Cardiovascular and interventional radiology
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Cardiovasc Intervent Radiol · Mar 2007
Comparative StudyMagnetic resonance imaging of acute reperfused myocardial infarction: intraindividual comparison of ECIII-60 and Gd-DTPA in a swine model.
To compare a necrosis-avid contrast agent (NACA) bis-Gd-DTPA-pamoic acid derivative (ECIII-60) after intracoronary delivery with an extracellular agent Gd-DTPA after intravenous injection on magnetic resonance imaging (MRI) in a swine model of acute reperfused myocardial infarction (MI). ⋯ Both Gd-DTPA and ECIII-60 strongly enhanced acute MI. Comparing with fading contrast in a narrow time window with intravenous Gd-DTPA, intracoronary ECIII-60 persistently demarcated the acute MI, indicating a potential method for postprocedural assessment of myocardial viability after coronary interventions.
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Cardiovasc Intervent Radiol · Mar 2007
Radiological interventions for correction of central venous port catheter migrations.
The purpose of the study is to evaluate radiological-interventional central venous port catheter corrections in migrated/malpositioned catheter tips. Thirty patients with migrated/malpositioned port catheter tips were included in this retrospective analysis. To visualize the catheter patency, a contrast-enhanced port catheter series was performed, followed by transfemoral port catheter correction with various 5F angiographic catheters (pigtail, Sos Omni), goose-neck snare, or combinations thereof. ⋯ No disconnection or port catheter dysfunction was observed after correction. In migrated catheter tips, radiological-interventional port catheter correction is a minimally invasive alternative to port extraction and reimplantation. In patients with a fibrin sheath and/or thrombosis, port catheter correction is often more challenging.
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Cardiovasc Intervent Radiol · Mar 2007
Percutaneous placement of peritoneal port-catheter in patients with malignant ascites.
We report our experience with a radiologically placed peritoneal port-catheter in palliation of malignant ascites. Port-catheters were successfully placed under ultrasonographic and fluoroscopic guidance in seven patients (five women, two men) who had symptomatic malignant ascites. The long-term primary patency rate was 100%. ⋯ Minor complications such as ascitic fluid leakage from the peritoneal entry site, migration of the catheter tip to the right upper quadrant, and reversal of the port reservoir occurred in four patients. None of these complications affected the drainage and required port explantation. In patients with symptomatic malignant ascites, a peritoneal port-catheter can provide palliation and eliminate multiple hospital visits for repeated paracentesis with high patency and low complication rates.
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Cardiovasc Intervent Radiol · Mar 2007
Distal embolization after stenting of the vertebral artery: diffusion-weighted magnetic resonance imaging findings.
We retrospectively evaluated our experience with stenting of the vertebral artery in an effort to determine the risk of distal embolization associated with the procedure. ⋯ Stenting of stenoses of the vertebral artery origin may be associated with a significant risk of asymptomatic distal embolization. Angiography, placement of the guiding catheter, inflation of the stent balloon, and crossing the lesion with guidewires or balloon catheters may potentially cause distal embolization. Further studies to evaluate measures to increase the safety of vertebral artery stenting, such as the use of distal protection devices or short-term postprocedural anticoagulation, should be considered for patients with clear indications for this procedure.
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Cardiovasc Intervent Radiol · Mar 2007
Case ReportsSuperficial temporal artery pseudoaneurysm: a conservative approach in a critically ill patient.
A 71-year-old man affected by cardio- and cerebrovascular disease experienced an accidental fall and trauma to the fronto-temporal area of the head. A few weeks later a growing mass appeared on his scalp. ⋯ His clinical condition favoured a conservative approach by ultrasound-guided compression and subsequent surgical resection. A conservative approach should be considered the treatment of choice in critically ill patients affected by superficial temporal artery pseudoaneurysm.