lesion type, and procedural data were analyzed. Strict intra-pedicular screw positioning was considered as technical success. Pain score was assessed according to the Visual Analogue Scale before the procedure and in the 1-month follow-up consultation. RESULTS Fifty-seven patients (38 men and 19 women) with a mean age of 72.8 (SD = 11.4) years underwent a vertebroplasty associated with pedicular screw insertion for the treatment of traumatic fractures (29 patients) and neoplastic disease (28 patients). Screw placement accuracy assessed by post-procedure CT scan was 95.7% (89/93 inserted screws). A total of 93 pedicle screw placements (36 bi-pedicular and 21 unipedicular) in 32 lumbar, 22 thoracic, and 3 cervical levels were analyzed. Mean reported procedure time was 48.8 (SD = 14.7) min and average injected cement volume was 4.4 (SD = 0.9) mL. A mean VAS score decrease of 5 points was observed at 1-month follow-up (7.7, SD = 1.3 versus 2.7, SD = 1.7), p < .001. CONCLUSION Combining a vertebroplasty and pedicle screw insertion is technically viable in the radiological setting, with a high screw positioning accuracy of 95.7%.
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Affiliation(s)
- Adrian Kastler
- Diagnostic and Interventional Neuroradiology Unit, Grenoble University Hospital, Grenoble, France.
| | - Inês Carneiro
- Neuroradiology Department, Centro Hospitalar Universitário Lisboa Norte, Lisbon, Portugal
| | - Romain Perolat
- Radiology Unit, Carémeau University Hospital, Nimes, France
| | - Alexandre Rudel
- Diagnostic and Interventional MSK Unit, Pasteur II Hospital, Nice, France
| | | | - Arnaud Lazard
- Neurosurgery Unit, Grenoble University Hospital, Grenoble, France
| | - Stephanie Isnard
- Neurosurgery Unit, Grenoble University Hospital, Grenoble, France
| | - Alexandre Krainik
- Diagnostic and Interventional Neuroradiology Unit, Grenoble University Hospital, Grenoble, France
| | - Nicolas Amoretti
- Diagnostic and Interventional MSK Unit, Pasteur II Hospital, Nice, France
| | - Sylvie Grand
- Diagnostic and Interventional Neuroradiology Unit, Grenoble University Hospital, Grenoble, France
| | - Nicolas Stacoffe
- Diagnostic and Interventional Radiology Unit, Lyon Sud Hospital, Lyon, France
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Suzuki T, Yamaguchi H, Kojima M, Kariyasu T, Nakamoto R, Nishikawa M, Machida H, Shoko T. Renal arteriovenous malformation treated using glue embolization under inflow and outflow control by balloon occlusion. Radiol Case Rep 2024; 19:2035-2038. [PMID: 38449487 PMCID: PMC10917633 DOI: 10.1016/j.radcr.2024.02.032] [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: 02/04/2024] [Revised: 02/06/2024] [Accepted: 02/12/2024] [Indexed: 03/08/2024] Open
Abstract
A 45-year-old female presented with gross hematuria. Right renal arteriovenous malformation on abdominal contrast-enhanced computed tomography necessitated urgent transcatheter arterial embolization. Right renal digital subtraction angiography revealed a single tortuous and dilated vessel converging to an aneurysmal dilated vein. To selectively embolize the malformation, we closed the arterial side with a microballoon and attempted glue embolization; filling occurred unexpectedly early, and another balloon on the vein side helped control the renal vein blood flow. Glue embolization was performed without adverse events. Glue embolization for high-flow arteriovenous malformation under balloon occlusion-mediated inflow and outflow control can effectively and safely embolize complete target vessels.
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Affiliation(s)
- Tensei Suzuki
- Emergency and Critical Care Medicine, Tokyo Women's Medical University Adachi Medical Center, Tokyo, Japan
| | - Hidenori Yamaguchi
- Department of Radiology, Tokyo Women's Medical University Adachi Medical Center, Tokyo, Japan
| | - Mitsuaki Kojima
- Emergency and Critical Care Medicine, Tokyo Women's Medical University Adachi Medical Center, Tokyo, Japan
| | - Toshiya Kariyasu
- Department of Radiology, Tokyo Women's Medical University Adachi Medical Center, Tokyo, Japan
| | - Raira Nakamoto
- Emergency and Critical Care Medicine, Tokyo Women's Medical University Adachi Medical Center, Tokyo, Japan
| | - Makiko Nishikawa
- Department of Radiology, Tokyo Women's Medical University Adachi Medical Center, Tokyo, Japan
| | - Haruhiko Machida
- Department of Radiology, Tokyo Women's Medical University Adachi Medical Center, Tokyo, Japan
| | - Tomohisa Shoko
- Emergency and Critical Care Medicine, Tokyo Women's Medical University Adachi Medical Center, Tokyo, Japan
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Pinto CJ, Maldar SB, Hegde S, Choukimath SM. Radiological impact of oral bisphosphonate use on polyostotic Paget's disease of bone over a 2 year period. Radiol Case Rep 2024; 19:1886-1892. [PMID: 38434784 PMCID: PMC10905954 DOI: 10.1016/j.radcr.2024.01.037] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/09/2024] [Accepted: 01/16/2024] [Indexed: 03/05/2024] Open
Abstract
Paget's disease of bone is a disorder of osteoclasts which hampers the physiological process of bone remodeling. It is the most common metabolic orthopedic disease in the Caucasian populace; we report the diagnosis of Paget's disease of bone in a South-Asian male in his early 50s with a history of gastrointestinal symptoms, weight loss and back pain. An alkaline phosphatase level of 1104 IU/L was noted. A 3-phase bone scan showed noncontiguous heterogenous nuclear uptake. After exhaustive evaluation, the patient was diagnosed with Paget's disease of bone. Despite the disease activity being mitigated by alendronate and monitored by ALP levels within normal range per protocol, the patient had compression fractures of the vertebrae requiring early reinitiation of oral bisphosphonates. This raised doubts about the efficacy of metabolic marker-based management in Paget's disease of bone.
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Affiliation(s)
- Christopher Jude Pinto
- Department of Medicine, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
- Western Michigan University, Homer Stryker M.D School of Medicine, Battle Creek, MI, USA
| | - Shadab B. Maldar
- Department of Medicine, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
| | - Siddhi Hegde
- Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
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6
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Culp WTN. Veterinary Interventional Oncology. Vet Clin North Am Small Anim Pract 2024; 54:491-500. [PMID: 38184437 DOI: 10.1016/j.cvsm.2023.12.005] [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: 01/08/2024]
Abstract
Interventional oncology (IO) is a rapidly growing field in veterinary medicine and has been accepted as a fourth pillar of treatment of neoplastic disease with other modalities including surgery, chemotherapy, and radiation therapy. The major categories of IO therapies in companion animals are focused on the use of locoregional therapies and stenting of malignant obstructions. Although significant assessment of veterinary IO techniques is still necessary, early evaluation of these varying techniques is demonstrating promising results.
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Affiliation(s)
- William T N Culp
- University of California-Davis, School of Veterinary Medicine, One Garrod Drive, Davis, CA 95616, USA.
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Huang ML, Lane DL, Bomar H, Kuerer H. Breast cryoablation for the palliative treatment of indolent subtype of multicentric triple-negative breast cancer. BMJ Case Rep 2024; 17:e259465. [PMID: 38627044 PMCID: PMC11029424 DOI: 10.1136/bcr-2023-259465] [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: 04/19/2024] Open
Abstract
Breast cryoablation for palliative and curative treatment of breast cancer has been performed for decades. Although there is a recent resurgence of interest in breast cryoablation with curative intent for unifocal, hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer, this report highlights the essential role that cryoablation can play in the palliative treatment of multicentric oestrogen and progesterone receptor-negative and human epidermal growth factor receptor 2-negative (triple-negative) breast cancer, meeting the select pretreatment objectives such as breast or nipple pain relief and prevention of tumour erosion through the skin or nipple in patients who have failed or cannot tolerate the standard of care treatment.
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Affiliation(s)
- Monica L Huang
- Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Deanna L Lane
- Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Hannah Bomar
- Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Henry Kuerer
- Breast Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
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Sui WF, Duan YX, Li JY, Shao WB, Fu JH. Safety and efficacy of transcatheter arterial embolization in autosomal dominant polycystic kidney patients with gross hematuria: Six case reports. World J Clin Cases 2024; 12:1954-1959. [PMID: 38660552 PMCID: PMC11036527 DOI: 10.12998/wjcc.v12.i11.1954] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 01/30/2024] [Accepted: 03/19/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND To retrospectively report the safety and efficacy of renal transcatheter arterial embolization for treating autosomal dominant polycystic kidney disease (ADPKD) patients with gross hematuria. CASE SUMMARY The purpose of this study is to retrospectively report the safety and efficacy of renal transcatheter arterial embolization for treating ADPKD patients with gross hematuria. Materials and methods: During the period from January 2018 to December 2019, renal transcatheter arterial embolization was carried out on 6 patients with polycystic kidneys and gross hematuria. Renal arteriography was performed first, and then we determined the location of the hemorrhage and performed embolization under digital subtraction angiography monitoring. Improvements in routine blood test results, routine urine test results, urine color and postoperative reactions were observed and analyzed. Results: Renal transcatheter arterial embolization was successfully conducted in 6 patients. The indices of 5 patients and the color of gross hematuria improved after surgery compared with before surgery. No severe complication reactions occurred. CONCLUSION For autosomal dominant polycystic kidney syndrome patients with gross hematuria, transcatheter arterial embolization was safe and effective.
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Affiliation(s)
- Wei-Fan Sui
- Department of Interventional Radiology, Zhenjiang First People's Hospital, Zhenjiang 212000, Jiangsu Province, China
| | - Yun-Xin Duan
- Department of Interventional Radiology, Zhenjiang First People's Hospital, Zhenjiang 212000, Jiangsu Province, China
| | - Jian-Yun Li
- Department of Interventional Radiology, Zhenjiang First People's Hospital, Zhenjiang 212000, Jiangsu Province, China
| | - Wei-Bin Shao
- Department of Nephrology, Zhenjiang First People’s Hospital, Zhenjiang 212000, Jiangsu Province, China
| | - Jian-Hua Fu
- Department of Interventional Radiology, Zhenjiang First People's Hospital, Zhenjiang 212000, Jiangsu Province, China
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Nadeem A, Salei A. Percutaneous biliary stent removal for benign biliary stricture post hepaticojejunostomy. BMJ Case Rep 2024; 17:e259589. [PMID: 38599795 PMCID: PMC11015180 DOI: 10.1136/bcr-2023-259589] [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] [Accepted: 03/19/2024] [Indexed: 04/12/2024] Open
Abstract
This case report presents the percutaneous extraction of a biliary stent in a patient with a history of liver transplant and Whipple procedure, suffering from benign biliary stricture post hepaticojejunostomy. After failed management with conventional benign biliary protocol, a fully covered WallFlex biliary stent was percutaneously placed and later removed using a balloon catheter technique. The procedure demonstrated anastomosis patency without complications, providing a drain-free option for complex anatomy where endoscopic management was not feasible. This case contributes valuable insights to the limited literature on percutaneous stent removal for benign biliary strictures, emphasising the importance of considering alternative approaches in challenging clinical scenarios.
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Affiliation(s)
- Arsalan Nadeem
- Department of Medicine, Allama Iqbal Medical College, Lahore, Punjab, Pakistan
| | - Aliaksei Salei
- Department of Radiology, The University of Alabama at Birmingham, Birmingham, Alabama, USA
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Tavares J, Freire I, Branco C, Luís A. Vertebral artery dissection as the underlying cause of ventral spinal epidural haematoma. BMJ Case Rep 2024; 17:e259591. [PMID: 38599792 PMCID: PMC11015211 DOI: 10.1136/bcr-2023-259591] [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: 04/12/2024] Open
Abstract
Spontaneous spine epidural haematoma is a rare occurrence, with an incidence of 0.1/100 000 inhabitants/year. The anterior location of the haematoma is very uncommon since the dural sac is firmly attached to the posterior longitudinal ligament. Vertebral artery dissection as its underlying cause is an exceptionally rare event, with only two documented cases.This article presents the case of young woman who arrived at the emergency room with a spinal ventral epidural haematoma extending from C2 to T10, caused by a non-traumatic dissecting aneurysm of the right vertebral artery at V2-V3 segment. Since the patient was tetraparetic, she underwent emergent laminectomy, and the vertebral artery dissection was subsequently treated endovascularly with stenting.Vertebral artery dissection with subsequent perivascular haemorrhage is a possible cause of spontaneous spine epidural haematoma, particularly when located ventrally in the cervical and/or high thoracic column. Hence the importance of a thorough investigation of the vertebral artery integrity.
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Affiliation(s)
- Joana Tavares
- Neurosurgery Department, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
| | - Inês Freire
- Neurorradiology Department, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
| | - Cristina Branco
- Neurorradiology Department, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
| | - Ana Luís
- Neurosurgery Department, Centro Hospitalar de Lisboa Ocidental EPE, Lisboa, Portugal
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Panesar H, Hatazaki M, Shekhtman Y. Scalp necrosis following preoperative endovascular embolisation of the superficial temporal artery for meningioma. BMJ Case Rep 2024; 17:e257848. [PMID: 38589239 PMCID: PMC11015201 DOI: 10.1136/bcr-2023-257848] [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: 04/10/2024] Open
Abstract
A woman in her late 50s with a left frontal lobe convexity meningioma underwent an elective endovascular embolisation of the left middle meningeal artery and distal branches of the left superficial temporal artery prior to surgical resection of the tumour. On postoperative day 46, she developed scalp necrosis, leading to poor wound healing requiring wound debridement and a complex plastic surgery reconstruction with a rotational flap. Endovascular embolisation of vascular tumours prior to surgical resection does not come without risks. The lack of consistency in the literature regarding indication, technique and outcomes makes it difficult to define the exact role of preoperative meningioma embolisation.
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Affiliation(s)
- Harsimran Panesar
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
- Surgery, Morristown Medical Center, Morristown, New Jersey, USA
| | - Mai Hatazaki
- Hackensack Meridian School of Medicine, Nutley, New Jersey, USA
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Mori K, Negishi T, Makabe K, Sekiguchi R, Tsuchida T. Patient radiation exposure dose reduction using stent-enhanced image processing in percutaneous coronary intervention. Radiol Phys Technol 2024:10.1007/s12194-024-00796-9. [PMID: 38578581 DOI: 10.1007/s12194-024-00796-9] [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: 12/28/2023] [Revised: 02/27/2024] [Accepted: 03/17/2024] [Indexed: 04/06/2024]
Abstract
We investigated the reduction in patient radiation exposure dose during percutaneous coronary intervention (PCI) by stent enhancement processing. We examined the effects of dose reduction based on the image quality of stent enhancement processing using a purpose-built dynamic phantom. We evaluated the image contrast (IC) of the stent in stent-enhanced images (SVref), digital angiography (DA), and stent-enhanced images with a 20%, 40%, and 60% lower imaging doses (SV20, SV40, and SV60). We visually evaluated graininess and stent shape using the mean opinion score (MOS) and retrospectively evaluated the acquisition duration of stent enhancement in PCI cases; finally, we estimated the decrease in patient radiation exposure due to stent enhancement. The image contrast of SVref at phantom thicknesses of 20 cm was 51.25 ± 3.82, while the image contrast of DA was significantly reduced at 14.90 ± 1.57 (p < 0.05). We observed a significant decrease in the MOS of graininess in SV60 and MOS of stent shape in DA (p < 0.05). Furthermore, the average imaging duration for stent enhancement using PCI was 22.65 ± 7.43 s, and the maximum imaging duration was 68.07 s. We hypothesize that patient radiation exposure dose can be reduced by up to 60.17 mGy by lowering the imaging dose during the stent enhancement process. Stent enhancement processing improves the visibility of stent images, and can reduce radiation exposure by approximately 40% during confirmation imaging of stents. Our study contributes to the reduction of radiation exposure dose for operators and patients in PCI.
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Affiliation(s)
- Kazuya Mori
- Department of Radiological Technology, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi, Saitama, 332-8558, Japan.
- Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, 7-2-10 Higashi-Ogu, Arakawa, Tokyo, 116-8551, Japan.
| | - Toru Negishi
- Department of Radiological Sciences, Graduate School of Human Health Sciences, Tokyo Metropolitan University, 7-2-10 Higashi-Ogu, Arakawa, Tokyo, 116-8551, Japan
| | - Kouhei Makabe
- Department of Radiological Technology, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi, Saitama, 332-8558, Japan
| | - Ryou Sekiguchi
- Department of Radiological Technology, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi, Saitama, 332-8558, Japan
| | - Takuji Tsuchida
- Department of Radiological Technology, Saiseikai Kawaguchi General Hospital, 5-11-5 Nishikawaguchi, Kawaguchi, Saitama, 332-8558, Japan
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Matsumoto T, Yoshimatsu R, Osaki M, Shibata J, Maeda H, Miyatake K, Noda Y, Yamanishi T, Yamagami T. Analgesic efficacy and safety of percutaneous thermal ablation plus cementoplasty for painful bone metastases: a systematic review and meta-analysis. Int J Clin Oncol 2024; 29:372-385. [PMID: 38217754 DOI: 10.1007/s10147-023-02458-z] [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: 08/11/2023] [Accepted: 12/11/2023] [Indexed: 01/15/2024]
Abstract
PURPOSE To conduct a systematic review and meta-analysis of publications to evaluate the analgesic efficacy and safety of percutaneous thermal ablation (PTA) plus percutaneous cementoplasty (PCP) (PTA + PCP) for painful bone metastases. METHODS We searched PubMed, Cochrane Library and Embase for articles published up to October 2022. Outcomes were a 10-point pain scale, morphine equivalents daily dose (MEDD) and complications. A subgroup confined to spinal bone metastases was analyzed. RESULTS Twenty-one articles were selected for the analysis. The 21 selected articles involved a total of 661 cases. The pooled pain scales at pre-PTA + PCP, 1 day, 1 week and 1-, 3-, and 6 months post-PTA + PCP were 7.60 (95% confidence interval [CI], 7.26-7.95, I2 = 89%), 3.30 (95% CI, 2.25-4.82, I2 = 98%), 2.58 (95% CI, 1.99-3.35, I2 = 94%), 2.02 (95% CI, 1.50-2.71, I2 = 93%), 1.78 (95% CI, 1.26-2.53, I2 = 95%), and 1.62 (95% CI, 1.14-2.31, I2 = 88%), and in the subgroup, 7.97 (95% CI, 7.45-8.52, I2 = 86%), 3.01 (95% CI, 1.43-6.33, I2 = 98%), 2.95 (95% CI, 1.93-4.51, I2 = 95%), 2.34 (95% CI, 1.82-3.01, I2 = 68%), 2.18 (95% CI, 1.57-3.03, I2 = 78%), and 2.01 (95% CI, 1.16-3.48, I2 = 86%). Mean MEDD decreased up to 3 months post-PTA + PCP in 4 articles. The overall pooled major complication rate was 4% (95% CI, 2-6%, I2 = 2%). CONCLUSIONS The updated systematic review and meta-analysis indicates that PTA + PCP for painful bone metastases is safe, and can lead to rapid and sustained pain reduction.
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Affiliation(s)
- Tomohiro Matsumoto
- Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan.
| | - Rika Yoshimatsu
- Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan
- Department of Radiology, Kochi Health Sciences Center, 2125-1 Ike, Kochi, 781-0111, Japan
| | - Marina Osaki
- Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan
- Department of Radiology, Kochi Health Sciences Center, 2125-1 Ike, Kochi, 781-0111, Japan
| | - Junki Shibata
- Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan
| | - Hitomi Maeda
- Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan
| | - Kana Miyatake
- Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan
| | - Yoshinori Noda
- Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan
| | - Tomoaki Yamanishi
- Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan
| | - Takuji Yamagami
- Department of Diagnostic and Interventional Radiology, Kochi Medical School, Kochi University, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan
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14
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Meram E, Russell E, Ozkan O, Kleedehn M. Variceal and Nonvariceal Upper Gastrointestinal Bleeding Refractory to Endoscopic Management: Indications and Role of Interventional Radiology. Gastrointest Endosc Clin N Am 2024; 34:275-299. [PMID: 38395484 DOI: 10.1016/j.giec.2023.09.014] [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: 02/25/2024]
Abstract
For over 60 years, diagnostic and interventional radiology have been heavily involved in the evaluation and treatment of patients presenting with gastrointestinal bleeding. For patients who present with upper GI bleeding and have a contraindication to endoscopy or have an unsuccessful attempt at endoscopy for identifying or controlling the bleeding, interventional radiology is often consulted for evaluation and consideration of catheter-based intervention.
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Affiliation(s)
- Ece Meram
- University of Wisconsin School of Medicine and Public Health, University of Wisconsin Hospitals and Clinics, 600 Highland Avenue, Madison, WI 53792, USA
| | - Elliott Russell
- University of Wisconsin School of Medicine and Public Health, University of Wisconsin Hospitals and Clinics, 600 Highland Avenue, Madison, WI 53792, USA
| | - Orhan Ozkan
- University of Wisconsin School of Medicine and Public Health, University of Wisconsin Hospitals and Clinics, 600 Highland Avenue, Madison, WI 53792, USA
| | - Mark Kleedehn
- University of Wisconsin School of Medicine and Public Health, University of Wisconsin Hospitals and Clinics, 600 Highland Avenue, Madison, WI 53792, USA.
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15
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Bhatti Y, Tan KT. Symptomatic hemodialysis arteriovenous fistula with associated subclavian stenosis and a normal fistulogram. Radiol Case Rep 2024; 19:1294-1297. [PMID: 38292798 PMCID: PMC10825551 DOI: 10.1016/j.radcr.2023.12.027] [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: 09/27/2023] [Revised: 12/14/2023] [Accepted: 12/18/2023] [Indexed: 02/01/2024] Open
Abstract
While arteriovenous fistulas (AVFs) are the optimal route of access for hemodialysis in terms of duration of patency and infection rates, they can still fail due a variety of reasons. Most commonly, AVF failure is due to venous stenotic lesions, resulting in reduced blood flow rate across the fistula. Fistulograms are often used to investigate cases of symptomatic or poor fistula function. This case discusses a 71-year-old man with a mature brachiocephalic AVF who presented with severe right upper extremity edema, and had a negative fistulogram, despite a severe stenosis in his AVF.
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Affiliation(s)
- Yudhvir Bhatti
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Kiat Tsong Tan
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
- Department of Interventional Radiology, Niagara Health, St. Catharines, Ontario, Canada; Department of Radiology, McMaster University, Hamilton, Ontario, Canada
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16
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Musa A, Hall H, Johnson SC, Alchammas J, Badawy M, Harb A. The role of moonlighting in radiology residency. Clin Imaging 2024; 108:110083. [PMID: 38340436 DOI: 10.1016/j.clinimag.2024.110083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Revised: 12/13/2023] [Accepted: 01/07/2024] [Indexed: 02/12/2024]
Affiliation(s)
- Arif Musa
- Department of Radiology, Detroit Medical Center, Detroit, MI 48201, United States of America.
| | - Hunter Hall
- Department of Radiology, Detroit Medical Center, Detroit, MI 48201, United States of America
| | - Samuel C Johnson
- Department of Radiology, Detroit Medical Center, Detroit, MI 48201, United States of America
| | - Jorge Alchammas
- Department of Radiology, Detroit Medical Center, Detroit, MI 48201, United States of America
| | - Mohamed Badawy
- Department of Radiology, Detroit Medical Center, Detroit, MI 48201, United States of America
| | - Ali Harb
- Department of Radiology, Detroit Medical Center, Detroit, MI 48201, United States of America
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17
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Talati J, Khazem M, Vogel J, Davis H, Heithaus R. Suction thrombectomy of a uterine carcinosarcoma tumor thrombus extending into the IVC and right atrium. Int Cancer Conf J 2024; 13:177-181. [PMID: 38524645 PMCID: PMC10957830 DOI: 10.1007/s13691-024-00662-w] [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: 10/01/2023] [Accepted: 01/24/2024] [Indexed: 03/26/2024] Open
Abstract
Uterine carcinosarcoma is a rare, aggressive tumor with several cases in the literature reporting cardiac tumor thrombus involvement. In this case report, we describe a 72-year-old female with a history of uterine carcinosarcoma, who presented with extensive thrombus in the Inferior Vena Cava (IVC) and right atrium. The patient underwent an aspiration thrombectomy which aided in intravascular debulking of the thrombus. Histopathological analysis of the thrombus revealed tumor thrombus. In cryptic cases of tumor thrombus, thrombectomy with histopathological analysis can help confirm the diagnosis of metastatic disease and help guide oncologic staging and further therapy.
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Affiliation(s)
- Jay Talati
- Division of Vascular and Interventional Radiology, University of Florida College of Medicine, Gainesville, FL USA
| | - Maher Khazem
- Division of Vascular and Interventional Radiology, University of Florida College of Medicine, Gainesville, FL USA
| | - Jeffrey Vogel
- Division of Vascular and Interventional Radiology, University of Florida College of Medicine, Gainesville, FL USA
| | - Hugh Davis
- Division of Vascular and Interventional Radiology, University of Florida College of Medicine, Gainesville, FL USA
| | - Robert Heithaus
- Division of Vascular and Interventional Radiology, University of Florida College of Medicine, Gainesville, FL USA
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18
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Zhang JL, Yuan B, Zhang H, Wang MQ. Transcatheter arterial embolization with N-butyl cyanoacrylate for postoperative hemorrhage treatment following pancreatoduodenectomy. Emerg Radiol 2024; 31:179-185. [PMID: 38334821 DOI: 10.1007/s10140-024-02211-7] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 01/31/2024] [Indexed: 02/10/2024]
Abstract
PURPOSE Postoperative hemorrhage (PPH) is a severe complication of pancreatoduodenectomy (PD) with a mortality rate of 5-20.2% and mortality due to hemorrhage of 11-58%. Transcatheter arterial embolization (TAE) has been widely recommended for PPH, however, TAE with N-butyl cyanoacrylate (NBCA) for PPH treatment has been reported rarely. Therefore, this study aimed to evaluate the safety and efficacy of TAE with NBCA for PPH treatment following PD. METHODS This retrospective study included 14 male patients (mean age, 60.93 ± 10.97 years) with postoperative hemorrhage following PD treated with TAE using NBCA as the main embolic agent from October 2019 to February 2022. The clinical data, technical and success rate, and complications were analyzed. RESULTS Among the 14 patients who underwent TAE, the technical and clinical success rates were 100 and 85.71%, respectively. Angiography revealed contrast extravasation in 12 cases and a pseudoaneurysm in 3 cases. One patient developed a serious infection and died 2 days after the TAE. CONCLUSION TAE with NBCA for PPH treatment following PD, especially for massive hemorrhage caused by a pancreatic fistula, biliary fistula, or inflammatory corrosion, can result in rapid and effective hemostasis with high safety.
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Affiliation(s)
- Jin Long Zhang
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, People's Republic of China
| | - Bing Yuan
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, 100853, People's Republic of China
| | - Heng Zhang
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, 100853, People's Republic of China
- Department of Radiology, National Clinical Research Center for Geriatric Diseases/Second Medical Center of Chinese PLA General Hospital, Beijing, 100853, China
| | - Mao Qiang Wang
- Department of Interventional Radiology, Chinese PLA General Hospital, Beijing, 100853, People's Republic of China.
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19
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Khan A, Garg T, Khunte M, Bajaj S, Wu X, Mezrich J, Malhotra A. Analysis of Medical Malpractice Claims Involving Interventional Radiologists: A Comprehensive Analysis From Two National Legal Databases. J Am Coll Radiol 2024; 21:656-662. [PMID: 37769859 DOI: 10.1016/j.jacr.2023.02.039] [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: 12/23/2022] [Revised: 02/15/2023] [Accepted: 02/21/2023] [Indexed: 10/03/2023]
Abstract
PURPOSE The nature of lawsuits involving interventional radiologists (IRs) is not well understood. The purposes of this article are to provide an overview of the causes of action underlying medical malpractice lawsuits related to IRs and to characterize the associated factors and outcomes. METHODS Two large legal databases were used to search for US legal cases in which there were jury awards and settlements involving IRs in the United States. Cases were screened to include only those cases in which the cause of action involved negligence on the part of IRs. RESULTS A total of 389 published case summaries were identified, of which 93 were eligible to be included in the analysis. In 46% of the cases (43 of 93), medical malpractice was alleged against an individual IR, whereas in 43% (40 of 93), it was alleged against both an individual IR and a health care institution. Thirty-five percent of IR malpractice cases (33 of 93) involved the performance of a vascular procedure, most commonly embolization procedures (30% [n = 10]), stenting or angioplasty (21% [n = 7]), and diagnostic arteriography and angiography (18% [n = 6]). Twenty-six percent of cases (24 of 93) involved IR performance of a biopsy. Eighteen percent of cases (17 of 93) involved a failure to gain informed consent in addition to an allegation of medical negligence during treatment. Eleven percent of cases (10 of 93) were resolved by settlement, with an average settlement amount of $877,500 (range, $200,000-$2,700,000). Among the 72 cases that went to trial, 74% (53 of 72) resulted in judgments for the defendants, and 26% (19 of 72) resulted in judgements for the plaintiffs, with an average award of $2,012,243 (range, $101,667-$6,400,000). CONCLUSIONS Vascular procedures and biopsies were the most frequent reasons for malpractice lawsuits involving IRs. Failure to gain informed consent in addition to an allegation of medical negligence during treatment was not infrequent. Although the majority of published medical malpractice claims involving IRs resulted in judgments in favor of the defendants, the average amount awarded to plaintiffs was higher compared with previous data reported for all physicians.
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Affiliation(s)
- Amin Khan
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Tushar Garg
- Division of Vascular and Interventional Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mihir Khunte
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Suryansh Bajaj
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Xiao Wu
- Department of Radiology, University of California, San Francisco, San Francisco, California
| | - Jonathan Mezrich
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Ajay Malhotra
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut.
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20
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Robbie R, Amrita R, Adrian C, Alexander S, Shastri S, Maharaj P. Cystic artery pseudoaneurysm. Radiol Case Rep 2024; 19:1413-1418. [PMID: 38292804 PMCID: PMC10827550 DOI: 10.1016/j.radcr.2023.12.058] [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: 06/14/2023] [Revised: 12/17/2023] [Accepted: 12/27/2023] [Indexed: 02/01/2024] Open
Abstract
Cystic artery pseudoaneurysm (CAP) is a rare entity, with just a few cases reported in the literature. The most common presentation of CAP is described by Quincke's triad of upper gastrointestinal bleeding, jaundice and right upper quadrant abdominal pain. We report the case of an 83-year-old male who presented to the adult emergency with a history of an acute cholecystitis 5 weeks prior for which responded to conservative management. Despite this patient not presenting with Quincke's triad, early suspicion of CAP was considered in light of his history of acute cholecystitis and a computed tomographic CT abdomen ordered promptly which showed a 6 mm cystic artery pseudoaneurysm and a thick-walled gallbladder with surrounding inflammatory changes. Management with an endovascular approach followed by an elective cholecystectomy was done.
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Affiliation(s)
- Rampersad Robbie
- Department of Radiology, University of the West Indies, St. Augustine, Trinidad and Tobago
| | | | - Chan Adrian
- Department of Radiology, University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Sinanan Alexander
- Department of Radiology, Sangre Grande Hospital, Trinidad and Tobago
| | - Sookhai Shastri
- Department of Surgery, Port of Spain General Hospital, Trinidad and Tobago
| | - Parmanand Maharaj
- Department of Radiology, University of the West Indies, St. Augustine, Trinidad and Tobago
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21
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Nakama R, Arai Y, Horii T, Kobayashi T. Computed tomography-guided percutaneous needle biopsy for middle mediastinal tumors with retroaortic paravertebral approach: A case report. Radiol Case Rep 2024; 19:1440-1444. [PMID: 38292803 PMCID: PMC10827543 DOI: 10.1016/j.radcr.2023.12.062] [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: 10/12/2023] [Revised: 12/27/2023] [Accepted: 12/27/2023] [Indexed: 02/01/2024] Open
Abstract
A 74-year-old man was referred to our hospital for a close examination of a mediastinal mass. Contrast-enhanced CT showed a middle mediastinal tumor. We planned to perform a CT-guided percutaneous needle biopsy of the tumor using a retroaortic paravertebral approach to avoid transpulmonary puncture. A coaxial blunt-tip needle with a side hole was used to create space in the mediastinum and avoid azygos vein injury. After injecting normal saline, a blunt-tip needle was advanced through the space between the aorta and the vertebral body to the anterior surface of the tumor, and tissue was obtained. The patient was discharged the following day with no complications. For percutaneous middle mediastinal tumor biopsy, the retroaortic paravertebral approach may be a safe, effective route.
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Affiliation(s)
- Rakuhei Nakama
- Department of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1 kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Yasunori Arai
- Department of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1 kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Toshihiro Horii
- Department of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1 kashiwanoha, Kashiwa, Chiba 277-8577, Japan
| | - Tatsushi Kobayashi
- Department of Diagnostic Radiology, National Cancer Center Hospital East, 6-5-1 kashiwanoha, Kashiwa, Chiba 277-8577, Japan
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22
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Bajaber A, Ali MH, Bazuhair AO, Bajaber O, Alsaiady M, Rabie S, BinMahmoud L, Alfaki D. Successful retrieval of deep intracardiac migrated broken umbilical venous catheter in a preterm infant: Case report. Radiol Case Rep 2024; 19:1235-1238. [PMID: 38292783 PMCID: PMC10825532 DOI: 10.1016/j.radcr.2023.12.022] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/09/2023] [Accepted: 12/12/2023] [Indexed: 02/01/2024] Open
Abstract
Umbilical catheters serve as indispensable tools in the realm of neonatal intensive care, contributing significantly to the well-being of premature infants. While rare, it is essential to approach their handling with utmost caution, as it can lead to fatal complications. We report a case of a preterm 9-day-old male infant, who was referred to our center for specialized treatment following an unsuccessful surgical attempt to address a fractured umbilical venous catheter (UVC). This case underscores the value of employing imaging techniques for prompt identification of such complications. Furthermore, the utilization of endovascular therapy emerges as a promising intervention in managing such complexities, thereby expanding the horizons of interventional radiology in elevating the standard of patient care.
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Affiliation(s)
- Abubakr Bajaber
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
| | - Magda Hag Ali
- Department of Pediatric Cardiology, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Adeeb Omar Bazuhair
- Medical Imaging Department, Interventional Radiology Section, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Omar Bajaber
- Medical Imaging Department, Pediatric Radiology Section, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Moath Alsaiady
- Medical Imaging Department, Pediatric Radiology Section, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Samy Rabie
- Department of Pediatric Cardiology, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Latifa BinMahmoud
- Neonatal Critical Care Department, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Doaa Alfaki
- Neonatal Critical Care Department, King Saud Medical City, Riyadh 12746, Saudi Arabia
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23
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Rigiroli F, Camacho A, Chung A, Andrabi SY, Brook A, Siewert B, Ahmed M, Brook OR. Safety profile and technical success of narrow window CT-guided percutaneous biopsy with blunt needle approach in the abdomen and pelvis. Eur Radiol 2024; 34:2364-2373. [PMID: 37707549 DOI: 10.1007/s00330-023-10231-z] [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: 03/08/2023] [Revised: 07/06/2023] [Accepted: 08/03/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVE To assess success and safety of CT-guided procedures with narrow window access for biopsy. METHODS Three hundred ninety-six consecutive patients undergoing abdominal or pelvic CT-guided biopsy or fiducial placement between 01/2015 and 12/2018 were included (183 women, mean age 63 ± 14 years). Procedures were classified into "wide window" (width of the needle path between structures > 15 mm) and "narrow window" (≤ 15 mm) based on intraprocedural images. Clinical information, complications, technical and clinical success, and outcomes were collected. The blunt needle approach is preferred by our interventional radiology team for narrow window access. RESULTS There were 323 (81.5%) wide window procedures and 73 (18.5%) narrow window procedures with blunt needle approach. The median depth for the narrow window group was greater (97 mm, interquartile range (IQR) 82-113 mm) compared to the wide window group (84 mm, IQR 60-106 mm); p = 0.0017. Technical success was reached in 100% (73/73) of the narrow window and 99.7% (322/323) of the wide window procedures. There was no difference in clinical success rate between the two groups (narrow: 86.4%, 57/66; wide: 89.5%, 265/296; p = 0.46). There was no difference in immediate complication rate (narrow: 1.3%, 1/73; wide: 1.2%, 4/323; p = 0.73) or delayed complication rate (narrow: 1.3%, 1/73; wide: 0.6%, 1/323; p = 0.50). CONCLUSION Narrow window (< 15 mm) access biopsy and fiducial placement with blunt needle approach under CT guidance is safe and successful. CLINICAL RELEVANCE STATEMENT CT-guided biopsy and fiducial placement can be performed through narrow window access of less than 15 mm utilizing the blunt-tip technique. KEY POINTS • A narrow window for CT-guided abdominal and pelvic biopsies and fiducial placements was considered when width of the needle path between vital structures was ≤ 15 mm. • Seventy-three biopsies and fiducial placements performed through a narrow window with blunt needle approach had a similar rate of technical and clinical success and complications compared to 323 procedures performed through a wide window approach, with traditional approach (> 15 mm). • This study confirmed the safety of the CT-guided percutaneous procedures through < 15 mm window with blunt-tip technique.
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Affiliation(s)
- Francesca Rigiroli
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Road, Boston, MA, 02215, USA.
| | - Andrés Camacho
- Department of Radiology, Mount Sinai Medical Center Miami Beach, Miami, FL, USA
| | - Andrew Chung
- Department of Radiology, Queen's University, Kingston, ON, Canada
| | - Syed Yasir Andrabi
- Department of Radiology, Temple Health, Lewis Katz School of Medicine, Philadelphia, PA, USA
| | - Alexander Brook
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Road, Boston, MA, 02215, USA
| | - Bettina Siewert
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Road, Boston, MA, 02215, USA
| | - Muneeb Ahmed
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Road, Boston, MA, 02215, USA
| | - Olga R Brook
- Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 1 Deaconess Road, Boston, MA, 02215, USA
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24
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Murai K, Yamamoto A, Kageyama K, Nakano M, Jogo A, Miki Y. A case of recurrent laryngeal nerve paralysis caused by radiofrequency ablation for mediastinal recurrence of lung cancer. Radiol Case Rep 2024; 19:1397-1400. [PMID: 38268738 PMCID: PMC10803787 DOI: 10.1016/j.radcr.2023.12.059] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/19/2023] [Accepted: 12/27/2023] [Indexed: 01/26/2024] Open
Abstract
Radiofrequency ablation (RFA) has emerged as a potent therapeutic modality for tumor treatment, and offers benefits such as reduced recovery time and minimal damage to nearby tissues. However, RFA is not devoid of complications, notably nerve damage during intrathoracic lesion treatments, which can significantly impact patients' quality of life. This report describes the unique case of a 71-year-old male who experienced hoarseness attributed to injury to the recurrent nerve after RFA for a locally recurrent lung cancer lesion in the mediastinum near the aortic arch. Although RFA has the advantages of a minimally invasive nature and positive outcomes, its risk of nerve injury, specifically in the thoracic region, highlights the need for improved techniques and preventive measures.
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Affiliation(s)
- Kazuki Murai
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Akira Yamamoto
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Ken Kageyama
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Mariko Nakano
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Atsushi Jogo
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan
| | - Yukio Miki
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3 Asahimachi, Abenoku, Osaka 545-8585, Japan
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25
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Barash Y, Livne A, Klang E, Sorin V, Cohen I, Khaitovich B, Raskin D. Artificial Intelligence for Identification of Images with Active Bleeding in Mesenteric and Celiac Arteries Angiography. Cardiovasc Intervent Radiol 2024:10.1007/s00270-024-03689-x. [PMID: 38530394 DOI: 10.1007/s00270-024-03689-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 02/20/2024] [Indexed: 03/28/2024]
Abstract
PURPOSE The purpose of this study is to evaluate the efficacy of an artificial intelligence (AI) model designed to identify active bleeding in digital subtraction angiography images for upper gastrointestinal bleeding. METHODS Angiographic images were retrospectively collected from mesenteric and celiac artery embolization procedures performed between 2018 and 2022. This dataset included images showing both active bleeding and non-bleeding phases from the same patients. The images were labeled as normal versus images that contain active bleeding. A convolutional neural network was trained and validated to automatically classify the images. Algorithm performance was tested in terms of area under the curve, accuracy, sensitivity, specificity, F1 score, positive and negative predictive value. RESULTS The dataset included 587 pre-labeled images from 142 patients. Of these, 302 were labeled as normal angiogram and 285 as containing active bleeding. The model's performance on the validation cohort was area under the curve 85.0 ± 10.9% (standard deviation) and average classification accuracy 77.43 ± 4.9%. For Youden's index cutoff, sensitivity and specificity were 85.4 ± 9.4% and 81.2 ± 8.6%, respectively. CONCLUSION In this study, we explored the application of AI in mesenteric and celiac artery angiography for detecting active bleeding. The results of this study show the potential of an AI-based algorithm to accurately classify images with active bleeding. Further studies using a larger dataset are needed to improve accuracy and allow segmentation of the bleeding.
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Affiliation(s)
- Yiftach Barash
- Department of Diagnostic Imaging, Chaim Sheba Medical Center, Emek Haela St. 1, 52621, Ramat Gan, Israel.
- The Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel.
- DeepVision Lab, Chaim Sheba Medical Center, Emek Haela St. 1, 52621, Ramat Gan, Israel.
| | - Adva Livne
- Department of Diagnostic Imaging, Chaim Sheba Medical Center, Emek Haela St. 1, 52621, Ramat Gan, Israel
- DeepVision Lab, Chaim Sheba Medical Center, Emek Haela St. 1, 52621, Ramat Gan, Israel
| | - Eyal Klang
- Department of Diagnostic Imaging, Chaim Sheba Medical Center, Emek Haela St. 1, 52621, Ramat Gan, Israel
- The Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- DeepVision Lab, Chaim Sheba Medical Center, Emek Haela St. 1, 52621, Ramat Gan, Israel
- Sami Sagol AI Hub, ARC, Chaim Sheba Medical Center, Emek Haela St. 1, 52621, Ramat Gan, Israel
| | - Vera Sorin
- Department of Diagnostic Imaging, Chaim Sheba Medical Center, Emek Haela St. 1, 52621, Ramat Gan, Israel
- The Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
- DeepVision Lab, Chaim Sheba Medical Center, Emek Haela St. 1, 52621, Ramat Gan, Israel
| | - Israel Cohen
- Department of Diagnostic Imaging, Chaim Sheba Medical Center, Emek Haela St. 1, 52621, Ramat Gan, Israel
- The Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Boris Khaitovich
- Department of Diagnostic Imaging, Chaim Sheba Medical Center, Emek Haela St. 1, 52621, Ramat Gan, Israel
- The Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
| | - Daniel Raskin
- Department of Diagnostic Imaging, Chaim Sheba Medical Center, Emek Haela St. 1, 52621, Ramat Gan, Israel
- The Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel
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Makki M, Bentaleb M, Abdulrahman M, Suhool AA, Al Harthi S, Ribeiro Jr MAF. Current interventional options for palliative care for patients with advanced-stage cholangiocarcinoma. World J Clin Oncol 2024; 15:381-390. [PMID: 38576598 PMCID: PMC10989261 DOI: 10.5306/wjco.v15.i3.381] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/18/2024] [Accepted: 02/27/2024] [Indexed: 03/22/2024] Open
Abstract
Primary biliary tract tumors are malignancies that originate in the liver, bile ducts, or gallbladder. These tumors often present with jaundice of unknown etiology, leading to delayed diagnosis and advanced disease. Currently, several palliative treatment options are available for primary biliary tract tumors. They include percutaneous transhepatic biliary drainage (PTBD), biliary stenting, and surgical interventions such as biliary diversion. Systemic therapy is also commonly used for the palliative treatment of primary biliary tract tumors. It involves the administration of chemotherapy drugs, such as gemcitabine and cisplatin, which have shown promising results in improving overall survival in patients with advanced biliary tract tumors. PTBD is another palliative treatment option for patients with unresectable or inoperable malignant biliary obstruction. Biliary stenting can also be used as a palliative treatment option to alleviate symptoms in patients with unresectable or inoperable malignant biliary obstruction. Surgical interventions, such as biliary diversion, have traditionally been used as palliative options for primary biliary tract tumors. However, biliary diversion only provides temporary relief and does not remove the tumor. Primary biliary tract tumors often present in advanced stages, making palliative treatment the primary option for improving the quality of life of patients.
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Affiliation(s)
- Maryam Makki
- Department of Surgery, Division of Trauma, Critical Care and Acute Care Surgery, Sheikh Shakhbout Medical City, Abu Dhabi 11001, United Arab Emirates
| | - Malak Bentaleb
- Department of Surgery, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi 11001, United Arab Emirates
| | - Mohammed Abdulrahman
- Department of Surgery, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi 11001, United Arab Emirates
| | - Amal Abdulla Suhool
- Department of Surgery, Division of Hepato-Pancreato-Biliary (HPB) Surgery, Sheikh Shakhbout Medical City, Abu Dhabi 91888, United Arab Emirates
| | - Salem Al Harthi
- Department of Surgery, Division of Hepato-Pancreato-Biliary (HPB) Surgery, Sheikh Shakhbout Medical City, Abu Dhabi 91888, United Arab Emirates
| | - Marcelo AF Ribeiro Jr
- Department of Surgery, Division of Trauma, Critical Care and Acute Care Surgery, Sheikh Shakhbout Medical City, Abu Dhabi 11001, United Arab Emirates
- Department of Surgery, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi 11001, United Arab Emirates
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Marcelin C, Maas P, Jambon E, Maaloum R, Andreo IM, Le Bras Y, Roman H, Grenier N, Brun JL, Cornelis FH. Long-term outcomes after percutaneous cryoablation of abdominal wall endometriosis. Eur Radiol 2024:10.1007/s00330-024-10689-5. [PMID: 38512491 DOI: 10.1007/s00330-024-10689-5] [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: 10/18/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/23/2024]
Abstract
OBJECTIVE To retrospectively evaluate the long-term outcomes after percutaneous cryoablation of abdominal wall endometriosis (AWE). METHOD The Institutional Review Board approved this retrospective observational review of 40 consecutive patients, of a median age of 37 years (interquartile range [IQR] 32-40 years), presenting with a total of 52 symptomatic AWE nodules. All patients underwent cryoablation between January 2013 and May 2022 with a minimum follow-up period of 12 months. Outcomes were assessed using a visual analog scale (VAS) that measured pain, as well as by magnetic resonance imaging (MRI). The pain-free survival rates were derived using the Kaplan-Meier estimator. Adverse events were analyzed and graded using the classification system of the Cardiovascular and Interventional Radiological Society of Europe. RESULTS The median follow-up time was 40.5 months (IQR 26.5-47.2 months). The median VAS score before cryoablation was 8 (IQR 7-9). Complete relief of symptoms was documented in 80% (32/40) of patients at 3 months after initial cryoablation and correlated with the absence of residual endometriosis nodules on MRI. The median pain-free survival rates were 89.2% [95% CI, 70.1-96.4%] at 36 months and 76.8% [95% CI, 55.3-83.8%] after 60 months. No patient or lesion characteristics were found to be prognostic of failure. No major adverse events or side effects were reported in long term. CONCLUSION Cryoablation safely and effectively afforded long-term pain relief for patients with AWE nodules. CLINICAL RELEVANCE STATEMENT AWE cryoablation was found to be safe and effective in the long-term. KEY POINTS • Cryoablation is highly effective with 80% of patients experiencing complete relief of AWE symptoms after a single procedure. • Cryoablation is safe without long-term adverse events or side effects. • The median pain-free survival rates are 89.2% at 36 months and 76.8% at 60 months.
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Affiliation(s)
- Clément Marcelin
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Service d'imagerie diagnostique et thérapeutique de l'adulte, 3300, Bordeaux, France.
- Université de Bordeaux, INSERM, Bordeaux Institute of Oncology, BRIC U1312, 33000, Bordeaux, France.
| | - Philippe Maas
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Service d'imagerie diagnostique et thérapeutique de l'adulte, 3300, Bordeaux, France
| | - Eva Jambon
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Service d'imagerie diagnostique et thérapeutique de l'adulte, 3300, Bordeaux, France
| | - Rim Maaloum
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Service d'imagerie diagnostique et thérapeutique de l'adulte, 3300, Bordeaux, France
| | - Isabelle Molina Andreo
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Service d'imagerie diagnostique et thérapeutique de l'adulte, 3300, Bordeaux, France
| | - Yann Le Bras
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Service d'imagerie diagnostique et thérapeutique de l'adulte, 3300, Bordeaux, France
| | - Horace Roman
- Clinique Tivoli- Ducos, Institut Franco-Européen Multidisciplinaire d'Endométriose (IFEMEndo), 33000, Bordeaux, France
| | - Nicolas Grenier
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Service d'imagerie diagnostique et thérapeutique de l'adulte, 3300, Bordeaux, France
| | - Jean-Luc Brun
- Centre Hospitalier Universitaire (CHU) de Bordeaux, Service de gynécologie, 33000, Bordeaux, France
| | - Francois H Cornelis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY, 10065, USA
- Weill Cornell Medical College, 1300 York Avenue, New York, NY, 10065, USA
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Ragland A, Stevens C, Bai N, Ahuja C, Virk C. Retrieval of an inferior vena cava Greenfield filter 34 years after insertion. BMJ Case Rep 2024; 17:e259053. [PMID: 38514161 PMCID: PMC10961489 DOI: 10.1136/bcr-2023-259053] [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: 03/23/2024] Open
Abstract
Inferior vena cava (IVC) filters are engineered medical devices deployed in the IVC primarily to prevent a pulmonary embolism from occurring. In this article, we present a case of an IVC filter that was successfully retrieved from a patient after being in place for 34 years. The patient presented to hospital for trauma in which subsequent imaging showed tines of an IVC filter protruding outside of the vessel with one of the tines penetrating the duodenal wall. The filter was successfully removed with no complications. This report adds to the existing literature by yielding an example of an adverse risk that can be associated with the placement of IVC filters. In addition, to the authors' best knowledge, this is the longest reported length of time that an IVC filter has stayed in a patient before being removed, thus adding another intriguing detail to the case.
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Affiliation(s)
- Amanda Ragland
- Louisiana State University Health Sciences Center Shreveport School of Medicine, Shreveport, Louisiana, USA
| | - Christopher Stevens
- Louisiana State University Health Sciences Center Shreveport School of Medicine, Shreveport, Louisiana, USA
| | - Nancy Bai
- Louisiana State University Health Sciences Center Shreveport School of Medicine, Shreveport, Louisiana, USA
| | - Chaitanya Ahuja
- Louisiana State University Health Sciences Center Shreveport School of Medicine, Shreveport, Louisiana, USA
| | - Chiranjiv Virk
- Louisiana State University Health Sciences Center Shreveport School of Medicine, Shreveport, Louisiana, USA
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vanSonnenberg E, Mueller PR, Towbin R, Silverman SG, Berliner L, D'Agostino HB. Transitioning from interventional radiology: ideas for the inevitable. Abdom Radiol (NY) 2024:10.1007/s00261-024-04234-7. [PMID: 38502212 DOI: 10.1007/s00261-024-04234-7] [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: 01/23/2024] [Revised: 01/23/2024] [Accepted: 02/01/2024] [Indexed: 03/21/2024]
Abstract
BACKGROUND Interventional Radiology (IR) is a highly rewarding specialty, both for its salutary effects for patients, as will as the satisfaction it provides for the operating radiologists. Nonetheless, arduous work and long hours have led to numerous reports of burnout amongst interventional radiologists (IRs). MATERIALS AND METHODS Six long-term academic radiologists in leadership positions briefly chronicle their becoming IRs, their type of transitioning from IR, and the pros and cons of those respective transitions. RESULTS The specific transitions include reduced time in IR, switching to diagnostic radiology, becoming involved in medical school education, ceasing IR leadership, and retirement. Pros and cons of the various transition strategies are highlighted. CONCLUSION As the taxing work and long hours are so ubiquitous for IRs, and as burnout is so common, transitioning from IR is highly likely eventually for IRs. The varied transition experiences highlighted in this report hopefully will be helpful for current and aspiring IRs.
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Affiliation(s)
- Eric vanSonnenberg
- Departments of Radiology and Student Affairs, University of Arizona College of Medicine Phoenix, HSEB Building, C536, 435 North 5th Street, Phoenix, AZ, 85004, USA.
| | - Peter R Mueller
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, USA
| | - Richard Towbin
- Department of Radiology, University of Arizona College of Medicine Phoenix, Phoenix, USA
| | - Stuart G Silverman
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, USA
| | - Leonard Berliner
- Department of Radiology, Staten Island University Hospital, Northwell Health, Staten Island, USA
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Cornelis FH, Moyne T, Dohan A. Percutaneous image-guided cryoablation of abdominal wall endometriosis: Towards a novel standard of care? Diagn Interv Imaging 2024:S2211-5684(24)00080-9. [PMID: 38508969 DOI: 10.1016/j.diii.2024.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 03/06/2024] [Indexed: 03/22/2024]
Affiliation(s)
- Francois H Cornelis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Weill Cornell Medical College, Radiology, New York, NY 10065, USA.
| | - Thibault Moyne
- Department of Radiology, Hopital Cochin, AP-HP, 75014 Paris, France; Université Paris Cité, Faculté de Médecine, 75006 Paris, France
| | - Anthony Dohan
- Department of Radiology, Hopital Cochin, AP-HP, 75014 Paris, France; Université Paris Cité, Faculté de Médecine, 75006 Paris, France
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Gentsu T, Yamaguchi M, Sasaki K, Kawasaki R, Horinouchi H, Fukuda T, Miyamoto N, Mori T, Sakamoto N, Uotani K, Taniguchi T, Koda Y, Yamanaka K, Takahashi H, Okada K, Hayashi T, Watanabe T, Nomura Y, Matsushiro K, Ueshima E, Okada T, Sugimoto K, Murakami T. Side branch embolization before endovascular abdominal aortic aneurysm repair to prevent type II endoleak: A prospective multicenter study. Diagn Interv Imaging 2024:S2211-5684(24)00079-2. [PMID: 38503637 DOI: 10.1016/j.diii.2024.03.003] [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: 01/15/2024] [Revised: 02/28/2024] [Accepted: 03/05/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE The purpose of the study was to evaluate the efficacy and safety of pre-emptive transcatheter arterial embolization (P-TAE) of aortic side branches to prevent type II endoleak in patients with abdominal aortic aneurysm after endovascular abdominal aneurysm repair (EVAR). MATERIALS AND METHODS This multicenter, prospective, single-arm trial enrolled 100 patients with abdominal aortic aneurysm from nine hospitals between 2018 and 2021. There were 85 men and 15 women, with a mean age of 79.6 ± 6.0 (standard deviation) years (range: 65-97 years). P-TAE was attempted for patent aortic side branches, including the inferior mesenteric artery, lumbar arteries, and other branches. The primary endpoint was late type II endoleak incidence at 6 months post-repair. Secondary endpoints included changes in aneurysmal sac diameter at 6- and 12 months, complications, re-intervention, and aneurysm-related mortality. Aneurysm sac changes at 6- and 12 months was compared between the late and no-late type II endoleak groups. RESULTS Coil embolization was successful in 80.9% (321/397) of patent aortic side branches, including 86.3% of the inferior mesenteric arteries, 80.3% of lumbar arteries, and 55.6% of other branches without severe adverse events. Late type II endoleak incidence at 6 months was 8.9% (8/90; 95% confidence interval: 3.9-16.8%). Aneurysm sac shrinkage > 5 mm was observed in 41.1% (37/90) and 55.3% (47/85) of the patients at 6- and 12-months post-EVAR, respectively. Patients with late type II endoleak had less aneurysm sac shrinkage than those without type II endoleak at 12 months (-0.2 mm vs. -6.0 mm; P = 0.040). No patients required re-intervention for type II endoleak, and no aneurysm-related mortalities occurred. CONCLUSION P-TAE is safe and effective in preventing type II endoleak, leading to early sac shrinkage at 12 months following EVAR.
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Affiliation(s)
- Tomoyuki Gentsu
- Department of Diagnostic and Interventional Radiology, Kobe University Hospital, Kobe, 7-5-2 Kusunokicho, Chuo Ward, Kobe City, Hyogo 650-0017, Japan
| | - Masato Yamaguchi
- Department of Diagnostic and Interventional Radiology, Kobe University Hospital, Kobe, 7-5-2 Kusunokicho, Chuo Ward, Kobe City, Hyogo 650-0017, Japan.
| | - Koji Sasaki
- Department of Diagnostic and Interventional Radiology, Kobe University Hospital, Kobe, 7-5-2 Kusunokicho, Chuo Ward, Kobe City, Hyogo 650-0017, Japan
| | - Ryota Kawasaki
- Department of Diagnostic and Interventional Radiology, Hyogo Prefectural Harima-Himeji General Medical Center, Himeji, Hyogo 670-8560, Japan
| | - Hiroki Horinouchi
- Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka 565-8565, Japan
| | - Tetsuya Fukuda
- Department of Radiology, National Cerebral and Cardiovascular Center, Suita, Osaka 565-8565, Japan
| | - Naokazu Miyamoto
- Department of Radiology, Kita-harima Medical Center, Ono, Hyogo 675-1323, Japan
| | - Takeki Mori
- Department of Radiology, Japanese Red Cross Kobe Hospital, Kobe, Hyogo 651-0073, Japan
| | - Noriaki Sakamoto
- Department of Diagnostic and Interventional Radiology, Kakogawa Central City Hospital, Kakogawa, Hyogo 675-8520, Japan
| | - Kensuke Uotani
- Department of Radiology, Hyogo Prefectural Awaji Medical Center, Sumoto, Hyogo 656-0021, Japan
| | | | - Yojiro Koda
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan
| | - Katsuhiro Yamanaka
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan
| | - Hiroaki Takahashi
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan
| | - Kenji Okada
- Division of Cardiovascular Surgery, Department of Surgery, Kobe University Hospital, Kobe, Hyogo 650-0017, Japan
| | - Taro Hayashi
- Department of Cardiovascular Surgery, Akashi Medical Center, Akashi, Hyogo 673-0896, Japan
| | - Toshitaka Watanabe
- Department of Cardiovascular Surgery, Akashi Medical Center, Akashi, Hyogo 673-0896, Japan
| | - Yoshikatsu Nomura
- Department of Cardiovascular Surgery, Hyogo Prefectural Harima-Himeji General Medical Center, Himeji, Hyogo 670-8560, Japan
| | - Keigo Matsushiro
- Department of Diagnostic and Interventional Radiology, Kobe University Hospital, Kobe, 7-5-2 Kusunokicho, Chuo Ward, Kobe City, Hyogo 650-0017, Japan
| | - Eisuke Ueshima
- Department of Diagnostic and Interventional Radiology, Kobe University Hospital, Kobe, 7-5-2 Kusunokicho, Chuo Ward, Kobe City, Hyogo 650-0017, Japan
| | - Takuya Okada
- Department of Diagnostic and Interventional Radiology, Kobe University Hospital, Kobe, 7-5-2 Kusunokicho, Chuo Ward, Kobe City, Hyogo 650-0017, Japan
| | - Koji Sugimoto
- Department of Diagnostic and Interventional Radiology, Kobe University Hospital, Kobe, 7-5-2 Kusunokicho, Chuo Ward, Kobe City, Hyogo 650-0017, Japan
| | - Takamichi Murakami
- Department of Diagnostic and Interventional Radiology, Kobe University Hospital, Kobe, 7-5-2 Kusunokicho, Chuo Ward, Kobe City, Hyogo 650-0017, Japan
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Burnett C, Chandler S, Jegatheesan D, Pearch B, Viecelli A, Mudge DW. The stuck haemodialysis catheter-a case report of a rare but dreaded complication following kidney transplantation. BMC Nephrol 2024; 25:104. [PMID: 38500070 PMCID: PMC10949815 DOI: 10.1186/s12882-024-03507-z] [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: 12/04/2023] [Accepted: 02/17/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Tunnelled cuffed haemodialysis catheters are at increased risk of incarceration or becoming 'stuck' via fibrotic adhesion to the central veins when left in situ for prolonged periods of time. Stuck catheters cannot be removed using standard techniques such as bedside dissection of the cuff. Whilst there are several strategies published for the removal of these incarcerated lines, there is no consensus on the best approach. Here we present a challenging case of a stuck haemodialysis catheter in the acute post transplantation period. CASE PRESENTATION A 66-year-old female on haemodialysis presented for kidney transplantation with a tunnelled-cuffed haemodialysis catheter in situ for five years. Following transplantation, removal of the line was unsuccessful despite dissection of the cuff, with traction causing a choking sensation with tracheal movement. Eventually, the line was removed without complications utilising sequential balloon dilatation by interventional radiology and the patient was discharged without complications. CONCLUSIONS This case serves as a timely reminder of the risks of long-term tunnelled haemodialysis catheters and as a caution towards proceeding with kidney transplantation in those with long-term haemodialysis catheters in situ. Greater nephrologist awareness of interventional radiology techniques for this challenging situation will help to avoid more invasive strategies. The risks of a stuck catheter should be included in the discussions about the optimal vascular access and transplantation suitability for a given patient.
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Affiliation(s)
- Cameron Burnett
- Department of Kidney and Transplantation Services, Princess Alexandra Hospital, Woolloongabba, QLD, Australia.
| | - S Chandler
- Department of Kidney and Transplantation Services, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - D Jegatheesan
- Department of Kidney and Transplantation Services, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- PA-Southside Clinic Unit, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - B Pearch
- Department of Interventional Radiology, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
| | - A Viecelli
- Department of Kidney and Transplantation Services, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- PA-Southside Clinic Unit, Faculty of Medicine, The University of Queensland, Brisbane, Australia
| | - D W Mudge
- Department of Kidney and Transplantation Services, Princess Alexandra Hospital, Woolloongabba, QLD, Australia
- PA-Southside Clinic Unit, Faculty of Medicine, The University of Queensland, Brisbane, Australia
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Mutlu IN, Cingoz M, Guzelbey T, Cingoz E, Kilickesmez O. Percutaneous CT-Guided Microwave Ablation for the Treatment of Osteoid Osteomas: A Single Center Experience. Acad Radiol 2024:S1076-6332(24)00095-3. [PMID: 38490842 DOI: 10.1016/j.acra.2024.02.025] [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: 01/20/2024] [Revised: 02/11/2024] [Accepted: 02/15/2024] [Indexed: 03/17/2024]
Abstract
RATIONALE AND OBJECTIVES The aim of the current study was to evaluate the feasibility and effectiveness of CT-guided microwave ablation (MWA) in the treatment of osteoid osteomas (OO). MATERIALS AND METHODS Data from 59 consecutive patients who underwent percutaneous CT-MWA for OO treatment were examined in the current retrospective study. The period of this study spanned from January 2021 to May 2023 at a single institution. The study involved an evaluation of clinical and radiological characteristics, procedural data, Visual Analog Scale (VAS) pain scores, complication incidences, as well as clinical and technical success rates. Statistical analyses were performed by using the Wilcoxon test with Bonferroni correction, Friedman, Spearman, Mann-Whitney U test. RESULTS 59 patients with an average age of 17.31 ± 8.53 years underwent CT-guided MWA for the treatment of OO. The procedure demonstrated a high success rate, with 96.6% of cases achieving both technical and clinical success. However, recurrence was observed in two patients (3.4%) at the three-month follow-up. These cases were successfully managed with a second MWA procedure. The median VAS pain scores reported by the patients was significantly improved post-procedure: from 8.64 ± 1.14 before treatment to 0.63 ± 0.98 in the first month, 0.41 ± 1.02 in the third month, and 0.15 ± 0.45 in the sixth month. Only one patient (1.7%) experienced a minor complication; no major complications were recorded in this study. CONCLUSION CT-guided percutaneous MWA is a minimally invasive and a highly effective and safe approach for the treatment of OO.
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Affiliation(s)
- Ilhan Nahit Mutlu
- Department of Radiology, Basaksehir Cam And Sakura City Hospital, Basaksehir 34480, Istanbul, Turkey
| | - Mehmet Cingoz
- Department of Radiology, Basaksehir Cam And Sakura City Hospital, Basaksehir 34480, Istanbul, Turkey.
| | - Tevfik Guzelbey
- Department of Radiology, Basaksehir Cam And Sakura City Hospital, Basaksehir 34480, Istanbul, Turkey
| | - Eda Cingoz
- Department of Radiology, Bagcilar Training and Research Hospital, Istanbul, Turkey
| | - Ozgur Kilickesmez
- Department of Radiology, Basaksehir Cam And Sakura City Hospital, Basaksehir 34480, Istanbul, Turkey
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Tsurumaki N, Suzuki M, Izumi S, Hojo M. Rupture of a bronchial artery pseudoaneurysm after radiotherapy. BMJ Case Rep 2024; 17:e259825. [PMID: 38471708 DOI: 10.1136/bcr-2024-259825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/14/2024] Open
Affiliation(s)
- Nozomu Tsurumaki
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
| | - Manabu Suzuki
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
| | - Shinyu Izumi
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
| | - Masayuki Hojo
- Respiratory Medicine, National Center for Global Health and Medicine Hospital, Shinjuku-ku, Japan
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Koenig AM, Froehlich L, Viniol S, Thomas RP, Mahnken AH. Occupational orthopedic problems and its relation to personal radiation protection in interventional radiology. Eur J Radiol 2024; 175:111401. [PMID: 38604091 DOI: 10.1016/j.ejrad.2024.111401] [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: 08/02/2023] [Revised: 01/24/2024] [Accepted: 02/29/2024] [Indexed: 04/13/2024]
Abstract
PURPOSE Several studies report occupational orthopedic problems among interventional cardiologists. These health problems are usually multifactorial. However, the personal protective equipment used should play a major role. An online survey was conducted to determine the frequency of such health problems among interventional radiologists and to correlate them with the use of personal radiation protective clothing. MATERIAL AND METHODS An anonymous online survey that comprised of 17 questions was sent via e-mail to 1427 members of the German Society for Interventional Radiology (DeGIR) in Germany, Austria and Switzerland. The questions were focused on interventional workload, the use of personal radiation protection apparel and orthopedic problems. Given the different scale levels, the associations between the variables were analyzed using different statistical methods. A significance level of p < 0.05 was chosen. RESULTS There were 221 survey responders (15.5% response rate). About half of responders (47.7%) suffered from more than five episodes of orthopedic problems during their interventional career. Lumbar spine was involved in 81.7% of these cases, cervical spine in 32.8%, shoulder in 28.5% and knee in 24.7%. Because of orthopedic problems, 16.1% of the responders had to reduce and 2.7% had to stop their interventional practice. The number of affected body regions correlates with the fit of the radiation protection means (p < 0.05, r = 0.135) and the reduction of activity as an interventional radiologist (p < 0.05, r = -0.148). CONCLUSION Overall, the survey reveals widespread orthopedic problems at several body regions among interventional radiologists, associated with the fit of radiation protection systems, among other factors. A connection between the orthopaedic complaints and the radiation protection system used could not be established.
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Affiliation(s)
- A M Koenig
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, Marburg, Germany.
| | - L Froehlich
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, Marburg, Germany
| | - S Viniol
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, Marburg, Germany
| | - R P Thomas
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, Marburg, Germany
| | - A H Mahnken
- Philipps-University of Marburg, Clinic of Diagnostic and Interventional Radiology, Marburg, Germany
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Nimma IR, Brahmbhatt P, Nimma S, Stancampiano F. Pantoea agglomerans bacteraemia after uterine artery embolisation: an unusual pathogen. BMJ Case Rep 2024; 17:e258345. [PMID: 38442980 PMCID: PMC10916084 DOI: 10.1136/bcr-2023-258345] [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: 03/07/2024] Open
Abstract
A woman in her 40s presented to the emergency department (ED) with a 3-week history of nausea, vomiting and diarrhoea. Blood cultures were positive for Serratia and Pantoea agglomerans spp. One month before her ED visit, she underwent targeted uterine artery embolisation with particles by an interventional radiologist. Uterine artery embolisation is considered a safe alternative to surgical removal of fibroids or hysterectomy. The patient was initially treated with targeted antibiotics for a large infected uterine fibroid but ultimately required a hysterectomy for source control. To our knowledge, this is the first documented case of P. agglomerans infecting a uterine fibroid.
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Affiliation(s)
- Induja Reddy Nimma
- Internal Medicine, Mayo Clinic Jacksonville Campus, Jacksonville, Florida, USA
| | - Pavan Brahmbhatt
- Radiology, Mayo Clinic Jacksonville Campus, Jacksonville, Florida, USA
| | - Sindhuja Nimma
- Anesthesiology, Mayo Clinic Jacksonville Campus, Jacksonville, Florida, USA
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Alonso Sánchez J, Parra DA, Parra-Fariñas C. Paediatric interventional radiology: it's not child's play. Radiologia (Engl Ed) 2024; 66:181-185. [PMID: 38614533 DOI: 10.1016/j.rxeng.2023.06.006] [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: 06/01/2023] [Accepted: 06/26/2023] [Indexed: 04/15/2024]
Abstract
Pediatric interventional radiology is a dynamic and growing subspecialty. The new training pathways in interventional radiology, the maintenance of skills with a small volume of cases or complex procedures, the limited availability of specific pediatric equipment and materials pose significant challenges and opportunities.
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Affiliation(s)
- J Alonso Sánchez
- Division of Imaged Guided Therapy, Department of Diagnostic Imaging, The Hospital for Sick Children (SickKids), University of Toronto, Toronto, Ontario, Canada.
| | - D A Parra
- Division of Imaged Guided Therapy, Department of Diagnostic Imaging, The Hospital for Sick Children (SickKids), University of Toronto, Toronto, Ontario, Canada
| | - C Parra-Fariñas
- Divisions of Neuroradiology and Imaged Guided Therapy, Department of Diagnostic Imaging, The Hospital for Sick Children (SickKids), University of Toronto, Toronto, Ontario, Canada
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Mussmann B, Larsen TR, Godballe M, Abdi AJ, Kantsø A, Jakobsen AR, Nielsen MV, Jensen J. Radiation dose to multidisciplinary staff members during complex interventional procedures. Radiography (Lond) 2024; 30:512-516. [PMID: 38241981 DOI: 10.1016/j.radi.2024.01.010] [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: 12/14/2023] [Revised: 01/05/2024] [Accepted: 01/12/2024] [Indexed: 01/21/2024]
Abstract
INTRODUCTION Complex interventional radiology procedures involve extensive fluoroscopy and image acquisition while staff are in-room. Monitoring occupational radiation dose is crucial in optimization. The purpose was to determine radiation doses received by staff involved in complex interventional procedures performed in a dedicated vascular or neuro intervention room. METHODS Individual real-time radiation dose for all staff involved in vascular and neuro-interventional procedures in adult patients was recorded over a one-year period using wireless electronic dosimeters attached to the apron thyroid shield. A reference dosimeter was attached to the C-arm near the tube housing to measure scattered, unshielded radiation. Radiology staff carried shoulder thermo-luminescent dosimeters with monthly read-out to monitor dose over time. RESULTS Occupational radiation dose was measured in 99 interventional procedures. In many cases prostate artery embolization procedures exposed radiologists to high radiation doses with a median of 15.0 μSv and a very large spread, i.e. 0.2-152.5 μSv. In all procedures except uterine fibroid embolization radiographers were exposed to lower doses than those of radiologists, with endovascular aortic repair being the procedure with highest median exposure to assisting radiographers, i.e. 2.2 μSv ranging from 0.1 to 36.1 μSv. Median radiation dose for the reference dosimeter was 670 μGy while median staff dose for all procedures combined was 3.2 μGy. CONCLUSION Radiation doses for multiple staff were determined and the ratio between staff dose and reference dosimeter indicated proper use of shielding in general. Some high-dose procedures may need further optimization for certain staff members, especially those not primarily employed in radiology. IMPLICATIONS FOR PRACTICE The study provides benchmark doses that may be used widely in audits and in the ongoing effort to optimize radiation protection for staff in interventional radiology.
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Affiliation(s)
- B Mussmann
- Research and Innovation Unit of Radiology, University of Southern Denmark, Kloevervaenget 10, 2nd. Floor. 5000 Odense C, Denmark; Department of Radiology, Odense University Hospital, JB Winslows Vej 4, 5000 Odense C, Denmark; Faculty of Health Sciences, Oslo Metropolitan University, Pilestedet 48, Oslo, Norway.
| | - T R Larsen
- Department of Radiology, Odense University Hospital, JB Winslows Vej 4, 5000 Odense C, Denmark
| | - M Godballe
- Department of Radiology, Odense University Hospital, JB Winslows Vej 4, 5000 Odense C, Denmark
| | - A J Abdi
- Research and Innovation Unit of Radiology, University of Southern Denmark, Kloevervaenget 10, 2nd. Floor. 5000 Odense C, Denmark; Department of Clinical Engineering, Region of Southern Denmark, Kloevervaenget 18, 5000 Odense C, Denmark
| | - A Kantsø
- Department of Radiology, Odense University Hospital, JB Winslows Vej 4, 5000 Odense C, Denmark
| | - A R Jakobsen
- Department of Radiology, Odense University Hospital, JB Winslows Vej 4, 5000 Odense C, Denmark
| | - M V Nielsen
- Department of Radiology, Odense University Hospital, JB Winslows Vej 4, 5000 Odense C, Denmark
| | - J Jensen
- Research and Innovation Unit of Radiology, University of Southern Denmark, Kloevervaenget 10, 2nd. Floor. 5000 Odense C, Denmark; Department of Radiology, Odense University Hospital, JB Winslows Vej 4, 5000 Odense C, Denmark
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Al-Naser Y, Halka F, Alshadeedi F, Albahhar M, Athreya S. The applications of augmented reality in image-guided tumor ablations: A scoping review. J Med Imaging Radiat Sci 2024; 55:125-133. [PMID: 38290953 DOI: 10.1016/j.jmir.2023.12.006] [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: 06/28/2023] [Revised: 11/14/2023] [Accepted: 12/21/2023] [Indexed: 02/01/2024]
Abstract
BACKGROUND Interventional radiology employs minimally invasive image-guided procedures for diagnosing and treating various conditions. Among these procedures, alcohol and thermal ablation techniques have shown high efficacy. However, these procedures present challenges such as increased procedure time, radiation dose, and risk of tissue injury. This scoping review aims to explore how augmented reality (AR) can mitigate these challenges and improve the accuracy, precision, and efficiency of image-guided tumor ablation while improving patient outcomes. METHODS A scoping review of the literature was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guideline to identify published literature investigating AR in image-guided tumor ablations. We conducted our electronic searches using PubMed, Scopus, Web of Sciences and CINAHL from inception to April 27th, 2023. The following Boolean terms were used for the search: ("augmented reality" OR "AR" OR "navigation system" OR "head mounted device" OR "HMD") AND ("tumor ablation" OR "radiofrequency tumor ablation" OR "microwave tumor ablation" OR "cryoablation"). We considered articles eligible for our scoping review if they met the following conditions: (1) published in English only, (2) focused on image-guided tumour ablations, (3) incorporated AR techniques in their methodology, (4) employed an aspect of AR in image-guided tumour ablations, and (5) exclusively involved human subjects. Publications were excluded if there was no mention of applying AR, or if the study investigated interventions other than image-guided tumour ablations. RESULTS Our search results yielded 1,676 articles in our initial search of the databases. Of those, 409 studies were removed as duplicates. 1,243 studies were excluded during the title and abstract screening. 24 studies were assessed for eligibility in the full-text stage. 19 studies were excluded, resulting in a final selection of only five studies that satisfied our inclusion criteria. The studies aimed to assess AR's efficacy in tumor ablations. Two studies compared an optical-based AR system with CT guidance. Two studies used a head-mounted AR device, while one used a dual-camera setup. Various tumor types were examined, including bone, abdominal soft tissue, breast, hepatic, renal, colorectal, and lung lesions. All studies showed positive results, including reduced radiation exposure, shorter procedures, and improved navigation, and targeting assistance. CONCLUSION AR systems enhance image-guided tumor ablations by improving the accuracy of ablation probe placements and increasing efficiency. They offer real-time guidance, enhanced visualization, and improved navigation, resulting in optimal needle placement. AR reduces radiation exposure and shortens procedure times compared to traditional CT-guided techniques. However, limitations like small sample sizes and technical challenges require further research. Despite this, AR shows potential benefits and larger, diverse studies are needed for validation.
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Affiliation(s)
- Yousif Al-Naser
- Medical Radiation Science, McMaster University, Hamilton, ON, Canada; Department of Diagnostic Imaging, Trillium Health Partners, Mississauga, ON, Canada.
| | | | | | - Mahmood Albahhar
- Department of Medical Imaging, Niagara Health, St Catharines, ON, Canada; Department of Radiology, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Sriharsha Athreya
- Department of Radiology, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; Department of Diagnostic Imaging, Hamilton Health Science, Hamilton, ON, Canada
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Ko TK, Yun Tan DJ, Hadeed S. IVC filter - assessing the readability and quality of patient information on the Internet. J Vasc Surg Venous Lymphat Disord 2024; 12:101695. [PMID: 37898304 DOI: 10.1016/j.jvsv.2023.101695] [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: 06/14/2023] [Revised: 09/01/2023] [Accepted: 10/07/2023] [Indexed: 10/30/2023]
Abstract
OBJECTIVE The internet is an increasingly favorable source of information regarding health-related issues. The aim of this study is to apply appropriate evaluation tools to assess the evidence available online about inferior vena cava (IVC) filters with a focus on quality and readability. METHODS A search was performed during December 2022 using three popular search engines, namely Google, Yahoo, and Bing. Websites were categorized into academic, physician, commercial, and unspecified websites according to their content. Information quality was determined using Journal of the American Medical Association (JAMA) criteria, the DISCERN scoring tool, and whether a Health On the Net Foundation certification (HONcode) seal was present. Readability was established using the Flesch Reading Ease Score (FRES) and Flesch-Kincaid Grade Level (FKGL). Statistical significance was accepted as P < .05. RESULTS In total, 110 websites were included in our study. The majority of websites were categorized as commercial (25%), followed by hospital (24%), academic (21%), unspecified (16%), and physician (14%). Average scores for all websites using JAMA and DISCERN were 1.93 ± 1.19 (median, 1.5; range, 0-4) and 45.20 ± 12.58 (median, 45.5; range, 21-75), respectively. The highest JAMA mean score of 3.07 ± 1.16 was allocated to physician websites, and the highest DISCERN mean score of 52.85 ± 12.66 was allocated to hospital websites. The HONcode seal appeared on two of the selected websites. Physician, hospital, and unspecified websites had a significantly higher mean JAMA score than academic and commercial websites (all with P < .001). Hospital websites had a significantly higher mean DISCERN score than academic (P = .007), commercial (P < .001), and unspecified websites (P = .017). Readability evaluation generated a mean FRES score of 51.57 ±12.04, which represented a 10th to 12th grade reading level and a mean FKGL score of 8.20 ± 1.70, which represented an 8th to 10th grade reading level. Only 12 sources were found to meet the ≤6th grade target reading level. No significant correlation was found between overall DISCERN score and overall FRES score. CONCLUSIONS The study results demonstrate that the quality of online information about IVC filters is suboptimal, and academic and commercial websites, in particular, must enhance their content quality regarding the use of IVC filters. Considering the discontinuation of the HONcode as a standardized quality assessment marker, it is recommended that a similar certification tool be developed and implemented for the accreditation of patient information online.
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Affiliation(s)
- Tsz Ki Ko
- New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, England, United Kingdom.
| | - Denise Jia Yun Tan
- New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, England, United Kingdom
| | - Sebastian Hadeed
- New Cross Hospital, The Royal Wolverhampton NHS Trust, Wolverhampton, England, United Kingdom
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Barat M, Dohan A, Kohi M, Marcelin C, Pelage JP, Denys A, Mafeld S, Kaufman CS, Soyer P, Cornelis FH. Treatment of adenomyosis, abdominal wall endometriosis and uterine leiomyoma with interventional radiology: A review of current evidences. Diagn Interv Imaging 2024; 105:87-96. [PMID: 38065817 DOI: 10.1016/j.diii.2023.11.005] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 11/21/2023] [Indexed: 01/16/2024]
Abstract
Interventional radiology shows promises in the field of women's health, particularly in pelvic interventions. This review article discusses the latest advancements in interventional radiology techniques for pelvic conditions affecting women including adenomyosis, abdominal wall endometriosis and uterine leiomyoma. Extraperitoneal endometriosis involving the abdominal wall may be treated by percutaneous thermal ablation, such as cryoablation, whereas uterine leiomyoma and adenomyosis can be managed either using percutaneous thermal ablation or using uterine artery embolization. Continued research and development in interventional radiology will further enhance the minimally-invasive interventions available for women's health, improving outcomes and quality of life for this large patient population of women.
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Affiliation(s)
- Maxime Barat
- Department of Radiology, Hopital Cochin, AP-HP, 75014 Paris, France; Université Paris Cité, Faculté de Médecine, 75006 Paris, France
| | - Anthony Dohan
- Department of Radiology, Hopital Cochin, AP-HP, 75014 Paris, France; Université Paris Cité, Faculté de Médecine, 75006 Paris, France
| | - Maureen Kohi
- Department of Radiology, University of North Carolina at Chapel Hill, NC 27599, USA
| | - Clement Marcelin
- Department of Radiology, Centre Hospitalo-Universitaire de Bordeaux, 33076 Bordeaux, France
| | - Jean-Pierre Pelage
- Department of Radiology, Research Institute of McGill University Health Centre, McGill University Health Centre, McGill University, Montreal, QC H4A 3J1, Canada
| | - Alban Denys
- Department of Diagnostic and Interventional Radiology, Lausanne University Hospital CHUV, Lausanne and University of Lausanne (UNIL), 1011 Lausanne, Switzerland
| | - Sebastian Mafeld
- Department of Medical Imaging, Division of Vascular and Interventional Radiology, Toronto General Hospital, University of Toronto, Toronto, ON, M5G 2C4, Canada
| | - Claire S Kaufman
- Dotter Interventional Institute, Oregon Health & Science University, Portland, OR 97239-3011, USA
| | - Philippe Soyer
- Department of Radiology, Hopital Cochin, AP-HP, 75014 Paris, France; Université Paris Cité, Faculté de Médecine, 75006 Paris, France
| | - Francois H Cornelis
- Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA; Weill Cornell Medical College, New York, NY 10065, USA.
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Marcelin C, Brun JL, Caprais J, Molina-Andreo I, Jambon E, Le Bras Y, Hocké C, Grenier N. Percutaneous cryoablation of symptomatic uterine adenomyomas: Initial experience. J Gynecol Obstet Hum Reprod 2024; 53:102727. [PMID: 38237806 DOI: 10.1016/j.jogoh.2024.102727] [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: 06/25/2023] [Revised: 12/03/2023] [Accepted: 01/14/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVE To assess the efficacy and safety of percutaneous image-guided cryoablation of adenomyomas MATERIAL AND METHODS: Five symptomatic women who wanted to preserve their uterus and fertility underwent a single session of percutaneous image-guided cryoablation of adenomyoma. Three to six 17-gauge cryoprobes were introduced percutaneously into the adenomyoma under ultrasound and laparoscopy guidance. Clinical efficacy was defined as the diminution of the Visual Analogue Scale of pain (VAS), the decrease in uterine bleeding and the improvement of quality of life assessed by the endometriosis health profile 5 (EHP-5) 12 months after treatment. Technical efficacy was defined by the reduction in volume of each treated adenomyoma on MRI. Complications were classified using the Clavien-Dindo classification system. Hysterosonography was performed at least 3 months after the procedure. RESULTS Compared to the baseline, all symptom scores had decreased after 12 months: median VAS 8/10 (range, 5-10) to 4/10 (range, 0-7); median dyspareunia score 7/10 (range, 0-10) to 2/10 (range, 0-8); median bleeding score 335 (range, 102-920) to 76 (range, 0-88); median EHP-5 score 60/100 (range, 50-75) to 50/100 (range, 32-55). The median volume of adenomyosis decreased from 57 cm3 (range, 8-87) to 9 cm3 (range, 2-45) at 12 months. No postoperative complications occurred. Two patients had incomplete intrauterine adhesions that were easily removed hysteroscopically. CONCLUSION Cryoablation may be a promising alternative treatment for symptomatic adenomyoma in women who want to preserve their uterus.
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Affiliation(s)
- Clément Marcelin
- Service d'imagerie diagnostique et thérapeutique de l'adulte, Hôpital Pellegrin, place Amélie-Raba-Léon, 33076, Bordeaux, France
| | - Jean-Luc Brun
- Service de chirurgie gynécologique, Hôpital Pellegrin, place Amélie-Raba-Léon, 33076, Bordeaux, France.
| | - Julie Caprais
- Service de chirurgie gynécologique, Hôpital Pellegrin, place Amélie-Raba-Léon, 33076, Bordeaux, France
| | - Isabelle Molina-Andreo
- Service d'imagerie diagnostique et thérapeutique de l'adulte, Hôpital Pellegrin, place Amélie-Raba-Léon, 33076, Bordeaux, France
| | - Eva Jambon
- Service d'imagerie diagnostique et thérapeutique de l'adulte, Hôpital Pellegrin, place Amélie-Raba-Léon, 33076, Bordeaux, France
| | - Yann Le Bras
- Service d'imagerie diagnostique et thérapeutique de l'adulte, Hôpital Pellegrin, place Amélie-Raba-Léon, 33076, Bordeaux, France
| | - Claude Hocké
- Service de chirurgie gynécologique, Hôpital Pellegrin, place Amélie-Raba-Léon, 33076, Bordeaux, France
| | - Nicolas Grenier
- Service d'imagerie diagnostique et thérapeutique de l'adulte, Hôpital Pellegrin, place Amélie-Raba-Léon, 33076, Bordeaux, France
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MacDowell CJ, Berezovsky D, Kumar P, Kim V, Livshits I, Kang F. Transvenous biopsy of inferior vena cava leiomyosarcoma: two case reports. Radiol Case Rep 2024; 19:1128-1135. [PMID: 38259705 PMCID: PMC10801149 DOI: 10.1016/j.radcr.2023.12.013] [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: 10/18/2023] [Revised: 11/22/2023] [Accepted: 12/06/2023] [Indexed: 01/24/2024] Open
Abstract
Leiomyosarcomas of the inferior vena cava (IVC) are uncommon malignancies. There is limited research detailing optimal diagnostic and clinical management. Here, we present 2 unique cases of IVC leiomyosarcoma including one in which the mass was partially ruptured through the vessel at initial presentation. We detail radiologic findings, 2 different transvenous approaches for biopsy of these masses, and subsequent oncological management.
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Affiliation(s)
| | - David Berezovsky
- Department of Radiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Pallavi Kumar
- Department of Hematology and Oncology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Victoria Kim
- Department of Radiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Ilya Livshits
- Department of Radiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Francis Kang
- Department of Radiology, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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Palmer B, Campbell M, Maertz K, Narigon L, Herzing K, Santry H, Boyce W, Narayanan R, Patel A. Analysis of middle meningeal artery embolization for the treatment of chronic, acute on chronic, and subacute subdural hematomas. Surg Neurol Int 2024; 15:71. [PMID: 38468652 PMCID: PMC10927174 DOI: 10.25259/sni_607_2023] [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: 07/19/2023] [Accepted: 02/07/2024] [Indexed: 03/13/2024] Open
Abstract
Background Chronic subdural hematoma (cSDH) is a common sequela of traumatic brain injury. Middle meningeal artery embolization (MMAE) has shown promising results as an emerging minimally invasive alternative treatment. The purpose of this study is to examine the safety and efficacy of MMAE performed in patients with cSDH, acute-on-chronic, and subacute SDH with a traumatic etiology. Methods This retrospective study included cases performed at a Level II Trauma Center between January 2019 and December 2020 for MMAE of cSDHs. Data collected included patient demographic characteristics and comorbidities, SDH characteristics, complications, and efficacy outcomes. The lesion measurements were collected before the procedure, 4-6 weeks and 3-6 months post-procedure. Results In our patient population, 78% (39) either had lesions improve or completely resolved. The sample included 50 patients with a mean age of 74 years old. Statistically significant reductions in lesion size were found from pre- to post-procedure in the left lesions, right lesions, and midline shifts. The left lesions decreased from 13.88 ± 5.70 mm to 3.19 ± 4.89 mm at 3-6 months with P < 0.001. The right lesions decreased from 13.74 ± 5.28 mm to 4.93 ± 7.46 mm at 3-6 months with P = 0.02. Midline shifts decreased from 3.78 ± 3.98 mm to 0.48 ± 1.31 mm at 3-6 months with P = 0.02. No complications were experienced for bleeding, hematoma, worsening SDH, pseudoaneurysm, or stroke. Conclusion Our pilot study from a single center utilizing MMAE demonstrates that MMAE is successful without increasing treatment-related complications not only for cSDH but also in acute-on-cSDH and SDH with a subacute component.
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Affiliation(s)
- Brandi Palmer
- Department of Trauma and Acute Care Surgery, Kettering Health Main Campus, Kettering, Ohio, United States
| | - Melody Campbell
- Department of Trauma and Acute Care Surgery, Kettering Health Main Campus, Kettering, Ohio, United States
| | - Kellie Maertz
- Department of Trauma and Acute Care Surgery, Kettering Health Main Campus, Kettering, Ohio, United States
| | - Laurie Narigon
- Department of Trauma and Acute Care Surgery, Kettering Health Main Campus, Kettering, Ohio, United States
| | - Karen Herzing
- Department of Trauma and Acute Care Surgery, Kettering Health Main Campus, Kettering, Ohio, United States
| | - Heena Santry
- Department of Trauma and Acute Care Surgery, Kettering Health Main Campus, Kettering, Ohio, United States
| | - William Boyce
- Department of Radiology, Kettering Health Main Campus, Kettering, Ohio, United States
| | - Ragavan Narayanan
- Department of Trauma and Acute Care Surgery, Kettering Health Main Campus, Kettering, Ohio, United States
| | - Akil Patel
- Department of Kettering Brain and Spine, Kettering Health Main Campus, Kettering, Ohio, United States
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Roth MF, Chick JFB, McLoughlin D, Shin DS, Chadalavada SC, Monroe EJ, Hage AN, Ji I, Lee E, Makary MS. Wellness Among Interventional Radiologists: Results From a Multidimensional Survey. Acad Radiol 2024; 31:1130-1140. [PMID: 37945493 DOI: 10.1016/j.acra.2023.09.018] [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: 07/31/2023] [Revised: 09/09/2023] [Accepted: 09/16/2023] [Indexed: 11/12/2023]
Abstract
RATIONALE AND OBJECTIVES To evaluate wellness among interventional radiologists using a multidimensional survey. MATERIALS AND METHODS An anonymous 53-item survey, including 36 Perceived Wellness Survey (PWS) prompts, was created in Qualtrics (an online survey tool) to assess wellness among interventional radiology attendings and residents. The survey was open from June to September, 2022, 2 years into the COVID-19 Pandemic. The survey was distributed via Society of Interventional Radiology Forums, social media (Twitter, LinkedIn, and Facebook), and personal correspondence. PWS scores were categorized into Wellness Composite and subscores (physical, emotional, intellectual, psychological, social, and spiritual). RESULTS 367 surveys were completed. 300 (81.7%) respondents were male and 67 (18.3%) were female. Respondents included attending physicians (297; 81.0%) and residents (70; 19.0%). Practice settings included academic (174; 47.4%), private (114; 31.0%), private-academic hybrid (62; 16.9%), and others (17; 4.7%). Mean Wellness Composite at academic centers (14.74 ± 3.16; range: 5.42-23.50) was significantly lower than at private (15.22 ± 3.37; range: 6.13-23.51) and hybrid (16.14 ± 2.47; range: 10.20-23.50) practices (p = 0.01). Respondents < 40 years old had significantly lower emotional wellness subscores compared to those ≥ 40 years old (4.34 ± 0.86 vs. 4.60 ± 0.87; p = 0.006). There were no significant differences between geographic regions in the United States, however, International respondents had significantly lower social and intellectual wellness (INT) subscores. Physical wellness subscore (4.00 ± 0.9) was significantly lower than the other subscores (4.59 ± 0.81) (p < .001). Overall mean Wellness Composite was 15.11 ± 3.13 (range: 5.42-23.51). CONCLUSION Overall self-reported wellness was lower among interventional radiologists practicing at academic centers. Interventional Radiologists < 40 years old and residents had lower emotional wellness, while international respondents had lower social and INT. Overall wellness scores were lower than prior PWS studies.
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Affiliation(s)
- Matthew F Roth
- Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio 43240, USA (M.F.R., D.M., M.S.M.).
| | - Jeffrey Forris Beecham Chick
- Division of Interventional Radiology, Department of Radiology, University of Washington, Seattle, Washington, USA (J.F.B.C., D.S.S.); The Deep Vein Institute, University of Washington, Seattle, Washington, USA (J.F.B.C., D.S.S.)
| | - Dane McLoughlin
- Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio 43240, USA (M.F.R., D.M., M.S.M.)
| | - David S Shin
- Division of Interventional Radiology, Department of Radiology, University of Washington, Seattle, Washington, USA (J.F.B.C., D.S.S.); The Deep Vein Institute, University of Washington, Seattle, Washington, USA (J.F.B.C., D.S.S.)
| | - Seetharam C Chadalavada
- Division of Interventional Radiology, Department of Radiology, University of Cincinnati, Cincinnati, Ohio, USA (S.C.C.)
| | - Eric J Monroe
- Division of Interventional Radiology, Department of Radiology, University of Wisconsin, Madison, Wisconsin, USA (E.J.M.)
| | - Anthony N Hage
- Division of Vascular and Interventional Radiology, Department of Radiology, Thomas Jefferson University Hospitals, Philadelphia, Pennsylvania, USA (A.N.H.)
| | - Ido Ji
- Department of Information and Statistics, Chungnam National University, Daejeon, South Korea (I.J., E.L.)
| | - Eunjee Lee
- Department of Information and Statistics, Chungnam National University, Daejeon, South Korea (I.J., E.L.)
| | - Mina S Makary
- Division of Vascular and Interventional Radiology, Department of Radiology, The Ohio State University Wexner Medical Center, Columbus, Ohio 43240, USA (M.F.R., D.M., M.S.M.)
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Chen X, Wang G, Xue L, Huang S, Fan S. Optimizing lung biopsy procedures:Comparative analysis of diagnostic efficacy and safety in experimental low-dose, conventional low-dose, and standard-dose CT-guided approaches. Eur J Radiol 2024; 172:111331. [PMID: 38295550 DOI: 10.1016/j.ejrad.2024.111331] [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: 10/26/2023] [Revised: 01/09/2024] [Accepted: 01/22/2024] [Indexed: 02/02/2024]
Abstract
PURPOSE Lung cancer is a major cause of cancer-related deaths, emphasizing the importance of early diagnosis. CT-guided percutaneous lung biopsy(CT-PLB) is a valuable method for diagnosing lung lesions, but multiple scans can elevate radiation exposure. This study aims to compare diagnostic efficacy and safety across different CT-PLB protocols. METHODS 273 consecutive patients who underwent CT-PLB between June 2018 and February 2021 were enrolled, and were divided into standard-dose, conventional low-dose, and experimental low-dose groups. The study mainly evaluated technical success, diagnostic efficacy, radiation dose, complications, and image quality. RESULTS 93 patients were assigned to standard-dose group, 85 to conventional low-dose group, and 95 to experimental low-dose group. Technical success rates in these groups were 97.9%, 100%, and 97.9%, respectively. Procedure-related complications rates were similar across the groups(pneumothorax:p=0.71, hemorrhage:p=0.59). Sensitivity, specificity, and overall diagnostic accuracy were comparable among three groups(p=0.59,1.0,0.65), with respective values of 90.5%, 100%, and 93.2% in standard-dose group, 88.1%, 100%, and 90.5% in conventional low-dose group, and 91.9%, 100%, and 93.4% in experimental low-dose group. The effective dose (ED) in the experimental low-dose group was significantly lower compared to both the standard-dose and conventional low-dose CT-PLB groups[ED: 1.49(1.0∼1.97) mSv vs 5.42(3.92∼6.91) mSv vs 3.15(2.52∼4.22) mSv, p<0.001]. CONCLUSIONS This study has developed a standardized six-step procedure for CT-PLB using experimental low-dose settings. It can achieve comparable diagnostic efficacy to conventional low-dose and standard-dose CT-PLB protocols while substantially reducing radiation exposure. These findings indicate that the experimental low-dose protocol could serve as a safe and effective alternative for CT-PLB.
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Affiliation(s)
- Xiamin Chen
- Department of Radiology, Wenzhou People's Hospital, Wenzhou 325041, China
| | - Gang Wang
- Department of Gastrointestinal Surgery, Wenzhou Central Hospital, Wenzhou 325000, China
| | - Liming Xue
- Department of Radiology, Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China
| | - Shiqiang Huang
- Customer Services of MR Application, Siemens Shanghai Medical Equipment Ltd (SSME), Shanghai 201318, China
| | - Shufeng Fan
- Department of Radiology, Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou 310005, China.
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Ciatawi K, Dusak IWS, Wiratnaya IGE. High-intensity focused ultrasound-a needleless management for osteoid osteoma: a systematic review. Musculoskelet Surg 2024; 108:21-30. [PMID: 38150115 DOI: 10.1007/s12306-023-00801-1] [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] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 10/24/2023] [Indexed: 12/28/2023]
Abstract
Osteoid osteoma is one of the most frequent benign musculoskeletal neoplasm. Radiofrequency ablation is the method of choice for non-conservative treatment of osteoid osteoma. Recently, high-intensity focused ultrasound (HIFU) has been proposed as a safer option. The objective of this study is to review the efficacy and side effects of HIFU in the management of osteoid osteoma. A comprehensive search was conducted in PubMed, Science Direct, and Clinical Key until June 30, 2022. Demographic data, baseline characteristics, success rates, pre- and post-procedure pain scores, recurrences, and complications were recorded. Eleven studies were included in this systematic review. Pooled analysis that involved 186 subjects resulted in an overall success rate of 91.94%. Recurrence was reported in two studies, in which it occurred in 4/177 (2.26%) subjects. Skin burn was found in 1 (0.54%) patients. No major or other complications were reported. Three studies compared the success rate of HIFU and RFA. Success rate was slightly higher in the RFA group with insignificant difference (p = 0.15). High-intensity focused ultrasound showed promising results. It offers a safer treatment approach for osteoid osteoma, especially in children, and can be considered for recalcitrant cases after RFA. Nonetheless, more studies are expected in the future.
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Affiliation(s)
- K Ciatawi
- Faculty of Medicine, University of North Sumatera, Medan, Indonesia.
| | - I W S Dusak
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Udayana University, Denpasar, Indonesia
| | - I G E Wiratnaya
- Department of Orthopaedic and Traumatology, Faculty of Medicine, Udayana University, Denpasar, Indonesia
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Charan BD, Thanneru S, Sebastian LJD, Jain S. Reconstructive endovascular treatment of petrous ICA pseudoaneurysm in skull base osteomyelitis: a hidden catastrophe. BMJ Case Rep 2024; 17:e258539. [PMID: 38417939 PMCID: PMC10900339 DOI: 10.1136/bcr-2023-258539] [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: 03/01/2024] Open
Abstract
Skull base osteomyelitis can be more life-threatening in immunocompromised patients and patients with diabetes. Here, we present a case of a petrous internal carotid artery pseudoaneurysm resulting from skull base osteomyelitis in a diabetic male in his 50s. This case report highlights the need to be conscious of the various complications associated with skull base osteomyelitis, be proficient in detecting them and treat them as early as possible for better outcomes. After adequate control of the disease process with medical treatment, immediate management of the aneurysm with balloon angioplasty and stenting was done. Acknowledging the trivial nasal and ear bleed, radiological evaluation is necessary to rule out rare complications like pseudoaneurysms in a diagnosed case of skull base osteomyelitis. In the discussion, we have cited the various treatment methods and similar cases of pseudoaneurysm caused by osteomyelitis. Currently, the patient continues to live a disease and disability-free life.
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Kundargi V, Patil S, Shukla V, Patil SB. Spontaneous occurrence and expulsion of a massive Steinstrasse. BMJ Case Rep 2024; 17:e259065. [PMID: 38413142 PMCID: PMC10900360 DOI: 10.1136/bcr-2023-259065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Affiliation(s)
- Vinay Kundargi
- Urology, Shri BM Patil Medical College, Bijapur, Karnataka, India
| | - Santosh Patil
- Urology, Shri BM Patil Medical College, Bijapur, Karnataka, India
| | - Vikas Shukla
- Urology, Shri BM Patil Medical College, Bijapur, Karnataka, India
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Barat M, Milot L. Is robotic assistance the future of percutaneous interventional radiology? Diagn Interv Imaging 2024:S2211-5684(24)00019-6. [PMID: 38403506 DOI: 10.1016/j.diii.2024.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/27/2024]
Affiliation(s)
- Maxime Barat
- Department of Radiology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, 75014 Paris, France; Génomique et Signalisation des Tumeurs Endocrines, Institut Cochin, INSERM U 1016, CNRS UMR8104, 75014 Paris, France; Université Paris Cité, Faculté de Médecine, 75006 Paris, France.
| | - Laurent Milot
- Department of Diagnostic and Interventional Radiology, Hôpital Edouard Herriot, Hospices Civils de Lyon, 69005 Lyon, France; LabTAU, INSERM U1032, 69003 Lyon, France; Université Claude Bernard Lyon 1, 69003 Lyon, France
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