Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 10 de 10
Filter
Add more filters










Publication year range
2.
Clin Kidney J ; 11(4): 549-554, 2018 Aug.
Article in English | MEDLINE | ID: mdl-30094020

ABSTRACT

BACKGROUND: Several peritoneal dialysis catheter (PDC) placement techniques have been described. The objective of this study was to compare the fluoroscopy and ultrasound guidance technique with the laparoscopic technique. METHODS: We retrospectively reviewed the medical records of 260 patients who had their first PDC placed between January 2005 and June 2016. We compared the outcomes of the fluoroscopic and ultrasound-guided catheter placement technique (radiologic group, n = 50) with the laparoscopic catheter placement technique (laparoscopic group, n = 190). The primary endpoint was complication-free catheter survival at 365 days. Secondary endpoints were complication-free catheter survival at 90 days, overall catheter survival at 90 and 365 days, median days to first complication and median days to catheter removal. RESULTS: In the radiologic group, the complication-free catheter survival at 90 and 365 days was 64% and 48%, respectively, while in the laparoscopic group it was 71% (P = 0.374) and 53% (P = 0.494), respectively. Catheter malfunction was significantly higher in the laparoscopic group (30%) compared with the radiologic group (16%, P = 0.048). The overall catheter survival at 90 and 365 days was 76% and 52%, respectively, in the radiologic group, while in the laparoscopic group it was 88% (P = 0.0514) an 48% (P = 0.652), respectively. There was no significant difference in the median days to first complication and the median days to catheter removal between the two groups (P = 0.71). CONCLUSION: The technique of fluoroscopic and ultrasound-guided PDC placement is a clinically effective and safe alternative to laparoscopic catheter placement with similar survival and complication rates.

4.
Vasc Endovascular Surg ; 52(4): 291-294, 2018 May.
Article in English | MEDLINE | ID: mdl-29463206

ABSTRACT

Intracardiac migration is a rare complication of inferior vena cava filters (IVCFs) that poses a significant risk to patients. Both endovascular and surgical options exist, although only a few endovascular options are described in the literature. This brief report describes the endovascular approach used to successfully remove a TrapEase IVCF from the right atrium in a single patient. A brief review of the literature is also provided.


Subject(s)
Cardiac Catheterization , Device Removal/methods , Endovascular Procedures , Foreign-Body Migration/therapy , Heart Atria , Vena Cava Filters/adverse effects , Aged , Echocardiography , Foreign-Body Migration/diagnostic imaging , Foreign-Body Migration/etiology , Heart Atria/diagnostic imaging , Humans , Male , Tomography, X-Ray Computed , Treatment Outcome
5.
Curr Probl Diagn Radiol ; 47(6): 428-436, 2018 Nov.
Article in English | MEDLINE | ID: mdl-29103837

ABSTRACT

Pulmonary arteriovenous malformations (PAVM) are an uncommon entity that interventional radiologists may face in their clinical practice. Many of these lesions are treated successfully using endovascular techniques with satisfactory long-term results. However, some PAVMs respond poorly to initial interventional techniques. This article reviews the signs and symptoms of persistent PAVMs, illustrates different imaging modalities used to diagnose these lesions, and outlines mechanisms by which these lesions may persist. The article highlights techniques and embolic agents used for percutaneous transcatheter embolotherapy of persistent PAVMs and discuss the outcomes of these interventions.


Subject(s)
Arteriovenous Fistula/diagnostic imaging , Arteriovenous Fistula/therapy , Embolization, Therapeutic/methods , Pulmonary Artery/abnormalities , Pulmonary Veins/abnormalities , Arteriovenous Fistula/classification , Female , Humans , Male , Pulmonary Artery/diagnostic imaging , Pulmonary Veins/diagnostic imaging , Treatment Outcome
6.
Radiographics ; 37(3): 963-977, 2017.
Article in English | MEDLINE | ID: mdl-28362557

ABSTRACT

Transarterial chemoembolization (TACE) is considered a standard local-regional treatment for intermediate-stage hepatocellular carcinoma (HCC) and the most common bridging therapy. This treatment is offered to more than 70% of patients who are on the waiting list for liver transplantation in the United States. HCC typically receives its blood supply from the hepatic artery; however, it can recruit a parasitic supply from extrahepatic collateral (EHC) arteries. The development of an EHC arterial blood supply can interfere with the therapeutic efficacy of TACE and result in treatment failure and poor outcome. Cross-sectional imaging-specifically computed tomography and magnetic resonance imaging-has some limitations in depicting the presence or absence of an EHC arterial supply during the pre-TACE evaluation. Catheterization and angiography of every possible EHC artery during a routine TACE procedure would be time consuming and technically challenging and would not always be feasible. Therefore, the prediction of a potential EHC arterial supply on the basis of tumor location before, during, and after TACE is fundamental to achieving optimal therapeutic efficacy. To perform TACE through EHC arteries, special considerations are necessary to avoid potentially serious complications. The authors review the factors influencing the development of an EHC arterial blood supply to HCC and describe a systematic approach to enhance the ability to predict the presence of EHC arteries. They also describe the proper technique for TACE of each EHC artery and how to avoid potential technique-related complications. ©RSNA, 2017.


Subject(s)
Carcinoma, Hepatocellular/blood supply , Carcinoma, Hepatocellular/diagnostic imaging , Carcinoma, Hepatocellular/therapy , Chemoembolization, Therapeutic/methods , Liver Neoplasms/blood supply , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/therapy , Collateral Circulation , Humans
7.
Case Rep Urol ; 2016: 2186049, 2016.
Article in English | MEDLINE | ID: mdl-27019759

ABSTRACT

We present a case of refractory hemorrhagic radiation cystitis in a patient who failed conservative management and was unable to undergo operative urinary diversion secondary to multiple comorbidities. His management was complicated by recurrent obstruction of his nephrostomy catheters due to marked ureteral thrombus formation from blood refluxing into the ureters from the urinary bladder. We were successful in treating his condition by occluding his distal ureters with a combination of embolization coils and glue to prevent the reflux of blood in order to allow his nephrostomy catheters to function properly.

8.
J Radiol Case Rep ; 9(12): 37-43, 2015 Dec.
Article in English | MEDLINE | ID: mdl-27200175

ABSTRACT

We report a case of an indwelling inferior vena cava filter that penetrated the IVC wall after Whipple's pancreatico-duodenectomy procedure performed in a patient with ampullary carcinoma, resulting in right ureteral injury and obstruction with subsequent hydroureter and hydronephrosis. This was incidentally discovered on a computed tomography scan performed as routine follow up to evaluate the results of the surgery. We retrieved the inferior vena cava filter and placed a nephrostomy catheter to relieve the ureteral obstruction. Our case highlights the importance of careful inferior vena cava manipulation during abdominal surgery in the presence of an inferior vena cava filter, and the option of temporary removal of the filter to be placed again after surgery in order to avoid this complication, unless protection is required against clot migration during the surgical procedure.


Subject(s)
Adenocarcinoma/surgery , Pancreatic Neoplasms/surgery , Tomography, X-Ray Computed , Ureter/injuries , Ureteral Obstruction/diagnostic imaging , Ureteral Obstruction/etiology , Vena Cava Filters/adverse effects , Vena Cava, Inferior/injuries , Aged, 80 and over , Cholangiopancreatography, Endoscopic Retrograde , Device Removal , Humans , Male , Pancreaticoduodenectomy/adverse effects
10.
J Med Pract Manage ; 21(5): 280-4, 2006.
Article in English | MEDLINE | ID: mdl-16711094

ABSTRACT

This article reviews each of the five components of emotional intelligence, describes their relevance to the management of contemporary medical practices, and provides some practical steps health professionals and practice managers can take to enhance emotional intelligence. The benefits derived from such a review will necessarily vary from person to person and practice to practice, depending on the baseline from which we begin. Nevertheless, all of us can benefit from learning more about emotional intelligence.


Subject(s)
Expressed Emotion , Personnel Management/methods , Practice Management/organization & administration , Humans , Interprofessional Relations , United States
SELECTION OF CITATIONS
SEARCH DETAIL
...