AJNR. American journal of neuroradiology
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AJNR Am J Neuroradiol · Jan 2007
Carotid blowout syndrome in patients with head-and-neck cancers: reconstructive management by self-expandable stent-grafts.
Some reports of reconstructive management of carotid blowout syndrome (CBS) with stent-grafts are promising, but some are unfavorable. This study sought to evaluate the hemostatic efficacy, safety, and outcome of reconstructive, endovascular stent-graft placement in patients with head-and-neck cancers in association with CBS. ⋯ Although stent-grafts achieved immediate and initial hemostasis in patients with head-and-neck cancers and CBS, long-term safety, stent patency, and permanency of hemostasis appeared unfavorable. This treatment may be for temporary or emergency purposes rather than serving as a permanent measure. We suggest its applications in patients with acute CBS that precludes performance of an occlusion test, as well as when carotid occlusion poses an unusually high risk of neurologic morbidity. We also propose prophylactic antibiotic treatment and combined embolization of pathologic vascular feeders to improve outcomes.
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AJNR Am J Neuroradiol · Jan 2007
Sacroplasty by CT and fluoroscopic guidance: is the procedure right for your patient?
Sacral insufficiency fractures are an infrequent but often disabling cause of severe low back pain. We report our results of a sacroplasty technique, using CT for needle placement and fluoroscopy to monitor the polymethylmethacrylate injection in a group of patients with sacral insufficiency fractures. ⋯ Sacroplasty is a safe and effective procedure in the treatment of sacral insufficiency fractures that can provide substantial pain relief and lead to a better quality of life.
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AJNR Am J Neuroradiol · Nov 2006
Low-field MR imaging of meningiomas including dynamic contrast enhancement study: evaluation of surgical and histopathologic characteristics.
Risks associated with surgery of meningiomas, especially those located in the skull base, are influenced by tumor consistency and vascularity. The purpose of this study was to find out if vascularity, consistency, and histologic characteristics of meningioma can be predicted preoperatively by using low-field MR imaging, including dynamic imaging of contrast enhancement. ⋯ Assessment of microvessel density, collagen content, and progesterone receptor expression of meningioma may be clinically feasible by using low-field MR imaging.
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AJNR Am J Neuroradiol · Oct 2006
Comparative StudyThe effects of cement volume on clinical outcomes of percutaneous vertebroplasty.
There exists significant variability in the volume of polymethylmethacrylate cement injected during percutaneous vertebroplasty. Larger cement volumes injected may be associated with better clinical outcomes, but larger volumes may also be associated with greater risk of complications related to cement leakage. We describe an analysis of the association between clinical and procedural variables, including cement volume injected, and the clinical outcomes of patients treated with single-level vertebroplasty. ⋯ Vertebroplasty operators need not feel compelled to achieve particular cement volumes injected in the pursuit of better clinical outcomes but should strive to achieve the maximal safe filling of individual vertebral bodies.