Cardiovascular and interventional radiology
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Cardiovasc Intervent Radiol · Feb 2010
Venous thromboembolism after removal of retrievable inferior vena cava filters.
The purpose of this study was to examine the incidence of new or recurrent venous thromboembolism (VTE) after retrieval of inferior vena cava (IVC) filters and risk factors associated with such recurrence. Between March 2001 and September 2008, at our institution, implanted retrievable vena cava filters were retrieved in 76 patients. The incidence of new or recurrent VTE after retrieval was reviewed and numerous variables were analyzed to assess risk factors for redevelopment of VTE after filter retrieval. ⋯ Although there was no significant difference in the incidence of new or recurrent VTE related to any risk factor investigated, a tendency for development of VTE after filter retrieval was higher in patients in whom DVT in the lower extremities had been so severe during filter implantation that interventional radiological therapies in addition to traditional anticoagulation therapies were required (40% in patients with recurrent VTE vs. 23% in those without VTE; p = 0.5866 according to Fisher's exact probability test) and in patients in whom DVT remained at the time of filter retrieval (60% in patients with recurrent VTE vs. 37% in those without VTE; p = 0.3637). In conclusion, new or recurrent VTE was rare after retrieval of IVC filters but was most likely to occur in patients who had severe DVT during filter implantation and/or in patients with a DVT that remained at the time of filter retrieval. We must point out that the fatality rate from PE after filter removal was high (2.6%).
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Cardiovasc Intervent Radiol · Nov 2009
Comparative StudyRadiofrequency ablation zones in ex vivo bovine and in vivo porcine livers: comparison of the use of internally cooled electrodes and internally cooled wet electrodes.
This experimental study was undertaken to compare radiofrequency (RF) ablation zones created by internally cooled (IC) and internally cooled wet (ICW) electrodes. IC and ICW electrodes with a 2-cm exposed active tip were used to induce 30 ablation zones in 10 explanted bovine livers with a 12-min ablation time, respectively. In addition, two kinds of electrodes produced 16 ablation zones in five living porcine livers, respectively. ⋯ In living porcine livers using IC and ICW electrodes, the corresponding values were 2.62 cm, 2.00 cm, 5.76 cm3, 15%, 3.84 cm, 2.89 cm, 18.50 cm3, and 25%, respectively. In both ex vivo and in vivo livers, long-axis diameters, short-axis diameters, volumes, and variable coefficients for the use of ICW electrodes were significantly greater than for the use of IC electrodes (each p<0.05). ICW electrodes produced significantly larger ablation zones than IC electrodes in both ex vivo and in vivo livers, but the ablation zones induced by IC electrodes were more reproducible.
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Cardiovasc Intervent Radiol · Nov 2009
Case ReportsTreatment of bilateral hand frostbite using transcatheter arterial thrombolysis after papaverine infusion.
Standard therapy for frostbite has been unaltered for more than 20 years. Recently there have been reports of improved outcomes with the addition of a vasodilator to intra-arterial thrombolytic therapy. ⋯ Intra-arterial catheters were placed in the brachial arteries and a papaverine infusion was initiated, followed by intra-arterial tPA thrombolysis. Follow-up examination at 4 months revealed full hand function and complete resolution of symptoms.
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Cardiovasc Intervent Radiol · Nov 2009
Embolization of renal angiomyolipomas: short-term and long-term outcomes, complications, and tumor shrinkage.
This study retrospectively evaluated outcomes, complications, and tumor shrinkage in renal angiomyolipomas after transcatheter arterial embolization (TAE). All renal angiomyolipoma patients who underwent TAE between August 2000 and December 2008 and had short-term (
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Cardiovasc Intervent Radiol · Sep 2009
Randomized Controlled Trial Comparative StudyA comparison of clinical outcomes with regular- and low-profile totally implanted central venous port systems.
The purpose of this study was to evaluate whether low-profile totally implanted central venous port systems can reduce the late complication of skin perforation. Forty patients (age, 57 +/- 13 years; 22 females, 18 males) were randomized for the implantation of a low-profile port system, and another 40 patients (age, 61 +/- 14 years; 24 females, 16 males) received a regular port system as control group. Indications for port catheter implantation were malignant disease requiring chemotherapy. ⋯ Two infections were observed, one port infection in each study group. Both infections were characterized as catheter-related infections (infection rate: 0.15 catheter-related infections per 1000 catheter days). In conclusion, low-profile port systems can be placed as safely as traditional chest ports and reduce the risk of developing skin perforations, which occurs when the port system is too tight within the port pocket.