Cardiovascular and interventional radiology
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Cardiovasc Intervent Radiol · May 2019
Comparative StudyComparison of Chimney Technique and Single-Branched Stent Graft for Treating Patients with Type B Aortic Dissections that Involved the Left Subclavian Artery.
To compare the short-term efficiency of two different endovascular repairs for type B aortic dissection involving the left subclavian artery. ⋯ For patients with TBADs involving the LSA, the chimney technique and the SBSG revealed comparable results. Further evaluation of more patients with longer follow-up is needed to substantiate these results.
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Cardiovasc Intervent Radiol · May 2019
Case ReportsSerious Neurological Complication Resulting from Inadvertent Intradiscal Injection During Fluoroscopically Guided Interlaminar Epidural Steroid Injection.
We describe the case of a 30-year-old patient who was referred for lumbar epidural corticosteroid injection due to right L5 radiculopathy. Two months earlier, MRI demonstrated a right large paracentral L4-L5 disk extrusion causing disabling L5 radiculopathy. The L4-L5 level was selected for interlaminar injection, using fluoroscopic guidance. ⋯ Although rare, serious neurological complication can result from inadvertent intradiscal injection of contrast material during lumbar epidural injection. This case illustrates the importance of recognizing the possibility of dynamic change in the size of an extruded disk fragment when the MRI precedes injection by a substantial time interval. LEVEL OF EVIDENCE: IV, Case Series.
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Cardiovasc Intervent Radiol · May 2019
Multicenter StudyLocal Thermal Ablation with Continuous EGFR Tyrosine Kinase Inhibitors for EGFR-Mutant Non-small Cell Lung Cancers that Developed Extra-Central Nervous System (CNS) Oligoprogressive Disease.
Most epidermal growth factor receptor (EGFR)-mutant non-small cell lung cancer (NSCLC) patients treated with tyrosine kinase inhibitors (TKIs) experience oligoprogressive disease. Local ablation for isolated resistant sites continued with the original EGFR-TKI showed good efficacy in these patients. We conducted this multicenter retrospective study to investigate the potential benefit of thermal ablation in NSCLC patients that developed extra-central nervous system (CNS) oligoprogressive disease during TKI treatment. ⋯ Local thermal ablation for the oligoprogressive lesions with continuous EGFR-TKI treatment is associated with additional 10 months of disease control and should be recommended in TKI acquired resistant-NSCLC patients.
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Cardiovasc Intervent Radiol · May 2019
Case ReportsPercutaneous Balloon Plasty for Thoracic Duct Occlusion in a Patient with Chylothorax and Chylous Ascites.
A patient developed abdominal distension, dyspnea, and nausea due to chylothorax and chylous ascites 1 month after bruising her back. Lymphangiography was unable to identify the site of lymph leakage, and lymphatic duct embolization was impractical. ⋯ Although embolization of the thoracic or lymphatic ducts has been reported as a treatment for lymphorrhea, it is impractical if the lymphatic duct responsible for leakage cannot be identified. In such a case, balloon plasty of the occluded thoracic duct to lower the pressure in the peripheral lymphatic ducts was successfully performed.
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Cardiovasc Intervent Radiol · Mar 2019
Case ReportsIce Ball Crack During CT-Guided Renal Cryoablation Using 1.5-mm-Diameter Cryoprobes.
Ice ball fracture and massive hemorrhage are serious complications associated with renal cryoablation. When cracks occur in an ice ball, it is usually associated with adjacent renal parenchymal fracture, leading to massive hemorrhage. However, few studies have examined ice ball fracture under image-guided percutaneous renal cryoablation. ⋯ Ice ball cracks were observed on CT images during cryoablation. However, there was no massive hemorrhage and further treatments were not necessary. This is the first report of ice ball cracks with a smaller diameter cryoprobe, which has not been considered to be associated with ice ball fracture.