RESUMO
BACKGROUND: The novel low-profile p48 flow diverter has been designed to treat aneurysms on small vessels of 1.75-3mm. We report our first clinical experiences. METHODS: Between March 2018-January 2020, 22 patients with 25 aneurysms were treated with the p48 in 3 centers. One patient had 3 aneurysms covered by one p48 and one patient had 2 aneurysms. There were 5 men, 17 women, with a mean age of 55 years (median 59, range 29-73 years). RESULTS: In 25 aneurysms, 24 p48 flow diverters were placed. In 1 patient additional coils were placed in the aneurysm. Procedural vessel rupture by the micro guidewire occurred in 2 patients and vessel rupture during p48 balloon dilatation occurred in 1 patient. Overall, the permanent morbidity rate was 13.6% (3 of 22, 95%CI 3.9-34.2%) and mortality was 4.5% (1 of 22, 95%CI <0.01-23.5%). Most complications were procedure-related and not device-specific. Of 22 patients with 25 aneurysms treated with p48, 18 patients with 20 aneurysms had angiographic follow-up after 5-18 months. Of 19 aneurysms, 10 were occluded and 7 showed a remnant. Two aneurysms were open after 6 months. Three aneurysms were still not occluded after 12, 14, and 18 months and these 3 were retreated. Retreatment rate was 16% (3 of 19) and the adequate occlusion rate was 90% (17 of 19). CONCLUSIONS: Treatment of aneurysms in small-caliber vessels with the p48 is feasible and effective but is not without complications. More data is needed to establish indications, safety, and efficacy more accurately.
Assuntos
Embolização Terapêutica , Procedimentos Endovasculares , Aneurisma Intracraniano , Adulto , Idoso , Angiografia , Feminino , Humanos , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/terapia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Stents , Resultado do TratamentoRESUMO
It has become rare to find the typical radiological manifestations of primary hyperparathyroidism like generalized osteoporosis, brown tumors and advanced bone resorption because of the generalized usage of biochemical screening techniques. We present a 17-year-old patient with a parathyroid adenoma resulting in these typical skeletal manifestation throughout the skeleton combined with secondary bilateral slipped capital femur epiphysiolysis.
Assuntos
Epifise Deslocada/complicações , Cabeça do Fêmur/diagnóstico por imagem , Hiperparatireoidismo/complicações , Adolescente , Epifise Deslocada/diagnóstico por imagem , Humanos , Hiperparatireoidismo/diagnóstico por imagem , Hiperparatireoidismo/cirurgia , Tomografia Computadorizada por Raios XAssuntos
Anabolizantes/efeitos adversos , Doenças Musculares/induzido quimicamente , Doenças Musculares/diagnóstico , Adulto , Diagnóstico Diferencial , Humanos , Imageamento por Ressonância Magnética , Masculino , Doenças Musculares/cirurgia , Necrose , Tomografia Computadorizada por Raios X , Levantamento de PesoRESUMO
Ectopic pancreatic tissue has the same characteristics than normal pancreatic tissue.Therefore it may be affected by the same diseases. We report a rare cause of epigastric pain due to gastric heterotopic pancreatitis.The rare diagnosis was suspected by ultrasound and CT and definitively confirmed by echo-endoscopic guided biopsies.
Assuntos
Abdome Agudo/diagnóstico por imagem , Coristoma/diagnóstico por imagem , Pâncreas , Pancreatite/diagnóstico por imagem , Gastropatias/diagnóstico por imagem , Adulto , Diagnóstico Diferencial , Gastroscopia , Humanos , Masculino , UltrassonografiaRESUMO
Takotsubo cardiomyopathy is an important differential diagnosis in patients with an acute coronary syndrome. This syndrome is typically characterized by a reversible contractile dysfunction of the left ventricular myocardium without any obstructive etiological coronary disease. This is not a rare entity in acute settings and a better knowledge of the syndrome could result in a heightened alertness and a higher detection. We present a case of takotsubo showing the importance of cardiac MRI in the differential diagnosis and reviewed the present literature concerning this syndrome and the usefulness of MRI in the detection.
Assuntos
Cardiomiopatia de Takotsubo/diagnóstico , Diagnóstico Diferencial , Eletrocardiografia , Feminino , Humanos , Imageamento por Ressonância Magnética , Pessoa de Meia-IdadeAssuntos
Malformações Arteriovenosas/diagnóstico por imagem , Artéria Pulmonar/diagnóstico por imagem , Veias Pulmonares/diagnóstico por imagem , Adulto , Meios de Contraste , Diagnóstico Diferencial , Humanos , Imageamento Tridimensional , Intensificação de Imagem Radiográfica , Telangiectasia Hemorrágica Hereditária/complicações , Tomografia Computadorizada Espiral/métodosRESUMO
Since its introduction in 2002, transcatheter aortic valve implantation (TAVI) has assumed growing importance in the treatment of patients with severe aortic stenosis (AS), because it offers a much less invasive alternative for those in high risk for surgery. Good early results and advances in percutaneous valve technology have led to a substantial increase in procedural success rate and number of patients undergoing this less invasive treatment. Pre-procedural screening of several anatomic factors to assess the feasibility of this technique is important. Multidetector row computed tomography (MDCT) is the technique of choice in assessing these factors.This technical note aims to describe and illustrate the key elements that need to be evaluated before the procedure.
Assuntos
Estenose da Valva Aórtica/diagnóstico por imagem , Valva Aórtica/diagnóstico por imagem , Implante de Prótese de Valva Cardíaca , Próteses Valvulares Cardíacas , Tomografia Computadorizada Multidetectores/métodos , Valva Aórtica/cirurgia , Estenose da Valva Aórtica/cirurgia , Humanos , Complicações Pós-Operatórias/prevenção & controle , Cuidados Pré-Operatórios , Desenho de Prótese , Doses de RadiaçãoRESUMO
The purpose of our study is to model cost-effectiveness of MDCTA for the diagnosis of NSTE-ACS with initially negative enzymes, in the emergency department. In Belgium, the use of multi-detector computed tomography (MDCTA) is probably cost-effective in the diagnosis of NSTE-ACS in the acute setting A decision tree model was developed and a mathematical study was performed that included two hypothetical strategies: MDCTA and admission with classic clinical follow-up and treatment. Cost-effectiveness for the Belgian situation was simulated with sensitivity analysis using known values for diagnostic performance and known costs for the different strategies or components of strategies.