ABSTRACT
PURPOSE: Hepatic venous transplant anastomotic pressure gradient measurement and transjugular liver biopsy are commonly used in clinical decision-making in patients with suspected anastomotic hepatic venous outflow obstruction. This investigation aimed to determine if sinusoidal dilatation and congestion on histology are predictive of hepatic venous anastomotic outflow obstruction, and if it can help select patients for hepatic vein anastomosis stenting. MATERIALS AND METHODS: This is a single-center retrospective study of 166 transjugular liver biopsies in 139 patients obtained concurrently with transplant venous anastomotic pressure gradient measurement. Demographic characteristics, laboratory parameters, procedure and clinical data, and histology of time-zero allograft biopsies were analyzed. RESULTS: No relationship was found between transplant venous anastomotic pressure gradient and sinusoidal dilatation and congestion (P = 0.92). Logistic regression analysis for sinusoidal dilatation and congestion confirmed a significant relationship with reperfusion/preservation injury and/or necrosis of the allograft at time-zero biopsy (OR 6.6 [1.3-33.1], P = 0.02). CONCLUSION: There is no relationship between histologic sinusoidal dilatation and congestion and liver transplant hepatic vein anastomotic gradient. In this study group, sinusoidal dilatation and congestion is a nonspecific histopathologic finding that is not a reliable criterion to select patients for venous anastomosis stenting.
ABSTRACT
The Association of American Medical Colleges announced the addition of preference signaling to the 2022-2023 residency match cycle for Diagnostic and Interventional Radiology. This new offering provided applicants the option to indicate their specific interest in up to 6 residency programs during initial application submission. Our institutional diagnostic radiology residency program received a total of 1294 applications. One hundred and eight applicants signaled the program. Interview invitations were sent to 104 applicants, 23 of which signaled the program. Out of the top 10 ranked applicants, 6 applicants signaled the program. Out of the 5 matched applicants, 80% used the program signal, and 100% did the geographic preference. Opting to signal programs during the initial application submission may be beneficial for both the applicants and the programs in finding the optimal match.
Subject(s)
Internship and Residency , Humans , Radiology, Interventional/educationABSTRACT
A 36-year-old woman with Ehlers-Danlos syndrome (EDS) presents with a painful and enlarging right lower extremity mass prompting imaging work up. Herein we present a case report of an uncommon complication and a unique treatment option of a large right anterior tibial artery pseudoaneurysm caused by repetitive microtrauma in a patient with EDS and a congenital club foot.
ABSTRACT
The chronic inflammatory skin condition hidradenitis suppurativa (acne inversa), characterized by hair follicle or apocrine gland infection, causes recurrent superficial nodules and abscesses in axillary, mammary, and perianal regions. Chronic reoccurrence results in fistula formation, causing scarring and fibrosis. Surgical excision of affected skin tissue with adequate free margins is the gold standard treatment to prevent recurrence. This case series describes 6 cases of radical excision of localized axillary hidradenitis suppurativa, with immediate or delayed perforator-based propeller flap defect closure. METHODS: All patients presenting for surgical treatment of hidradenitis suppurativa between 2016 and 2018 were identified from the hospital database. Only patients with hidradenitis suppurativa confined to the axilla were included. Patients with simple abscess incisions, recurrence after previous grafting/flap surgery, and extension of the disease outside the axilla region were excluded. Patient demographics, size of defect, complications, time of follow-up, recurrences, and level of patient satisfaction were documented. RESULTS: Six patients with localized axillary hidradenitis suppurativa were identified, with 8 propeller flap surgeries performed. Defect size was assessed by pathologic examination of excised specimens, ranging from 11-18 cm × 6-14 cm × 0.5-2 cm (length × width × depth). Seven of the eight wounds healed primarily. Functional and aesthetic results were satisfactory and there were no recurrences. The only observed complication was venous congestion following 1 flap procedure. CONCLUSION: These findings confirm that the propeller flap procedure can be effective for immediate or delayed defect closure after radical excision of localized axillary hidradenitis suppurativa, providing that no perifocal signs of infection are present after debridement.
