Journal of vascular and interventional radiology : JVIR
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J Vasc Interv Radiol · Nov 2000
Long-term outcome of embolotherapy and surgery for high-flow extremity arteriovenous malformations.
To assess the long-term efficacy of embolotherapy in combination with surgery for management of symptomatic high-flow arteriovenous malformations (HFAVMs) of the lower and upper extremities. ⋯ LE-AVM with diffuse involvement of all three trifurcation arteries ultimately required amputation because of recurrence of symptoms after technically and clinically successful embolotherapy. Cyanoacrylate embolotherapy alone or in combination with surgical resection of the AVM provided excellent long-term palliation in patients with UE-AVM.
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J Vasc Interv Radiol · Nov 2000
Venous thrombosis associated with the placement of peripherally inserted central catheters.
Peripherally inserted central catheters (PICCs) have become an essential component of the management of an increasing number of patients, including patients who may require hemodialysis. Reported symptomatic venous thrombosis rates associated with PICC lines are based on clinical signs and symptoms and range from 1% to 4%. The purpose of this study is to evaluate the true rate of thrombosis of upper extremity veins after the placement of PICCs and the potential impact on future access in hemodialysis patients. ⋯ There is a relatively high rate of venous thrombosis associated with PICCs, particularly cephalic thrombus. Because of the high rate of thrombosis associated with these catheters, an alternative mode of access should be considered in current or potential hemodialysis patients. All patients with a history of PICC line placement requiring dialysis access should undergo upper extremity venography prior to the placement of permanent access.
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J Vasc Interv Radiol · Nov 2000
Change in peripherally inserted central catheter tip position with abduction and adduction of the upper extremity.
This study examines whether the tip of peripherally inserted central catheters (PICCs) moves significantly with changes in arm position from abduction to adduction. ⋯ There is a tendency for the PICC tip to move in a caudal direction with the change in arm position from abduction to adduction; 58% of PICCs moved 20 mm or more. This change in position should be considered during final catheter tip positioning.
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J Vasc Interv Radiol · Nov 2000
Determination of optimal injection parameters for intraarterial gadolinium-enhanced MR angiography.
Rapid vascular depiction with use of a minimum of gadolinium (Gd) contrast agent will be required to generate road-map vascular images for magnetic resonance (MR) imaging-guided endovascular interventions. The objective of this study was to optimize intraarterial injections of MR contrast agent during magnetic resonance angiography (MRA), obtained during interventions, by determining the optimal Gd vascular concentration ([Gd]) for vessel depiction. ⋯ The theoretically predicted values for [Gd]optimal and the flow dilution model were successfully validated. The relationship between injected [Gd], injection rate, and blood flow rate permits rapid intraarterial administration of contrast material, using less overall contrast material than with standard intravenous Gd-enhanced MRA.