Techniques in vascular and interventional radiology
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Tech Vasc Interv Radiol · Sep 2001
ReviewPercutaneous endoscopy for biliary radiologic interventions.
Biliary endoscopy is an adjunct to percutaneous biliary interventions. Although there are technical and cost considerations, the interventional radiologist may apply this useful tool to patients with a wide range of biliary diseases (eg, patients with retained intrahepatic stones, patients with suspected lesions requiring biopsy, etc). ⋯ The procedure is generally performed on an outpatient basis under conscious sedation. Given access to a choledochofiberscope and familiarity with its use, percutaneous endoscopy for biliary radiologic interventions is a valuable technique and may be used to manage patients with complex biliary disease.
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Tech Vasc Interv Radiol · Jun 2001
Review Practice Guideline GuidelineAlteplase and tenecteplase: applications in the peripheral circulation.
Alteplase (t-PA), a recombinant analogue of human tissue plasminogen activator, became the first genetically engineered thrombolytic approved by the Food and Drug Administration in 1987 for acute myocardial infarction (AMI). In addition to AMI, alteplase is currently approved for the treatment of acute ischemic stroke and pulmonary embolism, and we anticipate approval for catheter clearance in late 2001 in a 2-mg vial configuration. With the withdrawal of human neonatal kidney cell-derived urokinase, alteplase has become an alternative agent in peripheral vascular applications. ⋯ Because of its enhanced safety profile, TNK may be a desirable agent for peripheral vascular applications. Initial clinical studies with TNK in acute arterial and venous disease are ongoing. This article outlines the Advisory Panel guidelines for using alteplase and highlights features of tenecteplase.