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1.
Background and Purpose
Radiofrequency ablation (RFA) is associated with low neural morbidity compared with surgery, which commonly causes debilitating long-term pain. The purpose was to review the thoracic neural anatomy relevant to percutaneous RFA and to retrospectively review symptomatic nerve injury after lung RFA at our institution.Materials and Methods
We retrospectively examined all symptomatic nerve injuries occurring after computed tomography (CT)-guided RFA treatment of lung tumors for 462 patients/509 procedures/708 lesions treated at our large tertiary referral centre during 10 years.Results
Eight patients experienced neurological complications after heating during the RFA procedure. These complications occurred in the phrenic (n = 1), brachial (n = 3), left recurrent (n = 1), and intercostal nerves (n = 2) and the stellate ganglion (n = 1). Three were grade 2, four grade 3 and one grade 4 injuries (CTCAE v3).Conclusion
Although rare, neurological complications can occur after RFA, and they can occasionally be severe. To prevent these complications, it is important for the interventional radiologist to be aware of the anatomy of nervous structures and to attempt to identify nerves on CT scans during the RFA procedure. Creating a pneumothorax can be useful to avoid nerve damage and related clinical complications.2.
J. Raupach M. Lojik V. Chovanec O. Renc M. Strýček P. Dvořák P. Hoffmann I. Guňka A. Ferko P. Ryška N. Omran A. Krajina P. Čabelková E. Čermáková R. Malý 《Cardiovascular and interventional radiology》2016,39(2):195-203
Purpose
Retrospective evaluation of 12-year experience with endovascular management of acute mesenteric ischemia (AMI) due to embolic occlusion of the superior mesenteric artery (SMA).Materials and methods
From 2003 to 2014, we analysed the in-hospital mortality of 37 patients with acute mesenteric embolism who underwent primary endovascular therapy with subsequent on-demand laparotomy. Transcatheter embolus aspiration was used in all 37 patients (19 women, 18 men, median age 76 years) with embolic occlusion of the SMA. Adjunctive local thrombolysis (n = 2) and stenting (n = 2) were also utilised.Results
We achieved complete recanalization of the SMA stem in 91.9 %. One patient was successfully treated by surgical embolectomy due to a failed endovascular approach. Subsequent exploratory laparotomy was performed in 73.0 % (n = 27), and necrotic bowel resection in 40.5 %. The total in-hospital mortality was 27.0 %.Conclusion
Primary endovascular therapy for acute embolic SMA occlusion with on-demand laparotomy is a recommended algorithm used in our centre to treat SMA occlusion. This combined approach for the treatment of AMI is associated with in-hospital mortality rate of 27.0 %.3.
Dongho Hyun Sung Ki Cho Sung Wook Shin Kwang Bo Park Hong Suk Park Sung Wook Choo Young Soo Do In-wook Choo Min Woo Lee Hyunchul Rhim Hyo Keun Lim 《Cardiovascular and interventional radiology》2016,39(3):417-425
Purpose
To report the results of combined therapy with transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) for early stage hepatocellular carcinoma (HCC) considered infeasible for ultrasound (US)-guided RFA in comparison with those of TACE monotherapy.Methods
From January 2007 through December 2010, 91 patients with early or very early stage HCC infeasible for US-guided RFA received either TACE alone (TACE group; n = 54) or TACE immediately followed by RFA (TACE–RFA group; n = 37) as a first-line treatment. 1-month tumor response, time to progression (TTP), and overall survival (OS) rates were calculated. Univariate and multivariate analyses were performed to identify prognostic factors.Results
TACE–RFA group showed a better 1-month tumor response than TACE group (P < .001). The mean TTP was 29.7 ± 3.4 months (95 % confidence intervals [CIs] 23.0–36.5) in TACE group and 34.9 ± 2.8 months (95 % CIs 29.4–40.4) in TACE–RFA group. TACE–RFA group had a significantly longer TTP (P = .014). Cumulative 1-, 2-, and 3-year OS rates in the TACE and TACE–RFA groups were 91, 79, and 71 % and 100, 97, and 93 %, respectively (P = .008). Initial treatment of TACE was found to be the only significant risk factor for tumor progression and OS in multivariate analysis.Conclusion
TACE–RFA combination therapy appears superior to TACE monotherapy in terms of 1-month tumor response, TTP, and OS when performed for early stage HCC infeasible for US-guided RFA.4.
Aukje A. J. M. van Tilborg Hester J. Scheffer Marcus C. de Jong Laurien G. P. H. Vroomen Karin Nielsen Cornelis van Kuijk Petrousjka M. P. van den Tol Martijn R. Meijerink 《Cardiovascular and interventional radiology》2016,39(10):1438-1446
Purpose
To retrospectively analyse the safety and efficacy of radiofrequency ablation (RFA) versus microwave ablation (MWA) in the treatment of unresectable colorectal liver metastases (CRLM) in proximity to large vessels and/or major bile ducts.Method and Materials
A database search was performed to include patients with unresectable histologically proven and/or 18F–FDG–PET avid CRLM who were treated with RFA or MWA between January 2001 and September 2014 in a single centre. All lesions that were considered to have a peribiliary and/or perivascular location were included. Univariate logistic regression analysis was performed to assess the distribution of patient, tumour and procedure characteristics. Multivariate logistic regression was used to correct for potential confounders.Results
Two hundred and forty-three patients with 774 unresectable CRLM were ablated. One hundred and twenty-two patients (78 males; 44 females) had at least one perivascular or peribiliary lesion (n = 199). Primary efficacy rate of RFA was superior to MWA after 3 and 12 months of follow-up (P = 0.010 and P = 0.022); however, after multivariate analysis this difference was non-significant at 12 months (P = 0.078) and vanished after repeat ablations (P = 0.39). More CTCAE grade III complications occurred after MWA versus RFA (18.8 vs. 7.9 %; P = 0.094); biliary complications were especially common after peribiliary MWA (P = 0.002).Conclusion
For perivascular CRLM, RFA and MWA are both safe treatment options that appear equally effective. For peribiliary CRLM, MWA has a higher complication rate than RFA, with similar efficacy. Based on these results, it is advised to use RFA for lesions in the proximity of major bile ducts.5.
Yuichi Sugino Koichiro Yamakado Takashi Yamanaka Masashi Fujimori Atsuhiro Nakatsuka Haruyuki Takaki Yoshiyuki Takei Hajime Sakuma Shuji Isaji 《Japanese journal of radiology》2017,35(5):254-261
Purpose
To retrospectively evaluate the role of curative treatment in patients with intermediate-stage hepatocellular carcinomas (HCCs), and to identify the subgroup having benefit from curative treatment.Methods
From April 2000 to December 2014, 100 patients with intermediate-stage HCCs underwent either curative treatment (hepatectomy: n = 23, radiofrequency ablation (RFA); n = 29, both: n = 4) or transarterial chemoembolization (TACE): n = 44) as initial treatments for HCCs. Overall survival, influence of treatment allocation on prognosis, and factors affecting treatment allocation were evaluated.Results
The 5-year survival rate was 59.2% [95% confidence interval (CI) 51.6–66.8%] in the curative group, and 25.1% (95% CI 11.5–38.7%) in the TACE group. Treatment allocation was the only significant prognostic factor (p = 0.014, hazard ratio: 0.382, 95% CI 0.177–0.821). The curative group consisted of more patients with Child-Pugh A (p = 0.0016) than the TACE group, a tumor number of 3 or fewer (p < 0.0001), a unilobar tumor location (p = 0.02), within 4 of 7 cm criterion (p = 0.001), and within up-to-7 criterion (p = 0.04). Child-Pugh A, within the 4 of 7 cm criterion, and a unilobar tumor location were significantly linked with treatment allocation in multivariate analysis.Conclusions
Curative treatment can prolong survival in selected patients with intermediate-stage HCCs.6.
Yusuke Matsui Takao Hiraki Hideo Gobara Toshihiro Iguchi Hiroyasu Fujiwara Takahiro Kawabata Takatsugu Yamauchi Takuya Yamaguchi Susumu Kanazawa 《Cardiovascular and interventional radiology》2016,39(6):894-901
Introduction
Computed tomography (CT) fluoroscopy-guided renal cryoablation and lung radiofrequency ablation (RFA) have received increasing attention as promising cancer therapies. Although radiation exposure of interventional radiologists during these procedures is an important concern, data on operator exposure are lacking.Materials and Methods
Radiation dose to interventional radiologists during CT fluoroscopy-guided renal cryoablation (n = 20) and lung RFA (n = 20) was measured prospectively in a clinical setting. Effective dose to the operator was calculated from the 1-cm dose equivalent measured on the neck outside the lead apron, and on the left chest inside the lead apron, using electronic dosimeters. Equivalent dose to the operator’s finger skin was measured using thermoluminescent dosimeter rings.Results
The mean (median) effective dose to the operator per procedure was 6.05 (4.52) μSv during renal cryoablation and 0.74 (0.55) μSv during lung RFA. The mean (median) equivalent dose to the operator’s finger skin per procedure was 2.1 (2.1) mSv during renal cryoablation, and 0.3 (0.3) mSv during lung RFA.Conclusion
Radiation dose to interventional radiologists during renal cryoablation and lung RFA were at an acceptable level, and in line with recommended dose limits for occupational radiation exposure.7.
Masaya Miyazaki Yasuaki Arai Akira Myoui Hideo Gobara Miyuki Sone Daniel I. Rosenthal Yoshito Tsushima Susumu Kanazawa Shigeru Ehara Keigo Endo 《Cardiovascular and interventional radiology》2016,39(10):1464-1470
Purpose
This multicenter prospective study was conducted to evaluate the safety and efficacy of percutaneous radiofrequency ablation (RFA) for painful osteoid osteoma (OO).Materials and Methods
Patients with OO (femur: n = 17, tibia: n = 2, humerus: n = 1, rib: n = 1) were enrolled and treated with RFA. In phase I, nine patients were evaluated for safety. In phase II, 12 patients were accrued, and an intent-to-treat analysis was performed on all patients. The primary endpoint was to evaluate the treatment safety. The secondary endpoint was to evaluate the efficacy for pain relief by the visual analogue scale (VAS) at 4 weeks after RFA. Treatment efficacy was classified as significantly effective (SE) when VAS score decreased by ≥5 or score was <2, moderately effective when VAS score decreased by <5–≥2 and score was ≥2, and not effective (NE) when VAS score decreased by <2 or score was increased. Cases where the need for analgesics increased after treatment were also NE.Results
RFA procedures were completed in all patients. Minor adverse effects (AEs) were observed as 4.8–14.3 % in 12 patients, and no major AEs were observed. Mean VAS score was 7.1 before treatment, 1.6 at 1 week, 0.3 at 4 weeks, and 0.2 at 3 months. All procedures were classified as SE. Pain recurrence was not noted in any patient during follow-up (mean: 15.1 months).Conclusion
RFA is a safe, highly effective, and fast-acting treatment for painful extraspinal OO. Future studies with a greater number of patients are needed.8.
Amanda Formosa Denise May Santos Daniel Marcuzzi Andrew A. Common Vikramaditya Prabhudesai 《Cardiovascular and interventional radiology》2016,39(4):606-610
Purpose
Catheter-directed computed tomography angiography (CCTA) has been shown to reduce the contrast volumes required in conventional CTA, thus minimizing the risk of contrast-induced nephropathy (CIN).Materials and Methods
A retrospective analysis was performed on cases where CCTA was used to assess access vessels prior to transfemoral aortic valve implantation (TAVI, n = 53), abdominal aortic aneurysm assessment for endovascular aneurysm repair (EVAR, n = 11), and peripheral vascular disease (PVD, n = 24).Results
We show that CCTA can image vasculature with adequate diagnostic detail to allow assessment of lower extremity disease, anatomic suitability for EVAR, as well as potential contraindications to TAVI. Average contrast volumes for pre-TAVI, pre-EVAR, and PVD cases were 7, 11, and 28 mL, respectively.Conclusion
This study validates the use of CCTA in obtaining diagnostic images of the abdominal and pelvic vessels and in imaging lower extremity vasculature.9.
Maria Pantelidou Ben Challacombe Andrew McGrath Matthew Brown Shahzad Ilyas Konstantinos Katsanos Andreas Adam 《Cardiovascular and interventional radiology》2016,39(11):1595-1603
Introduction
The authors compared the oncologic outcomes of radiofrequency ablation (RFA) with robotic-assisted partial nephrectomy (RPN) for the treatment of T1 stage renal cell carcinoma (RCC).Materials and methods
This was a retrospective data analysis of a high-volume single tertiary centre. Patients were treated with RFA or RPN following multidisciplinary decision making. Only histologically proven RCCs were included. Baseline demographics were collected, and PADUA scores of tumour features were calculated to standardize baseline anatomy. Peri-operative complications, kidney function and oncological outcomes were compared.Results
Sixty-three cases were included in each group. Baseline renal function was poorer in RFA, and 16/63 RFA patients had tumours in single kidneys compared to 1/63 RPN cases (p < 0.001). Length of stay was shorter in RFA (1 vs. 3 days, p < 0.0001). Post-procedure renal function decline at 30 days was significantly less in RFA [(?0.8) ± 9.6 vs. (?16.1) ± 19.5 mls/min/1.73 m2; p < 0.0001]. More minor complications were recorded in RPN (10/63 vs. 4/63, p = 0.15), but local recurrence was numerically higher in RFA (6/63 vs. 1/63, p = 0.11). Disease-free survival (DFS) was not significantly different (adjusted HR = 0.6, 95 % Cl 0.1–3.7; p = 0.60). Increasing tumour size was an independent predictor of local recurrence (adjusted HR = 1.7; 95 % Cl 1.1–2.6 per cm; p = 0.02).Conclusions
Both RPN and RFA offer very good oncological outcomes for the treatment of T1 RCC with low peri-operative morbidity and similar oncologic outcomes. RFA demonstrated fewer peri-operative complications and better preservation of renal function, whereas RPN had an insignificantly lower local recurrence rate. RFA should be offered alongside RPN for selected cases.10.
11.
Sachiko Achiwa Shozo Hirota Yasukazu Kako Haruyuki Takaki Kaoru Kobayashi Koichiro Yamakado 《Japanese journal of radiology》2017,35(4):206-214
Purpose
We evaluated anatomical variations of spontaneous splenorenal shunt (SSRS) and the prevalence of portosystemic shunts in patients with chronic liver disease by CT.Materials and methods
A total of 451 patients with chronic liver disease underwent contrast-enhanced computed tomography between October 2010 and April 2011. The prevalence of portosystemic shunts including SSRS and gastrorenal shunt, and the frequency of hepatic encephalopathy were examined. The course of the shunt and the point of confluence with the renal vein of the SSRS were analyzed.Results
SSRSs or gastrorenal shunts were found in 11.1 and 5.0% of the patients, respectively. Anatomical variations were classified into three types according to the point of confluence as follows: type 1 = the SSRS joined the inferior phrenic vein (n = 33), type 2 = the SSRS joined the gonadal vein (n = 7), and type 3 = the SSRS joined the left renal vein (n = 14). The course of the SSRS from the splenic hilum was classified as medial (n = 46), posterior (n = 2), or anterolateral (n = 2).Conclusions
SSRSs were classified into three types depending on the confluence point with the renal vein, and into three types of course. These findings are useful for preoperative information.12.
Yasukazu Kako Koichiro Yamakado Wataru Jomoto Toshiya Nasada Koichiro Asada Haruyuki Takaki Kaoru Kobayashi Takashi Daimon Shozo Hirota 《Japanese journal of radiology》2017,35(7):366-372
Purpose
To evaluate changes in liver perfusion after occlusion of spontaneous portosystemic shunt and to analyze mechanisms of liver profile improvement.Materials and methods
Liver function changes and portal venous and hepatic arterial blood flow were evaluated using perfusion CT before and after shunt occlusion in 23 patients who underwent percutaneous occlusion of spontaneous portosystemic shunt because of gastric varices (n = 15) or hepatic encephalopathy (n = 8).Results
Portal venous blood flow was significantly higher at 1 week (278.7 ml/min, 92.7–636.7, p = 0.012), 1 month (290.0 ml/min, 110.1–560.1, p < 0.001) and 3 months (299.6 ml/min, 156.7–618.5, p = 0.033) after shunt occlusion than the baseline (220.9 ml/min, 49.5–566.7). Hepatic arterial liver blood flow became lower than the baseline (132.3 ml/min, 47.9–622.3) after shunt occlusion, but a significant decrease was observed only at 1 month later (107.9 ml/min, 45.8–263.6 p = 0.027). Serum albumin concentration became significantly higher than the baseline (3.4 mg/dl, 1.9–4.5) at 1 month (3.8 mg/dl, 2.3–4.3, p = 0.018) and 3 months (3.9 mg/dl, 2.6–4.3, p = 0.024) after shunt occlusion.Conclusion
Shunt occlusion increases portal venous blood flow and decreases hepatic arterial blood flow, thereby improving the liver profile.13.
Kaan Esen Yuksel Balci Sermin Tok Enver Ucbilek Engin Kara Omer Kaya 《Japanese journal of radiology》2017,35(9):526-531
Purpose
The purpose of this study is to evaluate the relationship between right inferior phrenic artery diameter and portal hypertension in cirrhotic patients.Methods
CT examinations of 38 patients with chronic liver disease (patient group) and 40 patients without any liver disease (control group) were evaluated. The right inferior phrenic artery diameter of the patient and control group were measured. CT findings of portal hypertension, which were accepted as ascites, collaterals, splenomegaly and portal vein diameter greater than 13 mm, were determined and scored in the patient group. Patients obtained scores between one and four with respect to portal hypertension findings, and the scores were compared with phrenic artery diameters. Child-Pugh and MELD scores of the patients were also calculated.Results
The mean diameter of the right inferior phrenic artery in the patient group was larger than that in the control group (p < 0.001). The mean phrenic artery diameter of the patients with score 1 was significantly different from those with score 2 (p = 0.028), score 3 (p = 0.001) and score 4 (p = 0.005). We found a linear and moderate relationship between phrenic artery diameter values and Child-Pugh scores (p = 0.012, r = 0.405).Conclusion
Dilatation of the right inferior phrenic artery in cirrhotic patients may be a nonspecific sign of developing portal hypertension.14.
Murakami R Hirai T Nakamura H Furusawa M Nakaguchi Y Uetani H Kitajima M Yamashita Y 《Japanese journal of radiology》2012,30(3):193-197
Purpose
To evaluate progression pattern and progression-free interval for patients with glioblastoma multiforme (GBM), on the basis of the extent of resection.Materials and methods
Between January 2000 and September 2009, 138 patients with GBM underwent postoperative radiation therapy and longitudinal magnetic resonance imaging studies. The operations were classified as biopsy, partial resection (PR), and gross total resection (GTR). Progression patterns were classified as gross tumor volume (GTV), T2 hyperintensity (T2h), distant, and free. We used the Kruskal–Wallis test to compare progression-free intervals on the basis of the extent of resection and the progression pattern.Results
Recurrence of biopsied and PR tumors at the GTV site was 100 and 97%, respectively. The median progression-free interval was 3 months for biopsied (n = 29), 4 months for PR (n = 70), and 8 months for GTR (n = 39) tumors (p < 0.05). The median progression-free interval for progression patterns classified as GTV (n = 97), T2h (n = 24), distant (n = 12), and free (n = 5) was 3 (p < 0.05), 7, 8, and 29 months, respectively.Conclusion
Control of the GTV can increase the progression-free interval because gross residual tumors progress earlier than infiltrating tumor cells do.15.
Fabio Corvino Francesco Giurazza Gianluca Cangiano Enrico Cavaglià Francesco Amodio Giuseppe De Magistris Antonio Corvino Raffaella Niola 《La Radiologia medica》2018,123(5):369-377
Purpose
Demonstrate the role of endovascular management in the treatment of internal mammary artery (IMA) injuries using transcatheter embolization reviewing our 7-year experience.Materials and methods
Our retrospective analysis of cases consists of a total of 12 patients (8 M and 4 F; mean age 52 years) who underwent angiographic studies and transcatheter embolization for IMA injuries. Causes of vascular injury were divided in high-energy trauma (n = 6), iatrogenic (n = 3) and penetrating injuries (n = 3). Type of trauma, associated injury, imaging findings, treatments and complications were assessed. Imaging findings included active haemorrhage, pseudoaneurysm and focal dissection.Results
Embolization was performed with microcoils in all patients; complete thrombosis was obtained in four patients by additional injection of Spongostan pledgets and in two patients with 300–500 μm particles. The technical success rate was 100%. No patient died as a direct result of vascular injury; one died of myocardial contusion and one for severe multiorgan failure related to high-energy trauma. No major and minor complications were registered. No patient required emergency surgery or subsequent surgical treatment.Conclusion
Transcatheter embolization offers an effective, efficient and safe alternative to conventional surgical management of IMA injuries.16.
Suk Hyun Lee Soyoung Jin Hyo Sang Lee Jin-Sook Ryu Jong Jin Lee 《Annals of nuclear medicine》2016,30(9):629-636
Objective
Metformin-induced [F-18] fluorodeoxyglucose (FDG) bowel uptake can hinder positron emission tomography/computed tomography (PET/CT) evaluation of the bowel. This study aimed to investigate the segmental bowel uptake of FDG according to metformin discontinuation times up to 72 h.Methods
We retrospectively divided 240 diabetic patients into four groups: metformin discontinuation <24 h (group A; n = 86), 24–48 h (group B; n = 40), 48–72 h (group C; n = 12), and no metformin (control group; n = 102). Segmental FDG bowel uptakes were measured visually (four-point scale) and semi-quantitatively (maximum standardized uptake value).Results
Compared with the control group, FDG uptake increased significantly from the ileum to the rectosigmoid colon in group A, from the transverse to the rectosigmoid colon in group B, and from the descending colon to the rectosigmoid colon in group C in both visual and semi-quantitative analyses.Conclusions
Metformin discontinuation for <72 h is likely suboptimal for PET/CT image interpretation, especially with respect to the distal segments of the colon.17.
Joseph N. Liu Michael E. Steinhaus Grant H. Garcia Brenda Chang Kara Fields David M. Dines Russell F. Warren Lawrence V. Gulotta 《Knee surgery, sports traumatology, arthroscopy》2018,26(1):100-112
Purpose
With increasing incidence and indications for shoulder arthroplasty, there is an increasing emphasis on the ability to return to sports. The main goal of this study was to determine the rate of return to sport after shoulder arthroplasty.Methods
The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed to perform this systematic review and meta-analysis. A search was performed on MEDLINE, Scopus, EMBASE, and the Cochrane Library. The quality of the included studies was evaluated according to the Methodological Index for Nonrandomized Studies checklist. The main judgement outcome was the rate of return to sports activity after shoulder arthroplasty and the level of play upon return (identical or higher/lower level).Results
Thirteen studies were reviewed, including 944 patients (506 athletes), treated with shoulder arthroplasty at an average follow-up of 5.1 years (range, 0.5–12.6 years). The most common sports were swimming (n = 169), golf (n = 144), fitness sports (n = 71), and tennis (n = 63). The overall rate of return to sport was 85.1% (95% CI, 76.5–92.3%), including 72.3% (95% CI, 60.6–82.8%) returning to an equivalent or improved level of play, after 1–36 months. Patients undergoing anatomic total shoulder arthroplasty returned at a significantly higher rate (92.6%) compared to hemiarthroplasty (71.1%, p = 0.02) or reverse total shoulder arthroplasty (74.9%, p = 0.003).Conclusion
Most patients are able to return to one or more sports following shoulder arthroplasty, with anatomic total shoulder arthroplasty having the highest rate of return.Level of evidence
IV.18.
Romain Seil Caroline Mouton Julien Coquay Alexander Hoffmann Christian Nührenbörger Dietrich Pape Daniel Theisen 《Knee surgery, sports traumatology, arthroscopy》2018,26(4):1080-1085
Purpose
The purpose of this study was to analyse patient and injury characteristics as well as arthroscopic findings in a prospective cohort of ACL-injured patients with or without an associated ramp lesion.Methods
Two hundred and twenty-four patients undergoing a primary (n = 196) or revision (n = 28) ACL reconstruction were included. The presence of a ramp lesion was determined by a systematic arthroscopic inspection of the posteromedial compartment. Chi-square tests were used to compare the population of ACL-injured patients with and without a ramp lesion regarding sex, age, body mass index, previous ACL injuries, sport before injury, and injury characteristics. Significance was set at p < 0.05.Results
Fifty-three out of 224 patients had a ramp lesion (24%). The presence of the latter was not related to any of the analysed patient characteristics. The prevalence of the lesion was higher in contact injuries (n = 19; 41%) compared with non-contact injures (n = 34; 19%; p < 0.001). It was higher in patients with complete ACL ruptures (n = 49; 27%) as opposed to partial ruptures (n = 1; 4%; p = 0.01). A patient was 2.98 [95% CI 1.49–5.98] times more likely to have a ramp lesion if the ACL injury was declared to have been caused by direct contact and 8.71 [95% CI 1.15–66.12] times more likely if the ACL tear was complete.Conclusion
Ramp lesions may be anticipated in almost one out of four patients undergoing ACL reconstruction, especially if a patient sustained a contact injury and in the presence of a complete ACL tear.Level of evidence
III.19.
Purpose
To evaluate transarterial embolization (TAE) for the management of anomalous systemic arterial (ASA) supply to normal basal segments of the lung.Methods
Thirteen patients with ASA supply to normal basal segments of the lung underwent TAE. All patients presented with hemoptysis and had complete-type anomalies on pre-TAE or post-TAE computed tomography (CT). The anomaly was unilateral in all patients; 11 lesions were located in the left lung and 2 in the right. All patients underwent embolization with coils (n = 10) or a vascular plug (n = 3). Procedural success, clinical efficacy, and complications were assessed. Mean post-TAE CT and clinical follow-up was 25.4 and 42.1 months, respectively.Results
Technical success was achieved in 100 % of cases. Several changes were noted on follow-up CT: complete obstruction of the ASA in all cases, normal (n = 11) or decreased (n = 2) density of the affected lung parenchyma, reduction of the primary enlarged inferior pulmonary vein in all cases, and pulmonary infarction and thickening of the corresponding bronchial artery (n = 4). The main complication was pulmonary infarction in four cases.Conclusion
TAE is a safe, effective, and minimally invasive therapeutic option for patients with ASA supply to normal basal segments of the lung.20.
Carl Todd Anna Swärd Aminoff Cecilia Agnvall Olof Thoreson Leif Swärd Jon Karlsson Adad Baranto 《Knee surgery, sports traumatology, arthroscopy》2018,26(7):1959-1965