共查询到20条相似文献,搜索用时 31 毫秒
1.
《Cardiovascular and interventional radiology》1998,22(2):124-129
Purpose: To evaluate retrospectively the integrated diagnostic and therapeutic management of severely polytraumatized patients using
a combined computed tomography (CT) and angiography suite with a single pivoting table.
Methods: Eleven patients, aged 16–74 years (median 30 years), were managed with spiral CT and angiography without patient transfer.
Four patients were unstable, seven had received blood transfusions (2–18 units) and six were intubated. In 10 patients in
whom active bleeding was demonstrated (splenic 5, hepatic 2, renal 2, left inferior epigastric artery 1), hemostatic embolization
was obtained.
Results: Total procedure time did not exceed 80 min. Immediate hemostasis was achieved in all patients. Recurrent bleeding from the
liver required additional embolization in one patient. Median length of stay in the intensive care unit was 4 days and median
hospital stay was 27 days. All patients survived without significant sequelae.
Conclusion: The use of a combined CT–angiography suite enables rapid diagnostic investigation and hemostatic embolization in actively
bleeding trauma patients. 相似文献
2.
Fracture of memotherm metallic stents in the biliary tract 总被引:2,自引:0,他引:2
In a series of 66 patients who had palliation of malignant obstructive jaundice by percutaneous placement of Memotherm expanding
metal stents, we report four cases of stent fracture. This has not been reported previously. 相似文献
3.
O. Sami AAssar Jeanne M. LaBerge Roy L. Gordon Mark W. Wilson Sean J. Mulvihill Lawrence W. Way Robert K. Kerlan 《Cardiovascular and interventional radiology》1999,22(1):25-28
Purpose: To evaluate the efficacy of percutaneous drainage of fluid collections following pancreaticoduodenectomy (Whipple’s procedure).
Methods: We performed a retrospective review of 19 patients referred to our service with fluid collections following pancreaticoduodenectomy.
The presence of associated enteric or biliary fistulas, the route(s) of access for image-guided drainage, the incidence of
positive bacterial cultures, and the duration and success of percutaneous management were recorded.
Results: Fistulous communication to the jejunum in the region of the pancreatico-jejunal anastomosis was demonstrable in all 19 patients
by gentle contrast injection into drainage tubes. Three patients had concurrent biliary fistulas. In 18 of 19 patients, fluid
samples yielded positive bacterial cultures. Successful percutaneous evacuation of fluid was achieved in 17 of 19 patients
(89%). The mean duration of drainage was 31 days.
Conclusion: Percutaneous drainage of abscess following pancreaticoduodenectomy is effective in virtually all patients despite the coexistence
of enteric and biliary fistulas. 相似文献
4.
Giuseppe Sangiorgi Eloisa Arbustini Paolo Lanzarini Barbara del Bello Marcello Maestri Annalisa Gaspari Marco Solcia Renu Virmani Luigi Inglese 《Cardiovascular and interventional radiology》2001,24(4):260-270
Purpose: To test the vascular wall response to an expanded polytetrafluoroethylene-covered stent, compared with conventional stenting,
up to 6 months after deployment in the vascular district of a swine model.
Methods: Fourteen minipigs underwent implantation of expanded polytetrafluoroethylene-covered stents (CS) and bare stents (BS) in
five peripheral arteries. Animals were killed at different time points (from 1 to 180 days). Histopathologic assessment by
morphologic and morphometric analysis and by scanning electron microscopy (SEM) were used to assess the incorporation characteristics
and re-endothelialization extent of the two types of stents.
Results: A total of 70 stents (14 CS and 14 BS in the renal arteries; 28 CS in the iliac arteries, and 14 CS in the aorta) were implanted.
Microscopic examination confirmed the absence of occlusive thrombi in both the CS and BS groups. Microthrombi were observed
in 10 of 13 CS (77% of cases) and in four of four BS (100% of cases, p < 0.05). Inflammation was mild in 69% of segments in which a CS was implanted and in 74% of segments in which a BS was implanted (p= NS), while a severe inflammatory reaction was observed in 6% of CS segments and in 8% of BS segments (p= NS). No differences were detected at the long-term analysis between neointimal thickness in CS compared with BS segments
(0.46 ± 0.18 mm vs 0.42 ± 0.26 mm at 90 days and 0.36 ± 0.08 mm vs 0.35 ± 0.04 mm at 180 days; p= NS, respectively). At SEM analysis, re-endothelization was evident 15 days after the implant in both CS and BS starting
from the stent edges.
Conclusion: CS implantation did not elicit a more severe thrombotic deposition compared with that of BS. A similar inflammatory reaction
of the arterial wall was present in the two stent groups 3 and 6 months following the implant. In addition, CS implantation
did not stimulate excessive neointimal formation when compared with BS. 相似文献
5.
To lower the risk of stent migration in a graft–venous anastomosis stenosis following failed percutaneous transluminal angioplasty,
two Strecker stents of different caliber were placed in partly overlapping fashion across the stenosis. In contrast to other
methods, stent ``floating' on the venous side was eliminated by using a stent with a caliber matching the tapering postanastomotic
vein and anchoring it to both the venous wall and the second stent. Using this method we believe we accomplished better fixation
of the stent placed mostly in the venous side of the anastomosis, thus lowering its risk of migration. At 6 months follow-up
the stents are in place and the anastomosis is patent. 相似文献
6.
Hélène Vernhet Claudine Bousquet Betty Jean Alvian Lesnik Gérard Durand Jacques Giron Jean Paul Senac 《Cardiovascular and interventional radiology》1999,22(3):254-257
Bronchial artery dilatation and aneurysm formation is a potential complication of local inflammation, especially in bronchiectasis.
When the bronchial artery has an ectopic origin from the inferior segment of the aortic arch, aneurysms may mimick aortic
aneurysms. Despite this particular location, endovascular treatment is possible. We report two such aneurysms that were successfully
embolized with steel coils. 相似文献
7.
Alexandre Laurent Jean Jacques Durussel Jacques Dufaux Laurence Penhouët Anne Laure Bailly Michel Bonneau Jean Jacques Merland 《Cardiovascular and interventional radiology》1999,22(1):62-66
Purpose: To compare whole blood viscosity and erythrocyte aggregation in humans, pigs, and sheep, before and after adding water-soluble
iodinated contrast medium (CM).
Methods: Two CMs were studied: iopromide (nonionic) and ioxaglate (ionic). The blood-CM viscosity was measured with a Couette viscometer.
Erythrocyte aggregation was measured with an erythroaggregometer.
Results: The blood-CM viscosity was increased up to +20% (relative to pure blood) with a CM concentration of 0%–10%. At CM concentrations
from 10% to 50%, the viscosity decreased. The disaggregation shear stress was increased (relative to pure blood) at low CM
concentration (0%–10%). When the CM concentration increased from 10% to 20%, the disaggregation shear stress was decreased,
except with the pig blood–ioxaglate mixture.
Conclusion: At low CM concentration the blood viscosity was increased in pig, sheep, and humans and the disaggregation shear stress was
increased in pig and humans. The aggregation of sheep blood was too low to be detected by the erythroaggregometer. This rise
can be explained by the formation of poorly deformable echinocytes. At higher CM concentration, the viscosity and the disaggregation
shear stress decreased in relation to the blood dilution. We conclude that pig blood and sheep blood can both be used to study
the effect of CM injection on blood viscosity. Nevertheless, the rheologic behavior of pig blood in terms of erythrocyte aggregation
is closer to that of human blood than is sheep blood when mixed with CM. Pigs could thus be more suitable than sheep for in
vivo studies of CM miscibility with blood during selective cannulation procedures. 相似文献
8.
Penetrating atherosclerotic ulcer of the descending thoracic aorta: Treatment by endovascular stent-Graft 总被引:3,自引:0,他引:3
Salvatore Murgo M.D. Luc Dussaussois Jafar Golzarian Jean Christophe Cavenaile Hicham Tarik Abada José Ferreira Julien Struyven 《Cardiovascular and interventional radiology》1998,21(6):454-458
Purpose: To present four cases of penetrating ulcer of the descending thoracic aorta treated by transfemoral insertion of an endoluminal
stent-graft.
Methods: Four patients with penetrating aortic ulcers were reviewed. Three cases were complicated by rupture, false aneurysm, or retrograde
dissection. All patients were treated by endovascular stent-graft and were followed by helical computed tomography (CT).
Results: Endovascular stent-graft deployment was successful in all patients. However, in one case we observed a perigraft leak that
spontaneously disappeared within the first month, and two interventions were needed for another patient. Following treatment,
one episode of transient spinal ischemia was observed. The 30-day survival rate was 100%, but one patient died from pneumonia
with cardiac failure 34 days after the procedure. In one patient, helical CT performed at 3 months showed a false aneurysm
independent of the first ulcer. This patient refused any further treatment and suddenly died at home (unknown cause) after
a 6-month follow-up period.
Conclusion: Transluminal placement of endovascular stent-grafts for treatment of penetrating ulcers of the descending thoracic aorta
appears to be a possible alternative to classical surgery. After treatment, follow-up by CT is essential to detect possible
complications of the disease. 相似文献
9.
Joseph F. Polak Markus F. Berger Heriberto Pagan-Marin John E. Aruny Michael F. Meyerovitz 《Cardiovascular and interventional radiology》1998,21(4):314-318
Purpose: To compare the efficacy of surgery versus pulse-spray thrombolysis and angioplasty in patients with recurrent thrombosis
of polytetrafluoroethylene (PTFE) dialysis access grafts. Methods: We analyzed 96 consecutive interventions for thrombosed PTFE dialysis access grafts in 18 patients. Primary patency after
thrombolysis and angioplasty (n= 25) was compared with primary patency following thrombectomy alone (n= 50) or thrombectomy followed by graft revision (n= 21) using life-table analysis. A Cox proportional hazards model that accounted for graft age and number of previous interventions
was used to generate the relative risk for recurrent occlusion following therapy. Results: Life-table analysis showed that patency after thrombolysis and angioplasty was greater than that following thrombectomy alone
(p= 0.02). After accounting for the age of the graft and the number of previous interventions (average six per patient), the
relative risk for recurrent occlusion [3.0; 95% confidence intervals (CI): 1.5, 6.4] was greater for thrombectomy alone than
for thrombolysis/angioplasty [0.6; CI = 0.3, 1.3]. The relative risks of repeat occlusion following thrombolysis/angioplasty
[0.6; CI = 0.3, 1.3] and thrombectomy/surgical revision [1.0; CI = 0.5, 1.7] were similar. Conclusion: Outcome data from our retrospective study on recurrent thrombosis of PTFE dialysis access grafts suggest that thrombolysis/angioplasty
is superior to thrombectomy alone, and equivalent to thrombectomy/surgical revision. 相似文献
10.
Maxwell Lazinger Carl F. Beckmann M.D. Alda Cossi Robert A. Roth 《Cardiovascular and interventional radiology》1996,19(4):281-284
A 22-year-old man suffered a hiking accident with perineal trauma and developed a nonpainful priapism secondary to bilateral
arterial-cavernosal fistulas. To minimize the risk of impotence in this young patient, successive selective embolizations
with autologous blood clot were performed to close the fistulas. This led to an uncomplicated full recovery. No fistula was
detectable on Doppler ultrasonography at 1-year follow-up. Review of the literature confirms the safety of embolization with
autologous clot.
Received: 0/00/00/Accepted: 0/00/00 相似文献
11.
Polyorethaoe-covered nitinol strecker stents as primary palliative treatment of malignant biliary obstruction 总被引:5,自引:3,他引:2
Kanasaki S Furukawa A Kane T Murata K 《Cardiovascular and interventional radiology》2000,23(2):114-120
Purpose: To evaluate the clinical efficacy of the polyurethane-covered Nitinol Strecker stent in the treatment of patients with malignant
biliary obstruction.
Methods: Twenty-three covered stents produced by us were placed in 18 patients with malignant biliary obstruction. Jaundice was caused
by cholangiocarcinoma (n = 5), pancreatic cancer (n = 6), gallbladder cancer (n = 4), metastatic lymph nodes (n = 2), and tumor of the papilla (n = 1).
Results: The mean patency period of the stents was 37.5 weeks (5–106 weeks). Recurrent obstructive jaundice occurred in two patients
(11%). Adequate biliary drainage over 50 weeks or until death was achieved in 17 of 18 patients (94.4%). Late cholangitis
was observed in two patients whose stents bridged the ampulla of Vater. Other late severe complications were not encountered.
Conclusion: Although more study is necessary, our results suggest the clinical efficacy of our covered Nitinol Strecker stent in the
management of obstructive jaundice caused by malignant diseases. 相似文献
12.
Spiral CT quantification of aorto-renal calcification and its use in the detection of atheromatous renal artery stenosis: A study in 42 patients 总被引:3,自引:0,他引:3
Gayard P Garcier JM Boire JY Ravel A Perez N Privat C Lucien P Viallet JF Boyer L 《Cardiovascular and interventional radiology》2000,23(1):17-21
Purpose: To investigate whether a correlation exists between aortic and renal arterial calcifications detected with spiral CT and
significant angiographic renal artery stenosis (RAS).
Methods: Forty-two patients (mean age 67 years, range 37–84 years), of whom 24 were hypertensive, prospectively underwent abdominal
helical CT and aortic and renal arteriography. The 3-mm thickness CT scans (pitch = 1) were reconstructed each millimeter.
A manual outline of the renal artery including its ostial portion was produced. Calcific hyperdensities were defined as areas
of density more than 130 HU. CT data were compared with the presence or absence of RAS on angiography (24 cases); hypertension
and age were taken into account (Mann-Whitney U-test).
Results: CT detection and quantification appeared to be reliable and reproductible. We did not find any correlation between aortic
and renal arterial calcifications and RAS, even for the patients above 65 years, with or without hypertension. There was no
correlation either between calcifications and hypertension in patients without RAS.
Conclusion: In this population, aortic and renal arterial calcifications have no predictive value for RAS. 相似文献
13.
Paci E Antico E Candelari R Alborino S Marmorale C Landi E 《Cardiovascular and interventional radiology》2000,23(6):472-474
We report a case of a pseudoaneurysm of the common hepatic artery treated with a stent-graft in a 67-year-old man. The patient
presented with severe catheter bleeding through a drain following surgical and interventional procedures performed for therapeutic
management of a choledochal cholangiocarcinoma. Selective hepatic arteriography showed a pseudoaneurysm close to the origin
of the gastroduodenal artery. After a preliminary attempt at arterial embolization, it was decided to use a stent-graft to
bridge the false aneurysm. Complete pseudoaneurysm exclusion was seen after the procedure with preservation of hepatic arterial
flow. 相似文献
14.
Emergency endovascular treatment of an acute traumatic rupture of the thoracic aorta complicated by a distal low-flow syndrome 总被引:3,自引:0,他引:3
Guy Bruninx M.D. Didier Wery Eric Dubois Badih El Nakadi Eric Van Dueren Guy Verhelst Christian Delcour 《Cardiovascular and interventional radiology》1999,22(6):515-518
We report the case of a patient who suffered major trauma following a motorcycle accident that resulted in multiple fractures,
bilateral hemopneumothorax, pulmonary contusions, and an isthmic rupture of the aorta with a pseudoaneurysm compressing the
descending aorta. This compression was responsible for distal hypotension and low flow, leading to acute renal insufficiency
and massive rhabdomyolysis. Due to the critical clinical status of the patient, which prevented any type of open thoracic
surgery, endovascular treatment was performed. An initial stent-graft permitted alleviation of the compression and the re-establishment
of normal hemodynamic conditions, but its low position did not allow sufficient coverage of the rupture. A second stent-graft
permitted total exclusion of the pseudoaneurysm while preserving the patency of the left subclavian artery. 相似文献
15.
Fujiwara K Hayakawa K Nagata Y Hiraoka M Nakamura T Shimizu Y Ikada Y 《Cardiovascular and interventional radiology》2000,23(3):218-223
Purpose: We performed a basic investigation using white rabbits of the sustained release and embolizing effects of poly L-lactic acid
microspheres (PLA) to determine their usefulness for chemoembolization.
Methods: Fifteen male Japanese white rabbits were used. Sustained release of an embolizing material, EPI-PLA was accomplished with
1 mg of PLA containing 0.03 mg of epirubicin hydrochloride (EPI). Embolization with 50 mg of PLA (total dose of EPI 1.5 mg)
was performed after the renal artery of the rabbits was selected (Chemo-TAE group). A group in which a bolus of 1.5 mg EPI
alone was injected through the renal artery (TAI group) was established as a control group. Furthermore, a group in which
embolization was performed with 50 mg of PLA alone (TAE group) was also established. These three groups, each consisting of
five rabbits, were compared.
Results: Blood EPI levels were serially measured. The blood EPI level in the TAI group rapidly reached a peak more than 30 min after
injection, then decreased to almost zero 24 hr after injection. In the Chemo-TAE group, the blood EPI level was transiently
increased 30 min after embolization, but remained low thereafter until 24 hr after embolization. EPI levels in kidney tissue
isolated 24 hr after embolization were measured. In the Chemo-TAE group, the tissue EPI level was significantly higher than
that in the TAI group. When isolated kidneys were macroscopically and histologically examined, atrophy of the entire embolized
kidney, as well as infarction and necrosis in the renal cortex, were observed in both the TAE group and the Chemo-TAE group.
However, there were no such findings in the TAI group. The area of the infarction in the renal cortex did not significantly
differ between the Chemo-TAE group and the TAE group; however, there was vascular injury in the Chemo-TAE group and none in
the TAE group.
Conclusion: It was demonstrated that EPI-PLA, a chemoembolizing material, maintained high local concentrations of the anticancer drug,
while maintaining low blood levels of the anticancer drug. 相似文献
16.
Jens J. Froelich Martin Hoppe Christoph Nahrstedt Klemens H. Barth H. Joachim Wagner Klaus J. Klose 《Cardiovascular and interventional radiology》1997,20(6):452-456
Purpose: Luminal diameters measured in vivo by calibrated-catheter angiography and by intravascular ultrasound were correlated with
those obtained from pressure-fixed histologic cross-sections to determine the accuracy of both methods.
Methods: Angiographic and endosonographic diameter measurements were performed in the center of stents placed in the iliac arteries
of 10 miniature pigs and were compared with luminal and stent diameters in postmortem, pressure-fixed, histologic cross-sections
from identical locations.
Results: Compared with histologic diameters, magnification-corrected angiographic measurements still magnified vascular luminal diameters
by 0.7 ± 0.71 mm (r= 0.41, Pearson; p < 0.003, Wilcoxon, matched pairs), whereas intravascular ultrasound measurements proved to be almost identical to the histologic
lumina (r= 0.95, Pearson; p> 0.5, Wilcoxon, matched pairs). Similarly, stent diameters correlated well between endosonographic and histologic measurements
(r= 0.91; p= 0.002), and less well between angiographic and histologic diameters (r= 0.62; p= 0.002).
Conclusion: Since calibrated angiography still overestimates vascular lumina, endosonography is the preferred technique for accurate
in vivo measurements.
Received: 0/00/00/Accepted: 0/00/00 相似文献
17.
Growth characteristics and imaging properties of the morris hepatoma 3924a in ACI rats: A suitable model for transarterial chemoembolization 总被引:11,自引:0,他引:11
Trübenbach J Graepler F Pereira PL Ruck P Lauer U Gregor M Claussen CD Huppert PE 《Cardiovascular and interventional radiology》2000,23(3):211-217
Purpose: For experimental studies investigating modalities and efficacy of transarterial chemoembolization (TACE) in hepatocellular
carcinoma (HCC) an animal model resembling the human situation as closely as possible would be appropriate. Specifically,
reproducible tumor growth characteristics with the capability for appropriate in vivo imaging to monitor treatment efficacy
are required.
Methods: Morris hepatoma 3924A was implanted into the liver of 30 ACI rats. Tumor growth was followed by angiography (n = 10), ultrasound (US, n = 30), native computed tomography (CT, n = 16), and native magnetic resonance imaging (MRI, n = 30) between day 8 and day 36 after implantation. The radiological morphological characteristics were compared with the macroscopic
and microscopic histological findings of the explanted tumors.
Results: In all 30 animals a solitary liver tumor was found and macroscopically no signs of metastases, ascites, or peritoneal tumor
were visible. On histopathological examination tumor sizes ranged between 27 ± 3 mm3 (day 8) and 3468 ± 79 mm3 (day 36). The first signs of tumor necrosis occurred at day 16. US allowed tumor visualization from day 8, MRI from day 8,
angiography from day 10, and CT from day 14.
Conclusions: The tumor model has the potential to be used for the visualization of tumor growth by MRI and US. The potential for monitoring
therapeutic effects of TACE needs to be investigated. 相似文献
18.
Schulte-Altedorneburg G Droste DW Kollár J Hegedüs C Gomba S Ringelstein EB Csiba L 《Cardiovascular and interventional radiology》2000,23(4):312-314
Twenty carotid bifurcations were examined. During autopsy, carotid bifurcations were removed in toto. Unfixed carotids were
ligated and cannulated for injection of an angiographic contrast medium followed by injection of a tissue-embedding medium
at physiologic pressure and temperature. The carotid bifurcation was frozen and cut manually in 3-mm cross-sections. Photographs
were then taken of every slice. Angiography, filling with tissue-embedding material, and sectioning were successful in all
cases. In the macropathologic sections, the extent, configuration and location of atherosclerotic lesions could be identified. 相似文献
19.
We present a simple guidewire insertion technique and a new way of prepping for the procedure for readvancement of partially
retracted Hickman catheters with the aid of a stiff hydrophilic guidewire. 相似文献
20.
Karl Schürmann Dierk Vorwerk Robert Uppenkamp Bernd Klosterhalfen Arno Bücker Rolf W. Günther 《Cardiovascular and interventional radiology》1998,21(3):189-198
Purpose: To compare intravascular ultrasound (IVUS) and angiography with histology in determining the degree of stent stenosis in
an in vivo experiment.
Methods: In 16 sheep, a total of 64 stents were implanted into the external iliac arteries. Two stents were inserted on either side.
Patency was followed by angiography and IVUS. Four types of stent were used: two Dacron-covered (Cragg Endopro and heparinized
Cragg Endopro) and two non-covered (Cragg and Memotherm stents). Eight animals were killed after 1 month, eight others after
6 months. Histological sections were prepared from the stented vessels. Measurements of the patent and total stent diameters
determined by IVUS, angiography, and histology were compared.
Results: Correlation between IVUS and angiography was 0.75, between IVUS and histology 0.77, and between angiography and histology
0.85. A mean stent stenosis of 17 ± 11% (range 0–51%) was found on angiography, of 10 ± 11% (0–46%) on IVUS, and of 20 ± 11%
(4%–49%) on histology. In comparison with histology, IVUS underestimated the degree of stenosis by 10 ± 8%, and angiography
underestimated it by 3 ± 6%. Resolution of IVUS was calculated to be about 0.35 mm and that of angiography to be about 0.15
mm.
Conclusion: Under experimental conditions, IVUS was not superior to angiography in determining the degree of stent stenosis in long-segment
stenoses of iliac artery stents, when measurements were correlated with histology. Angiography is sufficient for following
the patency of iliac artery stents. 相似文献