共查询到20条相似文献，搜索用时 109 毫秒
1.
Roberto Iezzi Maurizio Pompili Alessandro Posa Eleonora Annicchiarico Matteo Garcovich Biagio Merlino Elena Rodolfino Vincenzo Di Noia Michele Basso Alessandra Cassano Carlo Barone Antonio Gasbarrini Riccardo Manfredi Cesare Colosimo 《Journal of vascular and interventional radiology : JVIR》2017,28(9):1234-1239
Purpose
To compare transfemoral approach (TFA) and transradial approach (TRA) in patients undergoing hepatic chemoembolization in terms of safety, feasibility, and procedural variables, including fluoroscopy time, radiation dose (reference air kerma [RAK]), and patient preference.Materials and Methods
A single-center prospective intrapatient comparative study was conducted with 42 consecutive patients with hepatic malignancies who received 2 consecutive treatment sessions of unilobar hepatic chemoembolization within a 4-week interval over a 6-month period with both TRA and TFA. All procedures were performed by 1 interventional radiologist who assessed the eligibility of patients for inclusion in the study. The primary endpoint was intraprocedural conversion rate. Secondary endpoints were access site complications, angiographic and procedural variables, and evaluation of patient discomfort and preferences.Results
A 100% technical success rate and a crossover rate of 0% were recorded. There were no major vascular complications and similar rates of minor complications (4.8% for TRA, 7.1% for TFA; P = .095), which were self-limited and without any clinical sequelae. TRA treatments required a significantly longer preparation time for the procedure (P = .008) with no significant differences for other procedural variables. Greater discomfort at the access route and patient inability to perform basic activities after the procedure were recorded for TFA (P < .001). TRA was preferred by 35 patients (35/42) for potential future transarterial procedures.Conclusions
TRA is safe and feasible for transarterial hepatic chemoembolization, with high technical success, low overall complications, and improved patient comfort. 相似文献2.
Bo Liu Joseph Limback Melissa Kendall Michael Valente Jamil Armaly Vincent Grekoski Alex Pinizzotto Jeremy Burt Thomas J. Ward 《Journal of vascular and interventional radiology : JVIR》2017,28(12):1727-1731
Purpose
To test the hypothesis that computed tomography (CT)-guided bone marrow biopsy in patients with a platelet count between 20,000/uL and 50,000/uL is safe and that preprocedure platelet transfusion is unnecessary.Materials and Methods
This single-center retrospective study included bone marrow biopsies performed between May 2009 and May 2016. The study population included 981 patients—age range, 15–93 years; average age, 57 years; 505 (51.5%) men; and 476 (48.5%) women. One hundred eighty-seven biopsies were performed in patients with a platelet count of 20,000–50,000/μL; 33 were performed in patients with a platelet count of < 20,000/μL. The primary endpoint was hemorrhagic complications, Society of Interventional Radiology (SIR) complication class C or above. The complication rates in thrombocytopenic patients were compared to patients with a platelet count of ≥ 50,000/uL. Ninety-five percent confidence intervals (CIs) for the complication rate in each group were also calculated.Results
There were no SIR class C or above postprocedure bleeding-related complications, including interventions or transfusions. For patients with a platelet count of < 20,000/μL and of 20,000–50,000/μL, hemorrhagic complications rates were 0% (95% CI: 0–9.1%) and 0% (95% CI: 0–1.6%), respectively.Conclusions
CT-guided bone marrow biopsy is safe in thrombocytopenic patients, with a hemorrhagic complication rate below 1.6% for patients with a platelet count of 20,000–50,000/μL. Routine preprocedure platelet transfusion may not be necessary for patients with a platelet count of 20,000–50,000/μL. 相似文献3.
Min Tae Kim Kun Yung Kim Ho-Young Song Jung-Hoon Park Jiaywei Tsauo Zhe Wang Pyeong Hwa Kim 《Journal of vascular and interventional radiology : JVIR》2017,28(11):1584-1591
Purpose
To assess the long-term outcomes of covered retrievable self-expandable metallic stent (REMS) placement for recurrent benign urethral stricture and to compare the outcomes associated with 3 types of covered REMSs.Materials and Methods
A retrospective study was performed in 54 male patients in whom 114 REMSs were placed between November 1998 and December 2016. These included 26 polyurethane-covered REMSs in 13 patients (group A), 47 internally polytetrafluoroethylene (PTFE)-covered REMSs in 21 patients (group B), and 41 externally PTFE-covered REMSs in 20 patients (group C). The outcomes were analyzed and compared between the groups.Results
Overall clinical success was achieved in 14 of the 54 patients (24%) at 5-year follow-up (group A, 12%; group B, 19%; group C, 40%). The overall complication rate was 60.5%, and the complication rate was significantly higher in group B than in groups A or C (group A vs B, P = .018; group B vs C, P = .002). The median stent indwelling time and maintained patency period were 3.1 months and 108 months, respectively. In multivariate analysis, stent indwelling time was the only significant factor associated with maintained patency.Conclusions
The long-term outcome of covered REMSs has not achieved the desired success rate for the standard treatment of recurrent urethral stricture. However, externally PTFE-covered REMSs showed a better long-term outcome than the other studied types. 相似文献4.
Hyukjoon Lee Chang Jin Yoon Nak Jong Seong Chang Ho Jeon Ho Il Yoon Joongseok Go 《Journal of vascular and interventional radiology : JVIR》2017,28(8):1161-1166
Purpose
To describe angiographic findings and assess safety and effectiveness of bronchial artery embolization (BAE) with N-butyl cyanoacrylate (NBCA) in patients with cryptogenic hemoptysis (CH).Materials and Methods
Between May 2003 and March 2014, 26 patients who underwent BAE for CH were enrolled. A retrospective review was conducted for angiographic findings and clinical outcomes of BAE, including technical and clinical success, complications, and recurrent hemoptysis.Results
Selective arteriograms were abnormal in 22 patients (85%), showing hypertrophied bronchial arteries (n = 19), parenchymal hypervascularity (n = 18), and bronchial-to-pulmonary shunting (n = 8). All abnormal bronchial and nonbronchial collateral arteries (n = 36) were successfully embolized with NBCA. Hemoptysis ceased within 24 hours in all patients. There were no procedure-related complications. During 11–117 months of follow-up (median, 60.2 mo), 1 patient (4%) experienced recurrent hemoptysis at 5 months after initial BAE, which was treated with repeat BAE. The 5-year hemoptysis-free survival rate was 96%.Conclusions
Bronchial arteries were angiographically abnormal in most patients with CH (85%). BAE is a safe and effective treatment with excellent short- and long-term results in patients with CH. NBCA appears to be a useful embolic material for this application. 相似文献5.
Julien Pintat Alain Silvestre Guy Magalon Alain Pierre Gadeau Lionel Pesquer Anne Perozziello Alain Peuchant Charbel Mounayer Benjamin Dallaudière 《Journal of vascular and interventional radiology : JVIR》2017,28(12):1708-1713
Purpose
To assess the feasibility and safety of concomitant intra-articular (IA) knee injection of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) under fluoroscopic guidance to treat patellofemoral osteoarthritis (OA).Materials and Methods
This prospective study included 19 consecutive patients referred for fluoroscopically guided IA MSC and PRP injection for symptomatic patellofemoral chondropathy in which conservative treatment had failed. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score and magnetic resonance (MR) data, including T2 mapping sequence, were prospectively collected before and 6 months after treatment. Clinical data without MR imaging were collected until 12 months after the procedure.Results
WOMAC scores were significantly lower after IA injection of MSCs and PRP at 6 months and during 12-months follow-up compared with baseline (mean score decreased from 34.3 to 14.2; P < .0018). Patients reported no complications. Concerning MR imaging follow-up, there were no significant differences in grade, surface, or T2 value of the chondral lesions (P > .375).Conclusions
IA injection of MSCs and PRP in early patellofemoral OA appears to allow functional improvement. 相似文献6.
Christopher R. Ingraham Guy E. Johnson Emily L. Albrecht Siddharth A. Padia Eric J. Monroe Brandon C. Perry Ethan M. Dobrow Daniel S. Hippe Karim Valji 《Journal of vascular and interventional radiology : JVIR》2018,29(1):55-61.e2
Purpose
To compare peristomal infection rates following percutaneous gastrostomy (PG) after a single dose of prophylactic antibiotics versus placebo and evaluate rates of peristomal infection in patients receiving concurrent antibiotics.Materials and Methods
This single-center, randomized trial (2012–2016) enrolled 122 patients referred for image-guided PG; all enrolled patients completed the study. Of enrolled patients, 68 were randomly assigned to receive either antibiotics (n = 34) or placebo (n = 34) before PG placement. The remaining 54 patients were taking pre-existing antibiotics and were assigned to an observation arm. Stoma sites were assessed for signs of infection by a blinded evaluator at early (between 3–5 d and 7–10 d) and late (between 14–17 d and 28–30 d) time points after the procedure. The primary outcome was peristomal infection.Results
Under intention-to-treat analysis, early infection rate was 11.8% (4/34 patients; 95% CI, 0.0%–9.4%) in the placebo arm and 0.0% (0/34 patients; 95% CI, 0.0%–8.4%) in the antibiotic arm (P = .057 for comparison of infections in the 2 arms). Under per-protocol analysis, early infection rate was 13.3% (4/30 patients; 95% CI, 4.4%–29.1%) in the placebo arm and 0.0% (0/32 patients; 95% CI, 0.0%–8.9%) in the antibiotic arm (P = .049). The number needed to treat to prevent 1 early infection was 8.5 and 7.5 from the 2 analyses, respectively.Conclusions
There is a trend toward reduction in rate of peristomal infection after PG when prophylactic antibiotics are administered. 相似文献7.
Hussein D. Aoun Peter J. Littrup Mohamed Jaber Fatima Memon Barbara Adam Mark Krycia Matthew Prus Elisabeth Heath Edson Pontes 《Journal of vascular and interventional radiology : JVIR》2017,28(10):1363-1370
Purpose
To retrospectively assess long-term outcomes of percutaneous renal cryoablation, including factors affecting complications and local recurrence rates.Materials and Methods
A total of 357 computed tomographic (CT) fluoroscopy–guided percutaneous cryoablation procedures were performed for 382 masses in 302 outpatients; 347 were biopsy-proven renal-cell carcinoma (RCC) or Bosniak category > III masses (n = 28). Benign pathologic conditions (n = 18) or metastatic non-RCC disease (n = 17) were included to analyze procedural complication rate, but recurrence rates, tumor staging, and nephrometry score were limited to RCCs. The average tumor diameter was 2.9 cm (range, 1–10.3 cm), and median nephrometry score for RCC was 8 (mean, 7.4). Protection of adjacent vital structures was performed in 34% of procedures (n = 121), and ureteral stent placement was performed for 9.2% (n = 33). All major complications were graded per surgical Clavien–Dindo criteria.Results
The average CT-visible cryoablation zone diameter was 5 cm (range, 2.5–10.5 cm). Grade ≥ 3 complications occurred in 2.8% of procedures (n = 10), and appeared related to only high nephrometry scores (P = .0086) and larger tumors (P = .0034). No significant changes in renal function before and after the procedure were noted (P = .18). At a mean follow-up of 31.8 months, the local tumor recurrence rate was 3.2% (11 of 347) for RCC, and no significant difference was noted between tumors larger or smaller than 3 cm (P = .15). The difference reached significance only among the small number of stage ≥ T2 RCC tumors (P = .0039).Conclusions
Long-term follow-up of percutaneous renal cryoablation demonstrates low recurrence rates with preserved renal function, even for patients with high nephrometry scores and body mass index, assuming thorough cytotoxic technique and protection measures. 相似文献8.
Seung Hun Kang Shin Jae Lee Gyeong Sik Jeon Sang-Wook Yoon 《Journal of vascular and interventional radiology : JVIR》2017,28(6):844-849
Purpose
To determine feasibility of scaled signal intensity (SSI) of uterine fibroids on T2-weighted magnetic resonance (MR) images to predict volume reduction rate (VRR) after uterine fibroid embolization (UFE).Materials and Methods
In this retrospective study, 66 premenopausal women underwent UFE. Patients underwent follow-up MR imaging 3 months after UFE. SSI of predominant fibroids was measured on T2-weighted MR images obtained before the procedure by standardizing the mean signal intensity to a 0-to-100 scale, with 0 representing rectus abdominis muscle and 100 representing subcutaneous fat (100) for reference values.Results
VRR of predominant fibroids was 12.3%–99.0% (mean 53.7%). SSI of predominant fibroids was 0.9–73.6 (mean 24.6). SSI was significantly related to VRR of fibroids (P < .01). The optimal SSI cutoff value to predict VRR > 50% was 18.16 with sensitivity of 78.8% and specificity of 66.7%. The optimal SSI cutoff value to predict VRR < 30% was 14.38 with sensitivity of 75% and specificity of 70.7%.Conclusions
SSI of fibroids was significantly related to fibroid VRR after UFE. SSI may be useful in the quantified prediction of volume reduction. 相似文献9.
Percutaneous CT–Guided Sympathicolysis with Radiofrequency for the Treatment of Palmar Hyperhidrosis
Paula García-Barquín Jesús Dámaso Aquerreta Beola José María Bondía Gracía Agustín España Alonso Juan Pérez Cajaraville Pablo Bartolomé Leal Gorka Bastarrika 《Journal of vascular and interventional radiology : JVIR》2017,28(6):877-885
Purpose
To evaluate the benefits of computed tomography (CT)–guided percutaneous sympathicolysis with radiofrequency in patients with primary palmar hyperhidrosis (PPHH) in terms of safety, patient satisfaction, and short- and long-term efficacy.Materials and Methods
A total of 139 procedures in 108 patients (mean age, 29.89 y ± 10.94), including 50 men and 58 women, with PPHH and therapy-resistance of nonsurgical treatments were retrospectively analyzed. Treatment was performed bilaterally at T2, T3, and T4 levels, reaching 90°C during 8 minutes. Technical success, immediate efficacy, and presence of complications were analyzed. For follow-up, the Hyperhidrosis Disease Severity Scale was used to evaluate the hyperhidrosis before, at one month, and in the long-term through a survey of 42 patients. Patients' satisfaction and complications were also recorded.Results
The technical success rate was 98.56%. The increase in palmar skin temperature was 4.88°C ± 1.85. A total of 85.3% of participants had completely dry hands immediately after treatment. The mean follow-up time was 41.34 months (range, 6–62 mo). One month after treatment, the response rate was 77.38% (P < .001). At long-term follow-up, the response rate was 69.04% (P < .001). Two major complications were observed (1.8%), 52.38% of patients were satisfied, and 59.52% of patients presented compensatory hyperhidrosis at long-term follow-up.Conclusions
Percutaneous CT–guided sympathicolysis is a safe and effective technique for the treatment of PPHH and can be considered as a second choice in patients in whom other nonsurgical therapeutic options have failed, despite the compensatory hyperhidrosis rates. 相似文献10.
Grégoire Leleup Audrey Fohlen Anthony Dohan Lara Bryan-Rest Vincent Le Pennec Olivier Limot Olivier Le Dref Philippe Soyer Jean-Pierre Pelage 《Journal of vascular and interventional radiology : JVIR》2017,28(5):696-701
Purpose
To evaluate the feasibility and efficacy of embolization of the round ligament arteries in the management of postpartum hemorrhage.Materials and Methods
Eleven women (mean age, 31 y) underwent round ligament artery because of persistent or recurrent hemorrhage after initial uterine or internal iliac artery embolization.Results
A total of 16 round ligament arteries were embolized. The round ligament artery arose from the inferior epigastric artery in 11 cases (69%) and directly from the external iliac artery in 5 (31%). Embolization was performed with calibrated microspheres in 7 women (63%) and gelatin sponge pledgets in 4 (37%). Coils were used in addition to gelatin sponge pledgets in 3 patients. Hemostasis was achieved in 10 patients (91%), and 1 required additional conservative surgery. The mean hemoglobin level before embolization was 7.2 g/dL ± 1 and increased significantly on day 1 after embolization (10.3 g/dL ± 1.0; P < .05). No procedure-related complication was reported. The mean hospital stay was 5.6 days ± 2. Two patients had further pregnancies 13 and 14 months after embolization.Conclusions
Selective embolization of the round ligament artery is a safe and effective treatment for obstetric hemorrhage. It should be considered in cases of persistent or recurrent bleeding after initial uterine or internal iliac artery embolization. 相似文献11.
Sangik Park Ji Hoon Shin Dong-Il Gwon Hyoung Jung Kim Kyu-Bo Sung Hyun-Ki Yoon Gi-Young Ko Heung Kyu Ko 《Journal of vascular and interventional radiology : JVIR》2017,28(7):1012-1021
Purpose
To evaluate outcomes of transcatheter arterial embolization (TAE) for gastric cancer–related gastrointestinal (GI) bleeding and factors associated with successful TAE and improved survival after TAE.Materials and Methods
This retrospective study included 43 patients (34 men; age 60.6 y ± 13.6) with gastric cancer–related GI bleeding undergoing angiography between January 2000 and December 2015. Clinical course, laboratory findings, and TAE characteristics were reviewed. Technical success of TAE was defined as target area devascularization, and clinical success was defined as bleeding cessation with hemodynamic stability during 72 hours after TAE. Student t test was used for comparison of continuous variables, and Fisher exact test was used for categorical variables. Univariate and multivariate analysis were performed to identify predictors of successful TAE and 30-day survival after TAE.Results
TAE was performed in 40 patients. Technical and clinical success rates of TAE were 85.0% and 65.0%, respectively. Splenic infarction occurred in 2 patients as a minor complication. Rebleeding after TAE occurred in 7 patients. Death related to bleeding occurred in 5 patients. Active bleeding (P = .044) and higher transfusion requirement (3.3 U ± 2.6 vs 1.8 U ± 1.7; P = .039) were associated with TAE failure. Successful TAE predicted improved 30-day survival after TAE on univariate and multivariate analysis (P = .018 and P = .022; odds ratio, 0.132).Conclusion
TAE for gastric cancer–associated GI bleeding may be a lifesaving procedure. Severe bleeding with a higher transfusion requirement and active bleeding on angiography predicted TAE failure. 相似文献12.
Luka Jeraj Mateja Kaja Jezovnik Pavel Poredos 《Journal of vascular and interventional radiology : JVIR》2017,28(7):941-944
Purpose
To investigate the relationship between recanalization rate of occluded veins after deep venous thrombosis (DVT) and development of postthrombotic syndrome (PTS).Materials and Methods
Patients treated for DVT of the lower limbs were evaluated 12–36 months after acute DVT. Of 100 patients, 34 developed PTS, defined as Villalta score of ≥ 5. Symptoms and signs of PTS were assessed, and ultrasound examination of the veins was performed, checking for residual thrombus and presence of reflux.Results
Patients with PTS were older (64.0 y vs 55.5 y; P = .007) and more frequently experienced recurrent DVT (15% vs 3%; P = .030). Patients with PTS had a lower rate of recanalization. Patients with residual thrombus appeared to be at increased risk for PTS development compared with patients with total recanalization (odds ratio 6.0; 95% confidence interval, 1.7–21.9; P = .006). No difference in the presence of reflux was observed.Conclusions
Incomplete or absent recanalization is associated with a higher incidence of PTS, probably as a consequence of deteriorated blood flow and increased venous pressure. This suggests early recanalization could improve the outcome of DVT treatment in selected patients. 相似文献13.
Simon Chun Ho Yu Carmen Cho Esther Hung Defeng Wang Peter Chiu Chi Hang Yee Anthony Ng 《Journal of vascular and interventional radiology : JVIR》2017,28(8):1167-1176
Purpose
It is hypothesized that intra-arterial administration of verapamil is a safe and effective way to reverse the flow in intraprostatic anastomoses to extraprostatic arteries without compromising treatment outcomes in prostatic artery embolization (PAE) for benign prostatic hypertrophy (BPH).Materials and Methods
A prospective study of 62 prostate sides in 31 consecutive patients (median age, 66 y; range, 60–71 y) with symptomatic BPH was undertaken. Median prostate volume was 72.4 mL (range, 48.8–85.8 mL), median International Prostate Symptom Score was 21 (range, 15-23), and median urine peak flow rate was 4 mL/s (range, 2–6 mL/s). The arterial anastomoses were classified as types I–III according to vascular morphology. Treatment safety was assessed in terms of adverse events and complications, and treatment effectiveness was assessed in terms of success rate of angiographic flow reversal.Results
The PAE procedure was successfully completed in all 31 patients (100%). Adverse events in both groups were transient and mild and did not necessitate prolonged hospitalization. There was no clinical evidence of any significant nontarget ischemic complication in either group. Intraprostatic anastomosis was diagnosed in 19 of 31 patients (61.3%) and 22 of 62 prostate sides (35.5%). Success rates of verapamil treatment were 88.9% overall (20 of 22) and 100% (19 of 19) in type II and III anastomoses. There was no difference between the treatment group and the control group in clinical, urologic, and imaging outcomes of PAE.Conclusions
Intra-arterial verapamil treatment was probably safe and effective in causing flow reversal in type II and III intraprostatic anastomoses and in preventing ischemic complications in PAE for BPH without compromising PAE outcomes. 相似文献14.
En-Li Shiau Huei-Lung Liang Yih-Huie Lin Ming-Feng Li Chia-Ling Chiang Matt Chiung-Yu Chen Jer-Shyung Huang Huay-Ben Pan 《Journal of vascular and interventional radiology : JVIR》2017,28(7):1025-1032
Purpose
To determine frequency of and assess risk factors for hepatic artery (HA) injury during percutaneous transhepatic biliary drainage (PTBD) and to discuss the technique and report the clinical outcome of embolization for HA injury.Materials and Methods
Over a 14-year period (2002–2016), 1,304 PTBD procedures in 920 patients were recorded. The incidence of HA injury was determined, and possible associated risk factors were analyzed. When injury occurred, HA embolization was performed at the site as close to the bleeding point as possible. Clinical outcomes of these patients after embolization were reported.Results
Of 1,304 PTBD procedures, a left-sided approach was used in 722 procedures (55.4%), and intrahepatic duct (IHD) puncture under ultrasound guidance was used in 1,161 procedures (90.1%). The IHD was nondilated in 124 (9.5%) patients. The punctured ductal entry site was peripheral in 1,181 (90.6%) patients. In this series, 8 procedures (0.61%) were complicated by HA injury. IHD dilatation status was the only risk factor (P = .017) for HA injury. Embolization was performed with technical and clinical success in all 8 patients. No recurrent hemobilia, intraabdominal bleeding, or other sequelae of HA injury after embolization was noted during 1 week to 84 months of follow-up.Conclusions
HA injury is a relatively rare complication of PTBD. IHD dilatation status was the only risk factor for HA injury in this study. When HA injury occurred, embolization therapy was effective in managing this complication. 相似文献15.
Jung-Hoon Park Guk Bae Kim Ho-Young Song Min Tae Kim Pyeong Hwa Kim Kun Yung Kim Jiaywei Tsauo Do Hoon Kim 《Journal of vascular and interventional radiology : JVIR》2017,28(8):1147-1153
Purpose
To evaluate the frequency, severity, and clinical significance of stent abutment (SA) after gastroduodenal stent placement in patients with gastric outlet obstruction caused by unresectable gastric cancer.Materials and Methods
A retrospective study was conducted in a single tertiary referral university hospital to identify the incidence and clinical significance of SA in 318 patients who underwent self-expandable metallic stent placement. SA was defined as abutment of the distal end of the stent to the duodenal wall and/or superior duodenal flexure. The outcomes included technical and clinical success, complications, repeat intervention, stent patency, and survival.Results
A total of 318 patients, 107 with SA (33.6%) and 211 without, were included. SA occurred partially (n = 64; 59.8%) and completely (n = 43; 40.2%). The technical and clinical outcomes and survival were similar in the groups with and without SA. Food impaction and resultant repeat intervention rates were higher in the SA group than in the non-SA group (P < .001 and P < .001, respectively), and were associated with complete SA (P = .007). Stent patency rate was lower in the SA group than in the non-SA group (P = .003).Conclusions
SA was associated with increased food impaction, resulting in a greater incidence of stent malfunction and shorter stent patency compared with a lack of SA. The concept of SA may be useful for the improvement of stent patency and avoidance of food impaction. 相似文献16.
Kaichuang Ye Jinbao Qin Minyi Yin Mi’er Jiang Weimin Li Xinwu Lu 《Journal of vascular and interventional radiology : JVIR》2017,28(10):1446-1453.e2
Purpose
To compare midterm outcomes of optimal medical treatment (OMT) alone with OMT and thoracic endovascular aortic repair (TEVAR) of acute type B intramural hematoma (IMHB).Materials and Methods
Retrospective analysis was performed of 65 patients treated with OMT alone (31 patients) or OMT with TEVAR (34 patients) for acute uncomplicated or complicated IMHB from January 2006 to December 2015 in a single institution. Primary outcome was aortic-related mortality during follow-up. Secondary outcomes were aortic-related adverse events, all-cause mortality, and occurrence of complete aortic remodeling.Results
Except for the morphologic nature of the aortic lesion, no significant differences in baseline characteristics between the 2 groups were observed. Mean follow-up time was 32 months ± 19 (range, 1–120 months). Patients in the OMT group had a significantly increased rate of aortic-related mortality (12.9% vs 0% in TEVAR group, P = .046) and aortic-related adverse events (29.0% vs 0% in TEVAR group, P < .001) and an insignificant but higher trending all-cause mortality rate (38.8% vs 19.8% in TEVAR group, P = .15). The occurrence of complete aortic remodeling was significantly lower in the OMT group (15.4% vs 82.1% in TEVAR group, P < .001).Conclusions
TEVAR is likely to protect from progression of IMHB and to be associated with a better prognosis than OMT alone. 相似文献17.
Jasmin D. Busch Maren Vens Catherine Mahler Jochen Herrmann Gerhard Adam Harald Ittrich 《Journal of vascular and interventional radiology : JVIR》2017,28(8):1177-1183
Purpose
To present frequency and types of complications related to silicone (SI) versus polyurethane (PUR) catheters of totally implanted venous access devices (TIVADs) placed in the upper arm.Material and Methods
A cohort of 2,491 consecutive patients with TIVADs implanted between 2006 and 2015 was retrospectively analyzed. Complications were classified according to SIR guidelines. Pearson χ2 test was used for categorical variables, and Student t test was used for continuous variables. Nominal P values were reported, and 2-sided P values < .05 were considered significant.Results
Of 2,270 patients meeting the inclusion criteria, 538 had an SI catheter, and 1,732 had a PUR catheter. Total dwell time was 584,853 catheter days. Mean total complication rate was 12.25% (SI, 14.87%; PUR, 11.43%; P = .040). Subanalysis revealed significant differences for material failures (eg, catheter fracture [SI, 3.35%; PUR, 0.06%; P < .001] and thrombotic catheter occlusion/venous thromboses [SI, 2.79%/0.74%; PUR, 1.33%/3.17%; P < .001]) but nonsignificant differences for infections (eg, local infection and catheter-related sepsis [SI, 4.64%; PUR, 4.68%; P = 1]) or other nonthrombotic dysfunctions (eg, catheter detachment, line migration, wound dehiscence [SI, 3.35%; PUR, 2.19%; P = .179]).Conclusions
The reported data suggest different risk profiles in SI catheters compared with PUR catheters, with more material failures and thrombotic catheter occlusions in SI catheters and more venous thromboses in PUR catheters. 相似文献18.
Edwin A. Takahashi David F. Kallmes Chad J. Fleming Robert J. McDonald Michael A. McKusick Haraldur Bjarnason William S. Harmsen Sanjay Misra 《Journal of vascular and interventional radiology : JVIR》2017,28(12):1687-1692
Purpose
To determine incidence, predictors, and clinical outcomes of postcontrast acute kidney injury (PC-AKI) following renal artery stent placement for atherosclerotic renal artery stenosis.Materials and Methods
This retrospective study reviewed 1,052 patients who underwent renal artery stent placement for atherosclerotic renal artery stenosis; 437 patients with follow-up data were included. Mean age was 73.6 years ± 8.3. PC-AKI was defined as absolute serum creatinine increase ≥ 0.3 mg/dL or percentage increase in serum creatinine ≥ 50% within 48 hours of intervention. Logistic regression analysis was performed to identify risk factors for PC-AKI. The cumulative proportion of patients who died or went on to hemodialysis was determined using Kaplan-Meier survival analysis.Results
Mean follow-up was 71.1 months ± 68.4. PC-AKI developed in 26 patients (5.9%). Patients with PC-AKI had significantly higher levels of baseline proteinuria compared with patients without PC-AKI (odds ratio = 1.38; 95% confidence interval, 1.11–1.72; P = .004). Hydration before intervention, chronic kidney disease stage, baseline glomerular filtration rate, statin medications, contrast volume, and iodine load were not associated with higher rates of PC-AKI. Dialysis-free survival and mortality rates were not significantly different between patients with and without PC-AKI (P = .50 and P = .17, respectively).Conclusions
Elevated baseline proteinuria was the only predictor for PC-AKI in patients undergoing renal artery stent placement. Patients who developed PC-AKI were not at greater risk for hemodialysis or death. 相似文献19.
Saebeom Hur Hwan Jun Jae Hyukjoon Lee Myungsu Lee Hyo-Cheol Kim Jin Wook Chung 《Journal of vascular and interventional radiology : JVIR》2017,28(12):1673-1680
Purpose
To evaluate 30-day safety and efficacy of superselective embolization for arterial upper gastrointestinal bleeding (UGIB) using N-butyl cyanoacrylate (NBCA).Materials and Methods
This single-center retrospective 10-year study included 152 consecutive patients with UGIB (gastric, n = 74; duodenal, n = 78) who underwent embolization with NBCA for angiographically positive arterial bleeding. The primary endpoint was clinical success rate defined as achievement of hemostasis without rebleeding or UGIB-related mortality within 30 days after embolization. Mean systolic blood pressure and heart rate were 121.2 mm Hg ± 27.4 and 97.9 beats/minute ± 22.5; 31.1% of patients needed intravenous inotropes, and 36.6% had coagulopathy. The etiology of bleeding was ulcer (80.3%) or iatrogenic injury (19.7%). Statistical analysis was performed to identify predictive factors for outcomes.Results
Technical success rate was 100%. Clinical success, 1-month mortality, and major complication rates were 70.4%, 22.4%, and 0.7%. There were significant differences in the clinical success rates between gastric and duodenal bleeding (79.4% vs 62.2%; P = .025). The need for intravenous inotropes at the time of embolization was a significant negative predictive factor in both gastric (odds ratio [OR] = 0.091, P = .004) and duodenal (OR = 0.156, P = .002) bleeding. The use of a microcatheter with a smaller tip (2 F) was associated with better outcomes in duodenal bleeding (OR = 7.389, P = .005).Conclusions
Superselective embolization using NBCA is safe and effective for angiographically positive arterial UGIB. 相似文献20.
Johnathan C. Valesano John J. Schmitz A. Nicholas Kurup Grant D. Schmit Michael R. Moynagh Thomas D. Atwell Bradley D. Lewis Robert A. Lee Matthew R. Callstrom 《Journal of vascular and interventional radiology : JVIR》2017,28(8):1156-1160