Cardiovascular and interventional radiology
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Cardiovasc Intervent Radiol · Sep 2007
Exclusion of atherosclerotic plaque from the circulation using stent-grafts: alternative to carotid stenting with a protection device?
To retrospectively assess the feasibility, safety, and clinical mid-term outcome of patients undergoing carotid artery stenting with stent-grafts. ⋯ Stent-grafts may prevent microembolic complications during stenting of atherosclerotic carotid lesions in selected cases, offering immediate exclusion of the atherosclerotic lesion from the circulation by pressing the plaque against the vessel wall. Comparative, randomized studies in larger series of patients are needed with carotid-dedicated stent-graft designs.
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Cardiovasc Intervent Radiol · Sep 2007
Randomized Controlled TrialUse of 120 kilovolt tube potential for digital subtraction angiography and fluoroscopy in an image-intensifier angiographic system: decrease of skin dose in transarterial chemoembolization therapy for hepatocellular carcinoma.
In an image-intensifier angiographic system, the tube potential is commonly regulated in ranges from 75 to 90 kV for digital subtraction angiography (DSA) and fluoroscopy in transarterial chemoembolization therapy (TACE) for hepatocellular carcinoma. The purpose of this study was to investigate whether or not a 120-kV tube potential could be used for DSA and fluoroscopy in TACE to decrease the skin dose. Forty-three patients administered TACE were randomly allocated into two groups: TACE was performed using standard-kilovoltage (75- to 90-kV) DSA and fluoroscopy modes (group A; n = 20) or using high-kilovoltage (120-kV) modes (group B; n = 23). ⋯ The peak skin dose (mGy) for group A was 383.6 +/- 176.5 and that for group B was 265.1 +/- 145.1. The peak skin dose was decreased by 31% in the 120-kV mode, a statistically significant difference (t-test, p = 0.022). We conclude that the use of 120 kV tube potential for DSA and fluoroscopy may be one option for performing TACE while decreasing the skin dose.
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Cardiovasc Intervent Radiol · Sep 2007
Case ReportsStrategies for the management of SVC stent migration into the right atrium.
Stent migration into the right atrium is a potentially fatal complication of stenting in the venous system and is most likely to occur during the treatment of superior vena cava obstruction. Endovascular approaches that can salvage this hazardous situation are described and the keys to successful treatment are highlighted. ⋯ We conclude that prompt management of right atrial stent migration is essential and can be successfully achieved by a variety of "bale-out" techniques which are within the technical range of most interventional radiologists.
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Cardiovasc Intervent Radiol · Sep 2007
ePTFE/FEP-covered metallic stents for palliation of malignant biliary disease: can tumor ingrowth be prevented?
To determine the application and clinical effectiveness of ePTFE/FEP-covered metallic stents for palliation of malignant biliary disease, and to evaluate the efficiency of stent coverage in preventing tumor ingrowth. ⋯ ePTFE/FEP-covered metallic stents are safe and effective for palliation of malignant biliary disease. The presence of the ePTFE/FEP coating is likely to prevent from tumor ingrowth.
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Cardiovasc Intervent Radiol · Sep 2007
Limitations influencing interventional radiology in Canada: results of a national survey by the Canadian Interventional Radiology Association (CIRA).
To describe the current state and limitations to interventional radiology (IR) in Canada through a large, national survey of Canadian interventional radiologists. ⋯ Interventional radiology in Canada is limited by a number of factors including funding, manpower, and referral support. A concerted effort should be undertaken by individual interventional radiologists and IR organizations to increase training capacity, funding, remuneration, and public exposure to IR in order to help advance the subspecialty.