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jvirmedia Portal Vein Embolization before Right Hepatectomy or Extended Right Hepatectomy Using Sodium Tetradecyl Sulfate Foam: Technique and Initial Results

Journal of Vascular and Interventional Radiology
Volume 25, Issue 7, Pages 1045–1053, July 2014

Image Caption:
(a) Digital subtraction angiogram obtained before the procedure demonstrates flow throughout the portal vein, including the segment III branch arising off the LPV (arrow). (b) Digital subtraction angiogram obtained after embolization demonstrates complete occlusion of the RPV and lack of flow within the previously visualized segment III branch (arrow) secondary to nontarget embolization.

Conclusion:
Preoperative PVE with STS foam is a safe and effective method to induce hypertrophy of the FLR.
2w

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nseecheran EP Jedi Knight. And 1 of my friends. New Attending! #ElectroPhysiology v. #Interventional #Cardiology #hardwork #success 2w

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Normal Deborah Cooper
_debbiedoo Last day doing procedures with this guy, enjoy retirement Dr Cornforth!! @sjchbakersfield #sjch #retirement #interventional #radiologist #nomorelungbiopsies #savethemfortheotherguys #timetorelax 3w

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jvirmedia Superselective Yttrium-90 Radioembolization for Hepatocellular Carcinoma Yields High Response Rates with Minimal Toxicity

Journal of Vascular and Interventional Radiology
Volume 25, Issue 7 , Pages 1067-1073, July 2014

Image caption:
A 60-year-old man with Child-Pugh B cirrhosis and a history of TIPS placement. (a) Axial contrast-enhanced CT image demonstrates a 3.2-cm HCC in segment VI (arrow). (b) Coronal CT reconstruction delineates the extent of tumor-associated portal venous thrombus (arrow). (c) Digital subtraction angiography of the celiac trunk demonstrates conventional hepatic arterial anatomy, with multiple branches off of the right hepatic artery. (d) Selective angiography of the segment VI branch of the right hepatic artery confirms tumor hypervascularity (arrow). C-arm CT (not shown) had been performed to facilitate detection of feeding arteries to the tumor. 90Y was infused from this microcatheter location. (e) After 90Y infusion, magnetic resonance imaging (contrast-enhanced T1-weighted fat-suppressed) performed at 1 month follow-up demonstrates complete necrosis of the targeted tumor, with expected surrounding inflammatory change. (f) Tumor necrosis is sustained on magnetic resonance imaging at 24 months follow-up.

Conclusions:
When performed in a segmental fashion, 90Y radioembolization demonstrates high response rates and low local tumor recurrence rates. Complete imaging response can be achieved in patients with locally aggressive disease. This study demonstrates no clinically significant hepatotoxicity, despite moderate liver dysfunction in many patients.
4w

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jvirmedia Percutaneous In Utero Thoracoamniotic Shunt Creation for Fetal Thoracic Abnormalities Leading to Nonimmune Hydrops

Journal of Vascular and Interventional Radiology
Volume 25, Issue 6 , Pages 889-894, June 2014

Image Caption:
Thoracoamniotic shunt creation. Fetal ultrasound image showing a sagittal oblique view of the fetal thorax. There is a large echogenic left chylous pleural effusion (black arrow). Under direct ultrasound guidance, an 18-gauge needle (black arrowhead) was percutaneously advanced via a transabdominal, transuterine approach into the chylothorax. The white arrow indicates a fetal lung, the white arrowhead indicates the uterus, and the dashed white arrow indicates amniotic fluid.

Conclusions:
A Seldinger-based percutaneous approach to draining fetal thoracic abnormalities is feasible and can allow for prolongation of pregnancy and antenatal lung development and ultimately result in fetal survival.
2mon

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2mon medirec.gr
Normal MediRec: Medical Recruitment
jvirmedia Comparison of Barbed versus Conventional Sutures for Wound Closure of Radiologically Implanted Chest Ports

Journal of Vascular and Interventional Radiology. Article in Press.

Image Caption:
Illustration of unidirectional barbed suture (straight arrows) showing the mechanism of barbs self-anchoring to tissue (circular arrow). (All rights reserved. Used with permission of Covidien.) Conclusions:
Barbed suture for incision closure in implantable dual-lumen chest ports was associated with lower rates of dehiscence and potentially lower rates of local infectious complications compared with traditional nonbarbed suture.
2mon

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jvirmedia Percutaneous Cryoablation of Hepatic Tumors Adjacent to the Gallbladder: Assessment of Safety and Effectiveness

Journal of Vascular and Interventional Radiology. Article in Press.

Image Caption:
Percutaneous cryoablation of a hepatic tumor 6 mm from the gallbladder in a 46-year-old man with metastatic esophageal cancer. T2-weighted MR image (a) demonstrates the relationship of the hepatic tumor (thick arrow) to the gallbladder (double arrow). Axial noncontrast CT image (b) obtained during the cryoablation procedure demonstrates the extension of the ice ball into the lumen of the gallbladder (outline). Axial, gadolinium-enhanced, fat-suppressed T1-weighted MR image (c) demonstrates the ablation zone (arrowhead) adjacent to the gallbladder (asterisk). Axial gadolinium-enhanced, fat-suppressed, T1-weighted images 6 months after the procedure show recurrent tumor (arrow) along the margin of the ablation zone adjacent to the gallbladder (asterisk). Note the gallbladder wall is normal.

Conclusions:
Percutaneous cryoablation of hepatic tumors adjacent to the gallbladder can be performed safely and successfully. Although postprocedural gallbladder changes are common, they are self-limited and clinically inconsequential, even when the ice ball extends into the gallbladder lumen.
2mon

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jvirmedia Acute Hand Ischemia after Unintentional Intraarterial Injection of Drugs: Is Catheter-Directed Thrombolysis Useful?

Journal of Vascular and Interventional Radiology
Volume 25, Issue 6 , Pages 963-968, June 2014

Image caption:
Thrombolysis for a proximal thrombus after unintentional drug injection in the right superior upper extremity (patient 2). (a) Initial digital subtraction angiography (injection volume, 8 mL; injection rate, 4 mL/s) (AXIOM Artis; Siemens Healthcare, Erlangen, Germany) shows a short intraluminal defect (arrow) at the end of the right brachial artery. Digital arteries were also occluded (not shown). (b) Follow-up angiogram (injection volume, 8 mL; injection rate, 4 mL/s) (Allura Xper FD; Philips Healthcare, Best, The Netherlands) obtained after pulse spraying rtPA into the thrombus shows complete clearance of the thrombus (arrow). The thrombolysis catheter was left in place to treat the distal occlusions.

Abstract:
Unintentional intraarterial injections are rare but may have devastating consequences. No consensus on treatment has been established owing to the wide variety of possible injected substances, incomplete understanding of the underlying pathophysiology, and the absence of case-controlled, prospective human studies. The aim of the present study and literature review was to evaluate the benefit of intraarterial thrombolysis combined with systemic anticoagulation therapy when an artery of the upper extremity is accidentally punctured and ischemia of the hand ensues.
2mon

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jvirmedia Coils versus Gelatin Particles with or without Intraarterial Antibiotics for Partial Splenic Embolization: A Comparative Evaluation

Journal of Vascular and Interventional Radiology
Volume 25, Issue 6 , Pages 852-858, June 2014

Image Caption:
PSE in the coil group. (a) Several branches of the splenic artery were embolized by coils placed beyond the anastomosis site with the left gastroepiploic artery (arrow) and caudal pancreatic artery (arrowhead). (b) Contrast-enhanced CT 1 week after PSE shows peripheral wedge-shaped infarction (asterisks). The volume of the residual enhanced area was measured by using volumetry (dotted lines), and the splenic infarction volume was calculated.

Conclusions:
The efficacy of PSE is similar with the use of coils versus GS particles. Prophylactic intraarterial antibiotic treatment could be useful in preventing inflammatory reactions after PSE.
2mon

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Amaro Mom 👬 May 23rd ️NA

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jvirmedia Long-Term Outcome of Percutaneous Transhepatic Balloon Angioplasty for Portal Vein Stenosis after Pediatric Living Donor Liver Transplantation: A Single Institute’s Experience

Journal of Vascular and Interventional Radiology. Article in Press.

Image Caption:
A 7-year-old girl with biliary atresia underwent left-lobe LDLT. PVS was suspected 5 years after LDLT, and percutaneous transhepatic portography was performed. The approach was percutaneous transhepatic. (a) Portogram obtained before treatment shows an anastomotic stricture (arrow), gastric varices, and poor flow through the intrahepatic portal vein. (b) Fluoroscopic view during balloon angioplasty shows the notch of the balloon at the stenosis. (c) Portogram obtained after balloon angioplasty shows improved blood flow through the portal vein and disappearance of gastric varices. PVS did not recur after balloon angioplasty.

Conclusions:
Percutaneous transhepatic balloon angioplasty is a safe and effective treatment with long-term patency for PVS after pediatric LDLT.
2mon

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jvirmedia Embolization of the Periprostatic Venous Plexus for Erectile Dysfunction Resulting from Venous Leakage

Journal of Vascular and Interventional Radiology
Volume 25, Issue 6 , Pages 866-872, June 2014

Image Caption:
Selective catheterization of the right internal pudendal vein (asterisk) and opacification of the draining right hypogastric vein (arrow). Conclusions:
AEPV for ED secondary to VOD is a safe alternative to surgical treatment that demonstrates promising short-term and midterm efficacy.
2mon

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jvirmedia Outcomes of Transcatheter Arterial Embolization for Acute Hemorrhage Originating from Gastric Adenocarcinoma

Journal of Vascular and Interventional Radiology
Volume 25, Issue 6 , Pages 847-851, June 2014

Image Caption:
Tumor vascularity arising from a hemorrhagic gastric adenocarcinoma in a 61-year-old man. Pre-embolization angiography demonstrates a large tumor blush (arrow) associated with the tumor.

Conclusions:
Transcatheter arterial embolization can be considered for cases of acute hemorrhagic gastric adenocarcinoma, with improved outcomes in patients with localized disease compared with nonresectable gastric adenocarcinoma.
2mon

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scotty_fiorini Blessed to have the opportunity to start shadowing a Surgical Orthopedic PA #MissionPAschool #cantstopme #orthopedics #physicianassistant #interventional#radiology #medical #foreverNerd 2mon

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jvirmedia Dynamic Volumetric CT Angiography for the Detection and Classification of Endoleaks: Application of Cine Imaging Using a 320-Row CT Scanner with 16-cm Detectors

Journal of Vascular and Interventional Radiology: Article in Press

Image Caption: Multiplanar reformation images in a man in his 70s who underwent dynamic volumetric CT angiography in Fowler position after EVAR showing a type II endoleak (same case as shown in Fig 3). (a) Sagittal image at initial enhancement of the aortic lumen (4 s). (b) Sagittal image at peak enhancement of the aortic lumen (8 s). (c) Sagittal image at peak enhancement of the endoleak (16 s) shows the endoleak arising from retrograde filling of the inferior mesenteric artery (arrows). Conclusions:
Low-dose dynamic volumetric CT angiography performed with the patient in Fowler position is feasible after EVAR. Dynamic information, including cine imaging, the timing of peak enhancement, and the Hounsfield units index, is useful in detecting and classifying endoleaks.
2mon

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jvirmedia Scanning electron microscopy images were obtained following catheter-directed transarterial embolization with 40-μm hydrogel microspheres. (Figure, a, shows a small hepatic arterial branch in the periphery of the right hepatic lobe filled with microspheres. Figure, b, shows a small volume of thrombus consisting of fibrinous strands and adherent cellular components between the spheres.

Catheter-directed transarterial embolization is one of the most widely practiced and established therapies in interventional oncology. Although histologic studies have successfully imaged embolic particles by using light microscopy, these electron microscopy images provide an enhanced appreciation of how the microspheres interact with cellular components of blood, leading to end vessel blockade.

Journal of Vascular and Interventional Radiology
Volume 24, Issue 2 , Page 255, February 2013
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jvirmedia Inferior Mesenteric Artery Collaterals to the Uterus during Uterine Artery Embolization: Prevalence, Risk Factors, and Clinical Outcomes
Journal of Vascular and Interventional Radiology
Volume 24, Issue 9 , Pages 1353-1360, September 2013

Image Caption:
A 41-year-old woman with diffuse adenomyosis. (a) Aortography performed after embolization reveals abnormal tissue staining in the uterus (arrows). (b) IMA angiography confirms collateral supply to the uterus.

Conclusion:
The IMA was the second most common (1.3%) source of collaterals to the uterus. IMA collaterals were more frequent in patients with adenomyosis than in patients with fibroids only, resulting in high frequency of treatment failure.
3mon

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