Cardiovascular and interventional radiology
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Cardiovasc Intervent Radiol · Jan 2006
Case ReportsPercutaneous repair of radial artery pseudoaneurysm in a hemodialysis patient using sonographically guided thrombin injection.
We report a case of a radial artery pseudoaneurysm complicating an incorrect puncture of a Brescia-Cimino hemodialysis fistula that was treated with percutaneous ultrasound-guided thrombin injection. The pseudoaneurysm recurred after the initial successful thrombin injection. ⋯ Our case illustrates that this procedure is an effective treatment in this type of arteriovenous fistula complication. We compare this case with the only similar one we could find in the literature.
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Cardiovasc Intervent Radiol · Nov 2005
Comparative StudyRadiofrequency ablation with a new perfused-cooled electrode using a single pump: an experimental study in ex vivo bovine liver.
The purpose of this study was to assess the efficacy of a new perfused-cooled electrode that uses a single pump for creating a large ablation zone in explanted bovine liver. This was done by comparing with the radiofrequency (RF) ablation zones that were created with a monopolar cooled electrode to the RF ablation zones that were created by the new perfused-cooled electrode. We developed a new perfused-cooled electrode that uses a single pump by modifying a 17-gauge cooled electrode (Radionics) with a 2.5-cm outer metallic sheath (15-gauge) in order to allow use of the internal cooling water (5.85 % hypertonic saline) for the infused saline. ⋯ Ablation zones created with the perfused-cooled electrode (group C) were significantly larger than those created with the 17-gauge cooled electrode (group A) and the 15-gauge cooled electrode (group B) according to the transverse diameter and vertical diameter on the gross specimens (p < 0.05): 3.6 +/- 0.38 cm and 4.4 +/- 0.20 cm in group A, 3.7 +/- 0.08 cm and 4.6 +/- 0.16 cm in group B, and 5.4 +/- 0.65 cm and 6.0 +/- 0.56 cm in group C, respectively. On the MR imaging, the calculated volumes of the ablation zones in group C were significantly larger than those in groups A and B (p < 0.05): 23.1 +/- 8.7 cm3 in group A, 28.9 +/- 5.7 cm3 in group B, and 80.0 +/- 34 cm3 in group C, respectively. A new perfused-cooled electrode using a single pump could efficiently increase the size of the ablation zone in liver compared with a monopolar cooled electrode, and this was due to its simultaneous use of internal cooling and saline infusion.
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Cardiovasc Intervent Radiol · Nov 2005
Embolization of isolated lumbar artery injuries in trauma patients.
The purpose of the study was to evaluate the angiographic findings and results of embolotherapy in the management of lumbar artery trauma. ⋯ In hemodynamically stable patients, selective embolization is a safe and effective method for immediate control of active extravasation, as well as to prevent future hemorrhage from an injured lumbar artery.
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Cardiovasc Intervent Radiol · Nov 2005
Case ReportsEndovascular treatment of a ruptured internal thoracic artery pseudoaneurysm presenting as a massive hemothorax in a patient with type I neurofibromatosis.
We report a case of acute hemothorax caused by a left internal thoracic artery pseudoaneurysm rupture in a patient with neurofibromatosis type I, which was successfully treated with endovascular coil embolization.
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Cardiovasc Intervent Radiol · Sep 2005
Case ReportsSharp central venous recanalization by means of a TIPS needle.
The purpose of this study was to perform an alternative technique for recanalization of a chronic occlusion of the left brachiocephalic vein that could not be traversed with a guidewire. Restoration of a completely thrombosed left brachiocephalic vein was attempted in a 76-year-old male hemodialysis patient with massive upper inflow obstruction, massive edema of the face, neck, shoulder, and arm, and occlusion of the stented right brachiocephalic vein/superior vena cava. Vessel negotiation with several guidewires and multipurpose catheters proved unsuccessful. ⋯ Venography demonstrated complete vessel patency with free contrast media flow via the stents into the SVC, which was reconfirmed in follow-up examinations. Immediate clinical improvement was observed. Venous vascular recanalization of chronic venous occlusion by means of a TIPS needle is feasible as a last resort under certain precautions.