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1.
J Vasc Interv Radiol ; 34(4): 585-590.e2, 2023 04.
Article in English | MEDLINE | ID: mdl-36521791

ABSTRACT

Uterine fibroid embolization (UFE) procedures performed from 2013 to 2019 were reviewed. Seventy-two patients were treated with a standard protocol consisting of sedation, ketorolac, ondansetron, and overnight parenteral analgesics and antiemetics. Ninety-six patients were treated with a new protocol, which added transdermal scopolamine, lorazepam, and intravenous acetaminophen. Outpatient uterine fibroid embolization (OP-UFE) not requiring hospitalization was successful in 81.4% and 2.7% of patients treated with the new and old protocols, respectively (odds ratio [OR], 141.4; P < .0001). Procedural fentanyl doses were lower with the new protocol than with the old one (mean, 148 vs 186 mcg; P = .0016). In the new protocol subset, patients were 1.01 times more likely to fail OP-UFE for every microgram increase in procedural fentanyl (OR, 0.99, P = .009), and those presenting with pain were less likely to succeed with OP-UFE than those with bleeding or bulk symptoms (OR, 0.31, P = .04). In conclusion, decreasing the opioid dose while increasing the antiemetic and nonopioid analgesic medications improves the chances of same day discharge after UFE.


Subject(s)
Embolization, Therapeutic , Leiomyoma , Uterine Neoplasms , Female , Humans , Leiomyoma/diagnostic imaging , Leiomyoma/therapy , Uterine Neoplasms/diagnostic imaging , Uterine Neoplasms/therapy , Embolization, Therapeutic/adverse effects , Embolization, Therapeutic/methods , Pain/etiology , Fentanyl , Nausea/etiology , Hospitalization , Hospitals
2.
J Comput Assist Tomogr ; 39(5): 752-9, 2015.
Article in English | MEDLINE | ID: mdl-26295189

ABSTRACT

OBJECTIVE: The aims of this study were to support the standard clinical assumption that preferential right-sided injection (RSI) over left-sided injection (LSI) results in improved head and neck computed tomography angiograms and to determine which patients most benefit from RSIs. METHODS: Head and neck computed tomography angiograms of 453 RSIs and 419 LSIs were included. Interactions between injection side, age, weight, body mass index, and left ventricular ejection fraction with mean vessel Hounsfield units (HU) were compared. Statistical analysis was performed using 2-tailed Student t tests, Mann-Whitney U tests, and simple linear (SL) and multiple linear regressions. RESULTS: Right-sided injection yielded higher HU for patients older than 40 years (eg, RSI of the right common carotid artery [RCCA] vs LSI of the RCCA; P < 0.01). Body mass index (eg, RCCA; r = -0.31, P < 0.01 [SL]) and weight (eg, RCCA; r = -0.39, P < 0.01 [SL]) were negatively correlated with HU. Female had higher HU (mean ± SE, +39.7 ± 7.6 HU; P < 0.01 [multiple linear]). Left ventricular ejection fraction had no interactions with injection side or HU. CONCLUSIONS: The findings support preferential RSI in patients older than 40 years with higher body mass index and weight, particularly male.


Subject(s)
Body Weight , Cardiac Output , Carotid Arteries/diagnostic imaging , Cerebral Arteries/diagnostic imaging , Contrast Media/administration & dosage , Tomography, X-Ray Computed , Adolescent , Adult , Aged , Aged, 80 and over , Angiography/methods , Body Mass Index , Child , Female , Head/blood supply , Head/diagnostic imaging , Humans , Jugular Veins/diagnostic imaging , Male , Middle Aged , Neck/blood supply , Neck/diagnostic imaging , Radiographic Image Enhancement , Sex Factors , Young Adult
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