Cheng-Yen Chang

Taipei Veterans General Hospital, T’ai-pei, Taipei, Taiwan

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Publications (202)242.27 Total impact

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    ABSTRACT: The analgesic effect of xylocaine alone versus xylocaine with corticosteroid injection after ultrasonographically (US)-guided treatment of rotator cuff calcific tendonosis has not been described in English literature. The aim of this study was to compare the analgesic effect of xylocaine only with xylocaine and corticosteroid following US-guided percutaneous treatment of rotator cuff calcific tendonosis.Methods This prospective study enrolled 88 patients who were given different analgesic treatments [xylocaine only, n = 23; xylocaine with corticosteroid, n = 44; control (no xylocaine or corticosteroid), n = 21]. The assessment of a patient's painful symptoms was recorded prior to treatment, 1 day, 1 week, 1 month, and 3 months after treatment by the visual analogue scale (VAS) system.ResultsThere were no significant differences in age, gender, calcification size prior to and after treatment, and amount of calcification decrease after treatment, but there was a significant difference in calcification morphology among the groups (p = 0.010). General linear model analysis indicated that the three groups had no difference in pain prior to treatment. After treatment, the xylocaine only and the xylocaine with corticosteroid groups had less pain than the control group at 1 day, 1 week, and 1 month after treatment. At 3 months after treatment, the xylocaine only group had less pain than the control group (p = 0.039), and the xylocaine with corticosteroid and control groups had similar levels of pain.Conclusion Injection of xylocaine alone after US-guided treatment of rotator cuff calcific tendonosis provided a longer pain relief period than that of a mixture of xylocaine with corticosteroid.
    Journal of the Chinese Medical Association 11/2014; · 0.75 Impact Factor
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    ABSTRACT: We herein describe a patient with segmental pulmonary artery transection after blunt trauma, which was diagnosed preoperatively by computed tomography. Bolus tracking contrast-enhanced computed tomography clearly depicted both aortic and pulmonary vasculatures. A one-step examination quickly disclosed aortic damage and injury to significant visceral organs. To the best of our knowledge, our patient appeared to be a unique case of pulmonary segmental artery transection after blunt injury, which was preoperatively diagnosed by computed tomography. Ultimately, successful surgical repair of the pulmonary artery was performed.
    Journal of the Chinese Medical Association : JCMA. 06/2014;
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    ABSTRACT: Microcalcifications are frequently associated with papillary thyroid cancers. Metastatic nodules from extrathyroid malignancies may mimic primary thyroid neoplasm on sonography, but do not present with microcalcifications. We report the case of a 45-year-old woman with a history of invasive ductal carcinomas of bilateral breasts, status post surgery and neoadjuvant chemotherapy. Four years after surgery, thyroid sonography revealed diffuse microcalcifications without nodular component. Core needle biopsy confirmed thyroid metastasis from primary breast cancer. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound, 2014;
    Journal of Clinical Ultrasound 02/2014; · 0.70 Impact Factor
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    ABSTRACT: With growing ketamine abuse, ketamine-induced uropathy (KIU) has become more prevalent in recent years. This research evaluates the presence, distribution and extent of KIU in the upper and lower urinary tracts by retrospectively reviewing CT urography (CTU) images. Patients diagnosed with KIU who underwent CT scanning from 1 January 2006 to 31 December 2011 were recruited. The CT protocols included three-phase CTU in six patients, split-bolus CTU in 17, two-phase CT in one and unenhanced CT in three. The CT images were retrospectively reviewed by two radiologists. A total of 27 patients participated in this study. The common CT findings included diffuse bladder wall thickening (88.9%), small bladder volume (66.7%) and perivesical inflammation (44.4%). Twelve patients (44.4%) were diagnosed with hydronephrosis, including three patients with unilateral hydronephrosis and nine with bilateral hydronephrosis. Of these patients, nine had ureteral wall thickening (33.3%) and two (7.4%) had ureterovesical junction involvement (ie, they had hydronephrosis but no ureteral wall thickening). One patient had a ureteral obstruction because of a ureter stone. The correlation between upper urinary tract involvement and grading of the interstitial cystitis was statistically non-significant (p=0.33). Four patients (14.8%) had a vesicovaginal fistula which could be detected in the excretory phase only. Upper urinary tract involvement is common in patients with KIU. CTU might aid evaluation of the extent of KIU and prompt adequate management.
    Postgraduate medical journal 01/2014; · 1.38 Impact Factor
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    ABSTRACT: Background Transarterial embolization of intracranial dural arteriovenous fistulas (DAVFs) is usually associated with inadequate embolization. The purpose of this study was to report our experience of transarterial Onyx embolization of intracranial DAVFs with an emphasis on treatment outcome with this new embolic agent in different types of DAVFs. Methods In the past 3 years, a total of 14 intracranial DAVFs have been treated by transarterial Onyx embolization. Among these, there were nine males and five females, aged from 30 years to 82 years (mean = 62 years). We retrospectively analyzed the injection volume and time of Onyx embolization as well as outcomes in different types of DAVFs. Results The locations of the DAVFs were sigmoid sinus (n = 6), tentorium (n = 3), sinus confluence (n = 2), transverse–sigmoid sinus (n = 1), sigmoid sinus–jugular bulb (n = 1) and the superior petrous sinus (n = 1). The mean volume and time of Onyx injection were 3.4 mL and 28 minutes, respectively (Cognard type I: 4.9 mL, 40 minutes; type II: 4.5 mL, 34 minutes; type III: 2.2 mL, 21 minutes; type IV: 2 mL, 22 minutes). Total fistula occlusion was achieved in six out of seven patients of type III and type IV DAVFs, and in four out of seven patients of type I and type II DAVFs. Nine patients had total resolution of their symptoms, whereas partial regression occurred in five patients. No significant periprocedural complication was found. Mean clinical follow-up period was 16 months. Conclusion Transarterial Onyx embolization of intracranial DAVFs is safe and effective. This technique is particularly useful in type III and type IV DAVFs with a high cure rate, and lower volume of Onyx as well as a short injection time.
    Journal of the Chinese Medical Association 01/2014; · 0.75 Impact Factor
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    ABSTRACT: Background Moyamoya disease (MMD) is an uncommon cerebrovascular disorder characterized by idiopathic progressive stenosis or the occlusion of the intracranial arteries. Digital subtraction angiography (DSA) is the reference diagnostic imaging modality for MMD. Use of the conventional Suzuki grading remains the gold standard for evaluating the severity of MMD. In this study, we propose a quantitative method using color-coded parametric quantitative DSA (QDSA) to improve prediction of the severity of MMD. Methods Eighteen DSA examinations from 18 patients with MMD and 14 control participants were included. All patients with MMD underwent DSA and dynamic susceptibility contrast perfusion-weighted imaging (DSC-PWI). QDSA was used to determine the delay time of maximal opacification (Td) between the internal carotid artery and the M2 segment of the middle cerebral artery. The time-to-peak (TTP) was measured in the medial frontal, lateral frontal, parietal, and occipital lobes from the DSC-PWI. The relative TTP (rTTP) values were then obtained by subtracting the TTP of the cerebellum. Results The Td was significantly longer in the patients with MMD presenting with infarction than in the control group. The Td significantly correlated with the angiographic Suzuki grading system and showed closer correlation with prolonged rTTP in the medial frontal, lateral frontal, and parietal regions compared with Suzuki grading. Conclusion The Td significantly correlated with conventional angiographic grading and with the status of hemodynamic impairment in patients with MMD. QDSA and Td measurements can provide a simple and quantitative angiographic grading system for patients with MMD.
    Journal of the Chinese Medical Association 01/2014; · 0.75 Impact Factor
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    ABSTRACT: Since the introduction of pancreas transplantation more than 40 years ago, surgical techniques and immunosuppressive regiments have improved and both have contributed to increase the number and success rate of this procedure. However, graft survival corresponds to early diagnosis of organ-related complications. Thus, knowledge of the transplantation procedure and postoperative image anatomy are basic requirements for radiologists. In this article, we demonstrate the imaging spectrum of pancreas transplantation with enteric exocrine drainage.
    Korean journal of radiology: official journal of the Korean Radiological Society 01/2014; 15(1):45-53. · 1.32 Impact Factor
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    ABSTRACT: We herein describe a patient with segmental pulmonary artery transection after blunt trauma, which was diagnosed preoperatively by computed tomography. Bolus tracking contrast-enhanced computed tomography clearly depicted both aortic and pulmonary vasculatures. A one-step examination quickly disclosed aortic damage and injury to significant visceral organs. To the best of our knowledge, our patient appeared to be a unique case of pulmonary segmental artery transection after blunt injury, which was preoperatively diagnosed by computed tomography. Ultimately, successful surgical repair of the pulmonary artery was performed.
    Journal of the Chinese Medical Association 01/2014; · 0.75 Impact Factor
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    ABSTRACT: PURPOSE Conventional digital subtraction angiography (DSA) helps to evaluate the severity of vascular spasm after subarachnoid hemorrhage (SAH). Being equipped with flat detector (FD), DSA is able to provide in-room assessment of peri-therapeutic cerebral hemodynamics and help tailoring endovascular treatments. The aim of current study is to compare the cerebral circulation time (CCT) that derived color-coded quantitative FD-DSA and CT perfusion (CTP) in SAH patients. METHOD AND MATERIALS Nineteen SAH patients entered our neurovascular service in 8 months interval and with available CCT derived from diagnostic FD-DSA and MDCT, were retrospectively recruited. The mean time interval between two examinations was 19 (4-36) hours. The CCT derived from FD-DSA was defined as the difference of Tmax (Time of maximum intensity) between the region-of-interest (ROI) of selected arteries and superior sagittal sinus (SSS). Four CCT were defined accordingly, namely, RA-CCT and LA-CCT (arterial ROI placed on the second portion of right and left anterior cerebral arteries), RM-CCT and LM-CCT (arterial ROI placed on the second portion of right and left middle cerebral artery). The CCT from MDCT was defined as the difference of time-to-peak between corresponding arterial (RM, LM) and SSS ROI. For CCT of anterior cerebral artery, only the dominant was defined due to limited spatial resolution. RESULTS The mean of RA-CCT, LA-CCT, RM-CCT and LM-CCT defined by FD-DSA were 5.6±1.5, 6.0±1.8, 5.9±1.9, 6.0±2.3 seconds respectively. The mean of RA-CCT, LA-CCT, RM-CCT and LM-CCT defined by MDCT were 6.0±2.3, 5.9±2.3, 6.0±2.3 seconds respectively. The intraclass classification of CCT merited from FD-DSA between two observers ranged from 0.86-0.99, and those from MDCT between two observers ranged from 0.72-0.98. The correlations of RA-CCT, LA-CCT, RM-CCT, and LM-CCT between two modalities were 0.70, 0.76, 0.70, 0.80, respectively. The correlation got worse when the CCT became longer. CONCLUSION With no extra radiation dose, FD-DSA provides CCT of SAH patients with comparable results as CTP. It facilitates the feasibility of both in-room peri-therapeutic hemodynamic monitoring and tailoring endovascular treatments. CLINICAL RELEVANCE/APPLICATION The CCT measured by QDSA provides additional hemodynamic information in SAH patients in addition to vascular morphology. It confirms the reproducibility of intra-arterial hemodynamic models.
    Radiological Society of North America 2013 Scientific Assembly and Annual Meeting; 12/2013
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    ABSTRACT: PURPOSE To quantitatively measure the hemodynamic change of hepatic artery before and after transcatheter arterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) by quantitative color-coding analysis (QCA). METHOD AND MATERIALS This prospective study was performed from December 2012 to February 2013. 64 patients (mean 67.5 year old; male 50, female 14) who were diagnosed with HCC and underwent TACE with doxorubicin and lipiodol emulsion or with microspheres were enrolled if superselective segmental TACE was technically feasible. The endpoint of TACE was sluggish of antegrade arterial flow. QCA (syngo iFlow; Siemens) was used to determine the maximal density time (Tmax) of selected intravascular region of interest (ROI). Relative Tmax (rTmax) was defined as the Tmax at the selected ROI minus the time of contrast medium spurting from the catheter tip. The catheter tip was placed in common hepatic artery, proper hepatic artery or lobar hepatic arteries before and after TACE with the same acquisition and injection protocols. The rTmax of treated and proximal hepatic arteries were analyzed before and after embolization. RESULTS The pre- and post-treatment rTmax of the landmarks at the treated segmental artery and proximal right hepatic artery were1.84~2.08s, 2.7~3.59s (p < 0.001) and 1.4~1.64s, 1.55~1.89s (p<0.05), respectively. However, in subgroup analysis of one lobe treatment including 30 patients of right lobe only and 8 patient of left lobe only, the pre- and post-rTmax of treated right and left segmental arteries were 1.86~2.26s, 2.73~3.95s (p < 0.001) and 1.55~2.24s, 1.56~3.8s (p = 0.12), respectively. The rTmax of the proximal lobar hepatic arteries or proper hepatic artery had no significant change before and after TACE. CONCLUSION QCA is feasible to quantify embolization endpoint by comparing the rTmax in selected hepatic arteries before and after TACE. The rTmax of treated segmental artery was significant prolonged after optimized procedures. CLINICAL RELEVANCE/APPLICATION QCA is able to quantitatively determine the adequate embolization endpoint in HCC patients.
    Radiological Society of North America 2013 Scientific Assembly and Annual Meeting; 12/2013
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    ABSTRACT: The angioarchitecture of arteriovenous fistulas (AVFs) of cerebral arteriovenous malformation (CAVM) after stereotactic radiosurgery (SRS) remain unclear. The purpose of this study is to report the angiographic change of AVF components of CAVMs after SRS and outcomes of endovascular embolisation. From 2002 to 2012, a total of 523 CAVMs had been treated primarily by SRS with more than 3-year latency. Among these databases, there were 19 patients with 21 AVFs undergoing embolization after SRS. We retrospectively analyzed the angioarchitecture of the CAVM to identify AVFs, morphologic change and outcomes of AVFs after SRS and embolisation. Eight AVFs were in the periphery of CAVMs, the other 13 were in a central location. Eighteen of 21 AVFs remained constant in morphology after SRS, while three feeders of AVFs were associated with radiation arteritis. The causes of failure to identify AVFs before SRS were overlooked (n = 7) or there was superimposition with feeders, nidus and/or venous drains of CAVMs (n = 14). Total fistula occlusion was achieved in all 21 AVFs; residual CAVMs was totally obliterated by embolisation and/or additional SRS in 12 patients. One patient had a small procedure-related intracerebral hemorrhage. Mean follow-up period was 26 months. Early detection of AVF components of CAVMs prior to SRS may be difficult, particularly those in a central location. However, most AVFs became evident and showed consistency in angiographic morphology after obliteration of the majority nidus parts of CAVMs. Endovascular embolisation is effective in managing these AVF components.
    Acta Neurochirurgica 11/2013; · 1.55 Impact Factor
  • Chih-Chun Wu, Rheun-Chuan Lee, Cheng-Yen Chang
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    ABSTRACT: OBJECTIVE. The purpose of this study was to investigate whether the diameter of superior hemorrhoidal vein on preoperative CT can predict the presence of lymphovascular invasion (LVI). SUBJECTS AND METHODS. This study recruited 102 patients with treatment-naive rectal cancers. The diameters of superior hemorrhoidal vein and inferior mesenteric vein (IMV) on pretreatment CT and postoperative pathologic reports were reviewed. Univariate analysis and receiver operating characteristic curve analysis were applied to determine the correlation between clinical factors and pathologic features and the diameters of superior hemorrhoidal vein and IMV. RESULTS. The diameter of superior hemorrhoidal vein was significantly higher in patients with LVI than in those without (mean diameter, 44 vs 30 mm, respectively; p < 0.001) and was significantly higher in patients with distant metastases than in those without (p = 0.044). There was no significant difference between IMV diameter in LVI and that in distant metastasis (p = 0.521). CONCLUSION. Patients having rectal cancers with LVI showed a significantly increased mean superior hemorrhoidal vein diameter at presentation, which could be identified with pretreatment CT and help to direct the application of neoadjuvant treatment strategies.
    American Journal of Roentgenology 11/2013; 201(5):985-92. · 2.90 Impact Factor
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    ABSTRACT: Cardiac fibromas (CFs) are benign primary tumors that typically occur during childhood and may be asymptomatic. However, due to the proximity of CFs to the cardiac structure, significant morbidity and mortality may also be anticipated. CFs do not show spontaneous regression and surgical resection generally remains the treatment of choice for these tumors in children. Thus, it is important to take aggressive steps to obtain accurate pretreatment image diagnosis. A full-term male infant was presented to our facility suffering from shortness of breath, after an episode of upper respiratory tract infection at age 1.5 months. Subsequent chest X-ray revealed widening of the mediastinum and trachea deviation. Cardiogenic pathology was suspected. Computed tomography and magnetic resonance imaging were performed, and we confirmed a diagnosis of benign CF. Thoracotomy biopsy of the tumor confirmed the pathological diagnosis.
    Journal of the Chinese Medical Association 07/2013; · 0.75 Impact Factor
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    ABSTRACT: There are few cases of giant pediatric intraspinal teratoma. We report a case of a 4-month-old female baby with giant intraspinal teratoma. Magnetic resonance imaging (MRI) of the spine revealed a large intradural tumor from the C7 to S2 level, with solid, cystic, and fatty components. Partial surgical removal of the tumor showed pathology of a mature cystic teratoma. The imaging diagnosis of intraspinal teratoma included the location, solid and cystic component, and fatty content. The MR techniques adopted included gradient echo sequences as used to detect teeth or calcification. The difficulties in surgical resection of this case are also presented.
    Journal of the Chinese Medical Association 05/2013; · 0.75 Impact Factor
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    ABSTRACT: OBJECTIVE: To evaluate the imaging quality of head CT at lowered radiation dose by combining filtered back projection (FBP) and iterative reconstruction (IR) algorithms. METHODS: Experimental group A (n = 66) underwent CT with 43 % tube current reduction, and group B (n = 58) received an equivalent reduced dose by lowering the tube voltage. An age- and sex-matched control group (n = 72) receiving the conventional radiation dose was retrospectively collected. Imaging for the control group was reconstructed by FBP only, while images for groups A and B were reconstructed by FBP and IR. The signal-to-noise ratios (SNRs), contrast-to-noise ratios (CNRs), sharpness, number of infarcts and severity of subcortical arteriosclerotic encephalopathy (SAE) were compared to assess imaging quality and diagnostic accuracy. RESULTS: There were no significant differences in SNRs and CNRs between group A and the control group. There were significantly decreased SNRs and increased CNRs in group B. Image sharpness decreased in both groups. Correlations between detected infarcts and severity of SAE across FBP and IR were high (r = 0.73-0.93). Head diameter was the only significant factor inversely correlated with infratentorial imaging quality. CONCLUSION: Head CT with 43 % reduced tube current reconstructed by IR provides diagnostic imaging quality for outpatient management. KEY POINTS: • Cranial CT using iterative reconstruction provides diagnostic images with 43 % mAs reduction. • Blurring of infratentorial images becomes evident using low-radiation head CT. • Head diameter was inversely correlated with imaging quality in the infratentorium. • Lowering tube kilovoltage requires a higher radiation dose to maintain image quality.
    European Radiology 05/2013; · 4.34 Impact Factor
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    ABSTRACT: BACKGROUND: Gamma-knife surgery (GKS) is ineffective for high-flow arteriovenous fistula (AVF). The purpose of this study was to present the angioarchitecture of the AVF of brain arteriovenous malformation (BAVM) and report our experience of endovascular embolization of AVF component prior to GKS. METHODS: In the past 10 years, a total of 523 BAVMs had been treated primarily by GKS. Among these, 10 patients with AVF components were identified and referred for embolization prior to GKS. Those patients underwent GKS within 4 weeks after embolization. We analyzed retrospectively the angioarchitecture of the AVFs of BAVMs, selection of embolic materials for embolization, and treatment outcomes. RESULTS: The location of the AVFs was anterior (n = 7) or middle (n = 3) cerebral artery. Central and peripheral types of AVFs were found in seven and three patients, respectively. Nine AVFs were totally occluded by a single session of endovascular embolization, while one failed to be embolized because it was inaccessible to a microcatheter. Detachable coils (n = 6) or combination of liquid adhesives (n = 3) were selected to embolize the AVF. No significant periprocedural neurological complication was found. BAVMs were obliterated totally by subsequent GKS in six patients and partial occlusion was achieved in one, while three still awaited the effect of GKS. Mean imaging and clinical follow-up periods were 35 and 48 months, respectively. CONCLUSION: Early detection of the central type of AVF of BAVM prior to GKS may be difficult because of its overlapping with feeder, nidus, and/or venous drains or it being overlooked. Peripheral-type AVFs were usually evident prior to GKS, particularly those with proximal dilated venous drains. Endovascular embolization is an effective modality for managing these AVFs, which may be treated by GKS ineffectively.
    Journal of the Chinese Medical Association 05/2013; 76(5):277-281. · 0.75 Impact Factor
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    ABSTRACT: Parametric-colored digital subtraction angiography using Tmax is almost a routine angiographic imaging procedure, currently. The current feasibility study is aimed to using the imaging to monitor treatment effects while embolizing indirect carotid-cavernous fistulas (CCF). Ten patients with CCFs receiving embolization and 40 patients with normal circulation time were recruited. Their color-coded DSAs were used to define the Tmax of selected intravascular ROIs. A total of 19 ROIs in the internal carotid artery (ICA) (cervical segment of ICA in AP view (I0), cavernous segment of ICA in AP view (I1), supraclinoid segment of ICA in AP view (I2) and cervical segment of ICA in lateral view (I0'), cavernous portion of ICA in lateral view (IA), supraclinoid portion of ICA in lateral view (IB)), ACA (first segment of anterior cerebral artery, second segment of anterior cerebral artery (A1, A2)), middle cerebral vein (MCA) first segment of MCA ((M1), second segment of MCA (M2)), frontal vein (FV), parietal vein (PV), superior sagittal sinus (SSS), sigmoid sinus (SS), internal jugular vein (JV), fistula, superior ophthalmic vein (SOV), inferior petrosal vein (IPS), and MCV were selected. Relative Tmax was defined as the Tmax at selected ROIs minus Tmax at I0 or I0'. An intergroup comparison between the normal and treatment groups and pre- and post-treatment comparison of the peri-therapeutic rTmax for the treatment group were performed. rTmax's for the normal group were as follows: Anterior-posterior view: I1: 0.16, I2: 0.32, A1: 0.31, M1: 0.35, SSS: 6.16, SS: 6.56, and MCV: 3.86 seconds. Lateral view: IA: 0.05, IB: 0.20, A2: 0.53, M2: 0.95, FV: 4.84, PV: 5.12, IPS: 4.62, JV: 6.81, and MCV: 3.86 seconds. Before embolization, rTmax of the IPS, SS, and JV for the treatment group were shortened (p < 0.05). No rTmaxs for any arterial ROIs in the fistula group were significantly different. After embolization, the rTmaxs for all venous ROIs returned to normal except for two which were partially obliterated. This postprocessing method does not require extra radiation exposure and contrast media. It facilitates real-time hemodyamic monitoring and may help determining the endpoint of embolization, which increases patient safety.
    Journal of the Chinese Medical Association 04/2013; 76(4):218-24. · 0.75 Impact Factor
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    ABSTRACT: BACKGROUND: Transarterial embolization is a standard method for management of direct carotid-cavernous fistula (DCCF). The purpose of this study was to report our experiences, and immediate and long-term outcomes of endovascular embolization of DCCFs by using detachable coils (DCs). METHODS: Over 8 years, 24 patients with 25 DCCFs underwent endovascular DC embolization. There were 15 men and nine women; age ranged from 8 to 82 years (mean, 39 years). Immediate and long-term angiographic as well as clinical outcomes after endovascular DC embolization were retrospectively analyzed. The number and the length of DCs used to occlude the fistula were also evaluated. RESULTS: Eighteen DCCFs were successfully occluded by single-session endovascular embolization with preservation of the parent artery. Retreatments by transvenous (n = 5) and/ or transorbital routes (n = 3) had to be performed in seven patients because of residual fistula (n = 4) or recurrent fistula (n = 4) occurring within 3 weeks after embolization. The average numbers and length of coils to occlude the fistulas were 14 (range, 2-31) and 189 cm (range, 16-756 cm), respectively. Four patients had small residual fistulas with spontaneous thrombosis on follow-up angiography. Three patients had transient cranial nerve impairment of the third (n = 1) or sixth (n = 2) nerve. There was no significant procedure-related neurological complication. The follow-up period was 3-48 months (mean, 19 months) CONCLUSION: Endovascular DC embolization of DCCFs was proved both efficacious and safe in managing high-flow fistulas with sustained angiographic and clinical effects, particularly in those DCCFs with small fistula track and/or cavernous sinus. However, retreatment via various routes may be necessary in some patients because of residual or recurrent fistulas.
    Journal of the Chinese Medical Association 01/2013; 76(1):31-36. · 0.75 Impact Factor

Publication Stats

1k Citations
242.27 Total Impact Points

Institutions

  • 2002–2014
    • Taipei Veterans General Hospital
      • Division of Radiology
      T’ai-pei, Taipei, Taiwan
  • 2001–2013
    • National Yang Ming University
      • School of Medicine
      T’ai-pei, Taipei, Taiwan
  • 2011
    • Taichung Veterans General Hospital
      • Department of Radiology
      Taichung, Taiwan, Taiwan
  • 2009
    • Buddhist Tzu Chi General Hospital
      T’ai-pei, Taipei, Taiwan
  • 2007
    • Fu Jen Catholic University
      • School of Medicine
      Taipei, Taipei, Taiwan
    • Mackay Memorial Hospital
      • Department of Internal Medicine
      T’ai-pei, Taipei, Taiwan
  • 2004
    • Tri-Service General Hospital
      T’ai-pei, Taipei, Taiwan