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Clin Imaging ; 83: 123-130, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1803768


Although COVID-19 coagulopathy typically manifests with thrombotic complications, hemorrhagic complications also occur and must be considered when making decisions about anticoagulation in these patients. Here, we report a case of massive hemoptysis occurring in a recently post-partum woman via Cesarean section with COVID-19 who was managed via bronchial artery embolization while on extracorporeal membrane oxygenation.

COVID-19 , Embolization, Therapeutic , Extracorporeal Membrane Oxygenation , Bronchial Arteries/diagnostic imaging , Cesarean Section/adverse effects , Embolization, Therapeutic/adverse effects , Extracorporeal Membrane Oxygenation/adverse effects , Female , Hemoptysis/diagnostic imaging , Hemoptysis/etiology , Hemoptysis/therapy , Humans , Postpartum Period , Pregnancy , SARS-CoV-2
Clin Imaging ; 76: 123-129, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1454081


PURPOSE: Thermal ablation (TA) and transarterial chemoembolization (TACE) may be used alone or in combination (TACE+TA) for the treatment of hepatocellular carcinoma (HCC). The aim of our study was to compare the time to tumor progression (TTP) and overall survival (OS) for patients who received TA alone or TACE+TA for HCC tumors under 3 cm. MATERIALS AND METHODS: This HIPAA-compliant IRB-approved retrospective analysis included 85 therapy-naïve patients from 2010 to 2018 (63 males, 22 females, mean age 62.4 ± 8.5 years) who underwent either TA alone (n = 64) or TA in combination with drug-eluting beads (DEB)-TACE (n = 18) or Lipiodol-TACE (n = 3) for locoregional therapy of early stage HCC with maximum tumor diameter under 3 cm. Kaplan-Meier analysis was performed using the log-rank test to assess TTP and OS. RESULTS: All TA and TACE+TA treatments included were technically successful. TTP was 23.0 months in the TA group and 22.0 months in the TACE+TA group. There was no statistically significant difference in TTP (p = 0.64). Median OS was 69.7 months in the TA group and 64.6 months in the TACE+TA group. There was no statistically significant difference in OS (p = 0.14). The treatment cohorts had differences in AFP levels (p = 0.03) and BCLC stage (p = 0.047). Complication rates between patient groups were similar (p = 0.61). CONCLUSION: For patients with HCC under 3 cm, TA alone and TACE+TA have similar outcomes in terms of TTP and OS, suggesting that TACE+TA may not be needed for these tumors unless warranted by tumor location or other technical consideration.

Carcinoma, Hepatocellular , Chemoembolization, Therapeutic , Liver Neoplasms , Aged , Carcinoma, Hepatocellular/diagnostic imaging , Carcinoma, Hepatocellular/therapy , Combined Modality Therapy , Female , Humans , Liver Neoplasms/therapy , Male , Middle Aged , Retrospective Studies , Treatment Outcome