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Objective: To investigate the DSA manifestations of the portosystemic collateral vessels (PSCV) in the patients with decompensated cirrhotic portal hypertension (DCPH) and the feasibility of portovenography performed with catheterizing in the portal vein directly through TIPS. Methods: Totally 274 patients with DCPH who were treated with TIPS were enrolled and retrospectively analyzed. DSA was directly performed with catheterizing in the superior mesenteric vein and splenic vein through TIPS, respectively. DSA manifestations of PSCV were observed and described. And PSCV were classified based on the manifestations. Results: All 274 patients were successfully treated with portal vein angiography and TIPS, and no postoperative complications occurred. According to the origin, PSCV could be classified into four types, including branch of portal vein type (2.55% [7/274]), which were blood to hepatic and mainly by shunt; main portal vein type (23.36% [64/274]), which were blood leaving hepatic with large blood flow; tributaries of the portal vein type (12.77% [35/274]), which were blood leaving hepatic with various ways to systemic circulation; multi-sources type (61.31% [168/274]), which were supplied by multiple origins. Conclusion: Direct portovenography through TIPS is safe and feasible,which can display classification of PSCV, including branch of portal vein type, main portal vein type, tributaries of portal vein type and multi-sources type, all having different hemodynamic characteristics.
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PURPOSE: To evaluate the influence of retinal collateral vessels in eyes with macular edema secondary to branch retinal vein occlusion (BRVO) treated with intravitreal bevacizumab (IVB). METHODS: We reviewed the medical records of patients with BRVO who were followed up for 12 months. To compare formations of collateral vessels, the patients were divided into 2 groups. The treatment group included 20 patients (20 eyes) treated with IVB, and the control group included 41 patients (41 eyes) without treatment. RESULTS: In the treatment group, the mean age was 58.4 ± 9.5 years. The average number of IVB injections performed during the 12 months was 4.5 ± 2.5 (range 2 to 8). After 12 months from diagnosis, 13 eyes (65%) presented with collateral vessels. In the control group, the mean age was 60.6 ± 9.3 years and 28 eyes (68.3%) presented with collateral vessel after 12 months. There was no difference in incidence of collateral vessel formation between the treatment group and the control group (p = 0.574). CONCLUSIONS: IVB does not influence the formation of retinal collateralization in eyes treated for macular edema secondary to BRVO.
Subject(s)
Humans , Diagnosis , Incidence , Macular Edema , Medical Records , Retinal Vein Occlusion , Retinal Vein , Retinaldehyde , BevacizumabABSTRACT
PURPOSE: To evaluate the influence of retinal collateral vessels in eyes with macular edema secondary to branch retinal vein occlusion (BRVO) treated with intravitreal bevacizumab (IVB). METHODS: We reviewed the medical records of patients with BRVO who were followed up for 12 months. To compare formations of collateral vessels, the patients were divided into 2 groups. The treatment group included 20 patients (20 eyes) treated with IVB, and the control group included 41 patients (41 eyes) without treatment. RESULTS: In the treatment group, the mean age was 58.4 ± 9.5 years. The average number of IVB injections performed during the 12 months was 4.5 ± 2.5 (range 2 to 8). After 12 months from diagnosis, 13 eyes (65%) presented with collateral vessels. In the control group, the mean age was 60.6 ± 9.3 years and 28 eyes (68.3%) presented with collateral vessel after 12 months. There was no difference in incidence of collateral vessel formation between the treatment group and the control group (p = 0.574). CONCLUSIONS: IVB does not influence the formation of retinal collateralization in eyes treated for macular edema secondary to BRVO.
Subject(s)
Humans , Diagnosis , Incidence , Macular Edema , Medical Records , Retinal Vein Occlusion , Retinal Vein , Retinaldehyde , BevacizumabABSTRACT
Objective To evaluate the efficacy of transcatheter arterial chemoembolization through left inferior phrenic artery (LIPA) in hepatocellular carcinoma (HCC) feeded by LIPA. Methods Angiographic data of 187 HCC patients were retrospectively analyzed. Five patients with LIPA feeding HCC were diagnosed and successfully treated with TACE through LIPA. Results All 5 patients underwent CT and angiography after 3 months, 3 of them achieved complete remission. LIPA recanalized in the other 2 patients, then these 2 patients underwent TACE through LIPA again. Conclusion LIPA could formed lateral branch to feed HCC. TACE through LIPA is safe and effective.
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Experiments show that collaterals that develop and maturate in branch retinal vein occlusion (BRVO) are helpful in the drainage of blood from a blocked area to an adjacent area. Laser treatment on the nonperfusion area can reduce the retinal blood inflow that can impair the formation of collateral vessels. Furthermore, if collaterals were accidentally destroyed by laser photocoagulation, leakage and neovascularization would increase. Forty-five patients with BRVO were reviewed retrospectively. Collateral vessels were noted from angiographic analysis in 27 of 45 (60%) patients. Good visual prognosis was noted in the patients with collaterals. Cases with neovascularization underwent laser treatment. In one case, laser photocoagulation was applied to the collateral vessels accidentally, after which the leakage significantly increased on fluorescein angiography. In conclusion, collateral vessels in BRVO have a favorable effect on visual prognosis. Careful laser treatment is recommended to avoid destroying collaterals in BRVO.
Subject(s)
Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Collateral Circulation , Fluorescein Angiography , Prognosis , Retinal Neovascularization/diagnosis , Retinal Vein Occlusion/diagnosis , Retrospective Studies , Visual AcuityABSTRACT
Objective To observe the changes in sublingual collateral vessels of elderly patients with diabetes. Methods Sublingual collateral vessels of 88 patients with diabetes were observed and compared with that of 76 normal people. Results The changes in sublingual collateral vessels of patients with diabetes were more serious than that of normal people (u=4.174, P
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Cerebral dural sinus thrombosis(CDST) has been described as a rare disease with a variety of patho-etiological factors. The diagnosis of CDST is difficult due to various symptoms and signs, none of which is specific to CDST. But timely diagosis is critical for effective management. The introduction and widespread use of computed tomography(CT), magnetic resonance imaging(MRI) and cerebral angiography made early diagnosis of CDST possible. In particular, MR venography is the most useful tool for establishing a correct diagnosis quickly. In early literature, mortality ranked between 30% and 50% but in more recent series it is between 5.5% and 30%. With the advent of diagnostic and therapeutic tools, early diagnosis and proper management has made the prognosis better. The appropriate therapy for CDST, however, has been the subject of much cortroversy. Individual variations of the venous system and collateral vessels are key factors to decide the proper treatment. In this report, we present two cases with symptomatic CDST treated without open surgical or direct endovascular interventions with good outcome.
Subject(s)
Cerebral Angiography , Diagnosis , Early Diagnosis , Mortality , Phlebography , Prognosis , Rare Diseases , Sinus Thrombosis, IntracranialABSTRACT
Cavernous transformation of the portal vein is a rare condition probably arising secondary to extrahepatic portal vein thrombosis or obstruction with recannalization and/or collateral veins formation to bypass the obstruction. It is believed that cavernous transformation of the portal vein is caused by a variety of diseases associated with periportal collateral development and hepatopedal flow. It is known that portal vein occlusion, which is the actual cause of cavernous transformation, has a wide variety of etiologies, such as congenital abnormalities, omphalitis, pancreatitis, various carcinoma, and liver cirrhosis. In most cases, the revealing symptom is upper gastrointestinal bleeding. Rarely, however, diagnosis is made from obstructive jaundice. Extensive collateral veins due to portal vein occlusion may compress and narrow the biliary tract. A 39-year-old man was admitted due to jaundice and abdominal discomfort for 1 month. He was confirmed to have obstructive jaundice due to collateral vessels of cavernous transformation of the portal vein. We report a case of obstructive jaundice caused by cavernous transformation of the portal vein.