Cardiovascular and interventional radiology
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Cardiovasc Intervent Radiol · Jan 2009
Case ReportsIntra-arterial calcium gluconate treatment after hydrofluoric acid burn of the hand.
Hydrofluoric acid (HF) is a colorless corrosive acid used in different industrial branches. Exposure to HF typically results from spills, and most often the hand or fingers are involved. Tissue damage through cutaneous HF exposure occurs through corrosive burns due to the free hydrogen ions and through skin penetration of the fluoride ions, causing a depletion of calcium in the deep tissue layers, ultimately leading to cell death and tissue necrosis. ⋯ Pain and vasospasm were successfully treated by repeated intra-arterial calcium gluconate injection. We conclude that intra-arterial calcium gluconate injection is a successful and well-tolerated therapy for HF burn associated with Raynaud's syndrome. Intra-arterial injection allows for well-controlled delivery of therapy as well as assessment of the vascular status.
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Cardiovasc Intervent Radiol · Jan 2009
Radiofrequency ablation assisted by real-time virtual sonography and CT for hepatocellular carcinoma undetectable by conventional sonography.
Real-time virtual sonography (RVS) is a diagnostic imaging support system, which provides the same cross-sectional multiplanar reconstruction images as ultrasound images on the same monitor screen in real time. The purpose of this study was to evaluate radiofrequency ablation (RFA) assisted by RVS and CT for hepatocellular carcinoma (HCC) undetectable with conventional sonography. Subjects were 20 patients with 20 HCC nodules not detected by conventional sonography but detectable by CT or MRI. ⋯ The mean follow-up period was 13.5 month (range, 9-18 months). No local recurrence was observed at the follow-up points. In conclusion, RFA assisted by RVS and CT is a safe and efficacious method of treatment for HCC undetectable by conventional sonography.
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Cardiovasc Intervent Radiol · Jan 2009
Retrieval of the protection filter with a soft coaxial catheter after carotid stenting.
The purpose of this study was to shorten and simplify the procedure of filter retrieval after carotid stenting with cerebral protecting devices. We propose a retrieval method with a soft-tip guiding catheter, which eliminates the step of balloon exchange and introduction of a retriever catheter for the protection filter. ⋯ One transient deficit occurred. In conclusion, retrieval of the filter with a soft coaxial catheter after carotid stenting is a feasible and safe method and may simplify cerebrovascular protection during stenting.
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Cardiovasc Intervent Radiol · Jan 2009
Assessment of snared-loop technique when standard retrieval of inferior vena cava filters fails.
To identify the success and complications related to a variant technique used to retrieve inferior vena cava filters when simple snare approach has failed. ⋯ The technique we describe increased the retrievability of the two filters studied. Hook endothelialization is the main factor resulting in failed retrieval and continues to be a limitation with these filters.
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Cardiovasc Intervent Radiol · Jan 2009
Comparative StudyThree-dimensional rotational angiography of the inferior vena cava as an adjunct to inferior vena cava filter retrieval.
The objective of this study was to explore the role of three-dimensional (3-D) rotational angiography (RA) of the inferior vena cava (IVC; 3-D CV) before filter retrieval and its impact on treatment planning compared with standard anteroposterior cavography (sCV). Thirty patients underwent sCV and 3-D CV before IVC filter retrieval. Parameters assessed were: projection of filter arms or legs beyond the caval lumen, thrombus burden within the filter and IVC, and orientation of the filter within IVC. ⋯ Thrombus was detected in 8 patients (27%), 1 thrombus of which was seen only on 3-D CV, and treatment was changed in this patient because of thrombus size. Mean effective radiation doses for 3-D CV were approximately two times higher than for sCV (1.68 vs. 0.86 mSv), whereas skin doses were three times lower (12.87 vs. 35.86 mGy). Compared with sCV, performing 3-D CV before optional IVC filter retrieval has the potential to improve assessment of filter arms or legs projecting beyond the caval lumen, filter orientation, and thrombus burden.