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ABSTRACT: Abstract Introduction:This study aimed to analyze factors influencing accuracy and complications in patients who underwent computed tomography (CT)-guided lung biopsy at our medical center. Material and methods: This study included all 107 patients (72 men, 35 women; mean age, 69 years; range, 41-83 years) who underwent CT-guided lung biopsy between January 2006 and October 2009. CT fluoroscopy was used in 45.7% of cases. Final diagnosis, when surgical resection was performed, was histopathological diagnosis from the lung lesion specimen, and when resection was not performed, clinical diagnosis after ≥ 6 months of follow-up. The accuracy of lung biopsy was assessed by comparison of biopsy results and final diagnosis. The influence of factors on accuracy was statistically analyzed. Results:Accuracy of CT-guided lung biopsy was 89.4%. None of the factors, including lesion size, lesion depth from pleura, lesion location, patient position, final diagnosis, and use or non-use of CT fluoroscopy, had any significant influence on accuracy. The only complications were Grade 1 and 2 pneumothorax and Grade 1 pulmonary bleeding. The incidence of pneumothorax and bleeding was significantly increased with smaller lesion size and significantly increased with greater lesion depth. In patients with pulmonary emphysema, bleeding was significantly less (p = 0.022). When CT fluoroscopy was used, bleeding was significantly increased (p < 0.001). Conclusions:None of the factors had any significant influence on accuracy. The incidence of pneumothorax and bleeding was affected by lesion size and lesion depth. When CT fluoroscopy was used, bleeding was significantly increased.
Minimally invasive therapy & allied technologies: MITAT: official journal of the Society for Minimally Invasive Therapy 02/2012; · 1.33 Impact Factor
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ABSTRACT: The objective of our study was to investigate the effects of percutaneous vertebroplasty on respiratory function in patients with compression fractures caused by osteoporosis.
Ninety-eight patients (87 women, 11 men; mean age, 74 years; age range, 60-90 years) with compression fractures of 75 thoracic (Th7-Th12) and 89 lumbar (L1-L5) vertebrae were enrolled in this study. Percentage vital capacity (VC%), percentage forced vital capacity (FVC%), and percentage forced expiratory volume in 1 second (%FEV1) were measured using a spirometer before, 1 day after, and 1 month after percutaneous vertebroplasty. The Wilcoxon signed rank test was used to evaluate whether any significant differences in VC%, FVC%, or %FEV1 values existed between before, 1 day after, and 1 month after percutaneous vertebroplasty.
The VC% and FVC% values had improved significantly by 1 month after percutaneous vertebroplasty compared with before percutaneous vertebroplasty (p<0.01). No significant difference was noted between values before and 1 day after percutaneous vertebroplasty. Likewise, no significant difference was identified in %FEV1 before percutaneous vertebroplasty and either 1 day or 1 month after percutaneous vertebroplasty. The mean degree of improvement in VC% values after percutaneous vertebroplasty for patients with one vertebra treated, which we refer to as the "single-vertebroplasty" group, and for patients with two or more vertebrae treated, or "multiple-vertebroplasty" group, was 1.1%±7% (SD) and 6.3%±8%, respectively, representing a significant difference between groups (p=0.01). The mean VC% values before and 1 month after percutaneous vertebroplasty differed significantly (p=0.02) in the thoracic group and overlapping group.
Percutaneous vertebroplasty improves restrictive ventilatory impairment, but this improvement requires approximately 1 month to occur. Greater improvement in restrictive ventilatory dysfunction was observed in patients who underwent multiple vertebroplasty procedures than those who underwent a single procedure and in patients who underwent treatment of thoracic vertebrae than those who underwent treatment of other vertebrae.
American Journal of Roentgenology 01/2012; 198(1):W51-4. · 2.78 Impact Factor
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Atsushi Komemushi,
Noboru Tanigawa, Shuji Kariya,
Rie Yagi,
Miyuki Nakatani,
Satoshi Suzuki,
Akira Sano,
Koshi Ikeda,
Keita Utsunomiya,
Yoko Harima,
Satoshi Sawada
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ABSTRACT: Purpose. To assess differences in dose distribution of a vertebral body injected with bone cement as calculated by radiation treatment planning system (RTPS) and actual dose distribution. Methods. We prepared two water-equivalent phantoms with cement, and the other two phantoms without cement. The bulk density of the bone cement was imported into RTPS to reduce error from high CT values. A dose distribution map for the phantoms with and without cement was calculated using RTPS with clinical setting and with the bulk density importing. Actual dose distribution was measured by the film density. Dose distribution as calculated by RTPS was compared to the dose distribution measured by the film dosimetry. Results. For the phantom with cement, dose distribution was distorted for the areas corresponding to inside the cement and on the ventral side of the cement. However, dose distribution based on film dosimetry was undistorted behind the cement and dose increases were seen inside cement and around the cement. With the equivalent phantom with bone cement, differences were seen between dose distribution calculated by RTPS and that measured by the film dosimetry. Conclusion. The dose distribution of an area containing bone cement calculated using RTPS differs from actual dose distribution.
Radiology research and practice. 01/2012; 2012:571571.
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ABSTRACT: The purpose of this article is to evaluate the technical and clinical outcomes of 194 patients with 500 osteoporotic vertebral compression fractures (VCFs) consecutively treated by percutaneous vertebroplasty, to investigate the long-term efficacy of percutaneous vertebroplasty, and to determine the frequency of new VCFs after percutaneous vertebroplasty.
One hundred ninety-four patients (168 women and 26 men; mean age, 73.3 years; range, 44-89 years) with 500 VCFs (T5-L5) were enrolled in this study. Evaluation at each follow-up time point (1 day, 1 month, 4 months, 1 year, and then once yearly) included pain response by using a pain visual analog scale (VAS) and frontal and lateral radiographs of the thoracic and lumbar vertebrae regardless of the symptoms.
The mean volume of cement injected was 3.3 mL (range, 0.5-12 mL) per level. Cement leakage was seen at 213 levels (42.6%). The mean follow-up time was 31 months (range, 1-97 months). The mean VAS score was 7.6 before percutaneous vertebroplasty and 3.1 at 1 day, 2.3 at 1 month, 1.7 at 4 months, 1.5 at 1 year, 1.2 at 2 years, 1.0 at 3 years, 1.1 at 4 years, 0.9 at 5 years, 0.9 at 6 years, and 1.0 at 7 years after percutaneous vertebroplasty. New VCFs were confirmed in 103 vertebrae in 65 patients (33.5%), affecting 65 adjacent vertebrae (63.1%) and 38 nonadjacent vertebrae (36.9%).
Percutaneous vertebroplasty was effective in relieving the pain associated with osteoporosis-induced VCFs, and the analgesic effect was long lasting when no new VCF occurred. However, radiologic follow-up observation showed that new VCFs occurred in approximately one-third of the patients.
American Journal of Roentgenology 06/2011; 196(6):1415-8. · 2.78 Impact Factor
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ABSTRACT: This animal study investigated the feasibility of creating a bypass between two hollow organs, using a modified gun-sight approach with a pull-through string and pull-through tow wire. Ten procedures (femoral arteriovenous shunt, n = 4; portacaval shunt, n = 4; cholangiogastrostomy, n = 2) were performed in six adult swine. Snares were inserted into the two hollow organs through the sheath and deployed at the site of bypass creation. When snares overlapped on fluoroscopy, a needle was inserted to pass through both snares. The string was inserted through the needle, with only the needle then withdrawn. The snare furthest from the skin was closed to capture the string and was then withdrawn. The other snare was withdrawn without closing. The string thus served as a pull-through string penetrating both hollow organs. This string was then attached to a pull-through tow wire, withdrawn, and exchanged for the pull-through tow wire. By withdrawing the pull-through tow wire, the delivery sheath connected to the pull-through tow wire was towed through the site of the bypass, and the stent was placed. In all cases, bypass creation was achieved. Percutaneous bypass creation using a modified gun-sight approach with a pull-through string and pull-through tow wire is feasible between two hollow organs.
Minimally invasive therapy & allied technologies: MITAT: official journal of the Society for Minimally Invasive Therapy 03/2011; 21(2):83-9. · 1.33 Impact Factor
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ABSTRACT: The purpose of this study was to evaluate the utility of metallic stents for treating central airway stenosis caused by malignant tumors. The subjects were 72 patients (16 women, 56 men; mean age, 61 years; age range, 28-87 years) treated with metallic stents for dyspnea due to tracheobronchial stenotic lesions caused by malignant tumors between May 1990 and August 2010. The underlying disorder was primary lung cancer in 42 patients, metastatic lung cancer in 29, and mediastinal tumor in one patient. In 69 of 72 patients (95.8%), dyspnea began to improve following completion of the procedure. The average Hugh-Jones classification score improved from 4.2 before stenting to 2.8 after stenting. The patients' average survival following stent placement was 3.6 months (two days-33 months). Thirteen lesions developed re-obstruction during follow-up. Of these 13 lesions, eight patients with dyspnea underwent re-interventions with metallic stent replacement and improved. Airway stent placement is an immediate and effective method of treatment for dyspnea caused by stenotic lesions of the central airway due to malignant tumor. It is effective for treating stenosis due to either tracheobronchial intraluminal tumor or extrinsic compression. Restenting is also useful to treat dyspnea caused by restenosis following stent placement.
Minimally invasive therapy & allied technologies: MITAT: official journal of the Society for Minimally Invasive Therapy 03/2011; 21(2):108-12. · 1.33 Impact Factor
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Yuzo Shomura,
Noboru Tanigawa,
Mitsuo Shibutani,
Shinya Wakimoto,
Kazutoshi Tsuji,
Takanori Tokuda,
Jiro Terada, Shuji Kariya,
Hiroyuki Kojima,
Atsushi Komemushi,
Satoshi Sawada
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ABSTRACT: To preliminarily examine whether solubility of water-soluble polyvinyl alcohol (PVA) microspheres in blood plasma changes in proportion to their degrees of saponification. The study also examined their feasibility as a temporary embolic agents in the pig renal artery.
Three types of PVA microspheres with the degrees of saponification of 97 mol% (S97), 98 mol% (S98), and 99 mol% (S99) were prepared. Seven kidneys in seven miniature pigs were embolized and divided into three groups so there would be at least two kidneys for each type of PVA. One animal in each group was euthanized immediately after angiography at 3 hours after embolization and the other one at 7 days after. In addition, one animal embolized with S99 microspheres was euthanized at 21 days after embolization.
With S97 microspheres, the vascular network had recovered to the preembolic state by 3 hours after embolization. With S98 microspheres, blood flow in the third-order branch had been restored in the same period. With S99 microspheres, the second- and lower order branches remained occluded until 21 days. Histopathologic specimens harvested at 3 hours revealed only a trace of PVA for S97 microspheres. With S98 microspheres, the vascular lumen was still found to be filled with PVA gel. With S99 microspheres, swollen microspheres densely filled the vascular lumen even on day 21.
Dissolution process in vitro and the duration of arterial occlusion in vivo were possibly related to the degree of saponification of PVA. This result may support feasibility of PVA microspheres as a temporary embolic agent.
Journal of vascular and interventional radiology: JVIR 02/2011; 22(2):212-9. · 1.81 Impact Factor
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ABSTRACT: We present a case of visceral pseudoaneurysm with situs inversus totalis, which was treated by transcatheter embolization. A 58-year-old man with chronic pancreatitis and situs inversus totalis was admitted to our hospital for epigastric pain. On celiac arteriography, a pseudoaneurysm was detected at the anterior superior pancreaticoduodenal artery (ASPD). We catheterized the ASPD with a microcatheter introduced coaxially through a 5Fr catheter, and we isolated the pseudoaneurysm with microcoils. The patient's recovery was uneventful and he was discharged 17 days after the procedure. We describe this case because of the rarity of this anomaly, and it is important in that recognition may help avoid mishaps at interventions, particularly in the emergency setting.
Minimally invasive therapy & allied technologies: MITAT: official journal of the Society for Minimally Invasive Therapy 01/2011; 20(1):54-7. · 1.33 Impact Factor
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Atsushi Komemushi,
Kenji Takizawa,
Norimitsu Tanaka,
Misako Yoshimatsu,
Kunihiro Yagihashi,
Yukihisa Ogawa,
Atsuko Fujikawa,
Iwao Uejima,
Yuya Koike,
Taiji Tamura, [......],
Koichiro Yamakado,
Seishi Nakatsuka,
Tetsuya Yoshioka,
Shozo Hirota,
Kenji Nakamura,
Yasuo Nakajima,
Sachio Kuribayashi, Shuji Kariya,
Noboru Tanigawa,
Satoshi Sawada
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ABSTRACT: Purpose. To evaluate the educational effect of the Japanese Society of Interventional Radiology 7th Academic Summer Seminar from a technical perspective. Materials and Methods. Nineteen trainees participated in the seminar. The seminar consisted of vertebroplasty trainings using swine with the single-plane landmark method and with the ISOcenter Puncture (ISOP) method. All trainees were advised by an instructor as they operated the instruments and punctured the vertebra. For each trainee, the accuracy in the final position of the needle tip of the initial puncture in each swine training was evaluated. Results. Error in the final position of the needle tip of ≥5 mm from the target puncture site occurred in the lateral direction in 42% (8/19) of trainees with the landmark method and 5% (1/19) with the ISOP method. No error ≥5 mm occurred in the vertical or anteroposterior directions. In terms of puncture accuracy, error in the lateral direction was significantly lower with the ISOP method than with the landmark method (2.2 ± 1.5 mm versus 5.6 ± 3.2 mm). Conclusion. This seminar was effective training for trocar placement for beginners. The puncture was more accurate with the ISOP method than with the landmark method.
Radiology research and practice. 01/2011; 2011:830961.
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ABSTRACT: Carbon dioxide (CO₂) is the only proven safe intravascular contrast agent in renal failure and contrast allergy. The use of CO₂ as a contrast agent for the evaluation of failing dialysis fistulas has the potential to preserve residual renal function by eliminating the use of contrast material or decreasing the amount used for fistulograms.
To evaluate the feasibility of fistulography using CO₂ for diagnosis and intervention in patients with failing hemodialysis access.
Dialysis access failure occurred in 94 patients (54 men, 40 women; mean age, 65 years; range, 32–89 years) on 146 occasions. CO₂ was used as the first-choice contrast agent for fistulography and PTA. Fistulography was performed with the injection of CO₂ in the brachial artery using a power injector.
Interventional treatment was indicated in 141 accesses. In 115 of these 141 cases, intervention was performed using CO₂ fistulography alone. When the access flow stopped or decreased very much due to an occlusion and severe stenosis, we could not visualize the access by CO₂ fistulography, or could not perform CO₂ fistulography. For those cases, iodinated contrast fistulography was performed. When the vascular rupture, dissection, or clot formation occurred during intervention, iodinated contrast fistulography was performed. In three patients with arteriovenous fistula, manual injection of CO₂ into the brachial artery resulted in reflux of the gas into the thoracic aorta causing transient loss of consciousness.
CO₂ is a useful contrast agent in the diagnosis and intervention of failing hemodialysis access, eliminating or limiting the use of iodinated contrast material. Caution should be exercised to prevent CO₂ reflux into the aorta when injecting the gas into the brachial artery.
Acta Radiologica 11/2010; 51(9):994-1001. · 1.37 Impact Factor
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ABSTRACT: A 65-year-old man developed respiratory distress during insertion of a central venous catheter (CVC). The presence of gas in the pulmonary trunk and ascending aorta was observed on computed tomography (CT) scans performed immediately after insertion, and paradoxical air embolism (PAE) was diagnosed. There were no symptoms of cerebral or coronary arterial embolism, and the patient was maintained in the same supine position as during CVC insertion. CT conducted after 200 min confirmed disappearance of the gas, and the resting position was discontinued. No subsequent symptoms of PAE occurred. In this patient with respiratory distress during CVC insertion, CT revealed PAE, and PAE was resolved and systemic arterial embolism did not occur by maintenance of the supine position and O(2) administration. This case also highlights the potential risk for the occurrence of asymptomatic PAE related to CVC insertion.
Japanese journal of radiology 07/2010; 28(6):473-5. · 0.65 Impact Factor
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ABSTRACT: A 52-year-old woman was treated for a splenic aneurysm that was found on abdominal computed tomography (CT) during a preoperative assessment for rectal cancer. The aneurysm was embolized using the "double coil-delivered microcatheter technique," and 4 ml of a mixture of N-butyl 2-cyanoacrylate (NBCA) and iodized oil (Lipiodol) (NBCA/Lipiodol = 1.0: 2.5) were injected into the aneurysm. The patient complained of left upper quadrant abdominal pain immediately after the procedure. A blood test 2 days after the procedure showed an increased white blood cell count (13,100/microl), C-reactive protein (13.36 mg/dl), and pancreatic amylase (428 U/l). Abdominal CT scan showed a huge cystic lesion at the pancreatic tail, in the center of which was a highly enhanced area due to accumulated NBCA-Lipiodol. Postembolization pancreatitis was diagnosed, and treatment with fasting and a drip infusion of nafamostat mesilate was started. The patient's abdominal pain became less severe within 3 days, and the pancreatic enzyme level had normalized 14 days after treatment. On CT, the cystic lesion at the pancreatic tail was smaller 20 days after the procedure, and it had disappeared completely 75 days after the procedure.
Japanese journal of radiology 04/2010; 28(3):239-42. · 0.65 Impact Factor
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ABSTRACT: The purpose of our study was to compare the incidence and location of cement leakage in percutaneous vertebroplasty for osteoporotic compression fractures with and without intravertebral clefts.
Percutaneous vertebroplasty was performed in 120 consecutive patients with 300 osteoporotic compression fractures. The cement volume injected was recorded. The cement leakage was evaluated using spinal radiography, MRI, and fluoroscopy during the procedure and CT after the procedure.
One hundred seven vertebrae contained intervertebral clefts, and 193 vertebrae had no clefts. The cement volume injected (+/- SD) was 4.0 +/- 2.0 and 3.6 +/- 1.6 mL into vertebrae with clefts and without clefts, respectively, with no statistically significant difference (p = 0.14). There was no statistically significant difference in the incidence of cement leakage between vertebrae with clefts (53 of 107) and those without clefts (78 of 193) (p = 0.13). Leakage occurred into the epidural veins (12 of 107), perivertebral soft tissues (7 of 107), disks (41 of 107), intervertebral foramen (1 of 107), and spinal canal (1 of 107) in fractures with clefts and into the epidural veins (47 of 193), perivertebral soft tissues (13 of 193), disks (25 of 193), paravertebral veins (5 of 193), large vein (2 of 193), lung (2 of 193), intervertebral foramen (1 of 193), and spinal canal (1 of 193) in fractures without clefts. Cement leakage into the epidural vein was significantly more frequent in vertebrae without clefts (p < 0.01). Disk leakage was significantly more frequent in vertebrae with clefts compared with those without clefts (p < 0.01).
There was no statistically significant difference in the incidence of cement leakage between vertebrae with clefts and without clefts. However, cement leakage into the epidural vein was significantly more frequent in vertebrae without clefts and disk leakage was significantly more frequent in vertebrae with clefts.
American Journal of Roentgenology 11/2009; 193(5):W442-5. · 2.78 Impact Factor
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ABSTRACT: We used metal wires and fibers to fabricate a composite knitted stent and then compare the mechanical characteristics of this stent with those of a pure metallic stent of the same construction in order to develop a stent that offers a comparable degree of expandability as metallic stents but can be used for highly curved lesions that cannot be treated using metallic stents. We fabricated two types of composite knitted stent (N-Z stents), using nitinol wire with a diameter of 0.12 mm and polypara-phenylene-benzobisoxazole (PBO) multifilament fiber (Zyron AS; Toyobo, Osaka, Japan). Stents were knitted into a cylindrical shape using the same textile pattern as a Strecker stent. Two loop lengths (L) of nitinol wire were used in the N-Z stents: L = 1.84 mm (N-Z stent L = 1.84) and L = 2.08 mm (N-Z stent L = 2.08). For the sake of comparison, we fabricated a metallic stent of nitinol using the same textile pattern (N-N stent L = 1.92). We applied a radial compression force diametrically to each stent and applied a bending force diametrically at the free end of a stent with one end fixed in order to evaluate the relationship between stent elasticity and load values. In addition, we macroscopically evaluated the generation of kinks when the stent was bent 180 degrees . The radial compressive force when the stent diameter was reduced by 53% was 6.44 N in the case of N-Z stent L = 1.84, 6.14 N in the case of N-Z stent L = 2.08, and 4.96 N in the case of N-N stent L = 1.92 mm. The composite stent had a radial compressive force higher than that of a metallic stent. The restoring force to longitudinal direction at a 90 degrees bending angle was 0.005 N for N-Z stent L = 1.84, 0.003 N for N-Z stent L = 2.08, and 0.034 N for N-N stent L = 1.92. The restoring force of the composite stent was significantly lower. Finally, the composite stent generated no definitive kinks at a bending angle of 180 degrees , regardless of loop length. However, the N-N stent clearly produced kinks, causing blockage of the inner cavity. In conclusion, the use of a metal and fiber composite in the construction of a knitted stent ensures an expansion performance comparable to that of metallic stents, while providing better kink resistance.
CardioVascular and Interventional Radiology 07/2009; 32(5):1028-32. · 2.09 Impact Factor
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ABSTRACT: Percutaneous translumbar inferior vena cava (IVC) cannulation is an alternative approach for central venous catheterization, but there have been sporadic reports of puncture-related complications. To avoid complications during IVC puncture, percutaneous translumbar IVC cannulation was performed under computed tomography (CT) guidance in addition to fluoroscopy in two patients. To perform chemotherapy for recurrent breast cancer, we planned subcutaneous port catheter placement for central venous access. Under CT guidance, the direction and insertion distance of a long elastor needle were adjusted, and the IVC was punctured at the level of the third lumbar vertebra while taking care to avoid the right urinary tract. A guidewire was inserted through the long elastor needle, and a catheter was placed over the guidewire. It was possible to perform central venous catheterization by percutaneous translumbar inferior vena cava cannulation under CT guidance.
Japanese journal of radiology 06/2009; 27(4):176-9. · 0.65 Impact Factor
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ABSTRACT: The purpose of the present study was to evaluate the clinical outcome of peripheral stent placement after failed balloon angioplasty in patients with grafts who are on hemodialysis. We examined 30 Wallstents that were placed in 26 patients because balloon angioplasty failed or early restenosis (<3 months) occurred within 3 months. We retrospectively reviewed 267 consecutive balloon angioplasties performed in 71 patients with graft access between August 2000 and March 2007. Stent placements accounted for 30 (11.2%) of the 267 balloon angioplasties. The clinical success rate of stent placement was 93.3% (28 of 30 stent placements). The 3-, 6-, and 12-month primary patency rates were 73.3%, 39.3%, and 17.7%, respectively. The 1-, 2-, and 3-year secondary patency rates were 90.2%, 83.8%, and 83.8%, respectively. Primary patency was significantly prolonged by stent placement after early restenosis compared with previous balloon angioplasty alone (P = 0.0059). Primary patency after stent placement was significantly lower than after successful balloon angioplasty without indications for stent placement (P = 0.0279). Secondary patency rates did not significantly differ between stent placement and balloon angioplasty alone. The mean number of reinterventions required to maintain secondary patency after stent placement was significantly larger than that after balloon angioplasty alone (Mann-Whitney U test, P = 0.0419). We concluded that peripheral stent placement for graft access is effective for salvaging vascular access after failed balloon angioplasty and for prolonging patency in early restenosis after balloon angioplasty. However, reinterventions are required to maintain secondary patency after stent placement. Furthermore, peripheral stent placement for graft access cannot achieve the same primary patency as balloon angioplasty alone.
CardioVascular and Interventional Radiology 06/2009; 32(5):960-6. · 2.09 Impact Factor
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ABSTRACT: We report herein a case of a patient with high-flow priapism for whom a gelatin sponge was used as a temporary occlusive agent in arterial embolization, resulting in favorable outcome. The American Urological Association guideline on the management of priapism recommends using temporary occlusive agents. We reviewed all reports published after the introduction of this guideline to compare temporary and permanent occlusive agents in terms of symptom improvement and onset of erectile dysfunction. The rate of symptom improvement differed significantly between temporary and permanent embolizing materials, but no significant difference was apparent in the rate of erectile function improvement.
Minimally invasive therapy & allied technologies: MITAT: official journal of the Society for Minimally Invasive Therapy 02/2009; 18(1):1-5. · 1.33 Impact Factor
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ABSTRACT: The purpose of this study is to evaluate the clinical efficacy of transcatheter embolization for pseudoaneurysms of peripheral arteries with n-butyl cyanoacrylate (NBCA). From November 2000 to February 2008, 17 patients with 18 pseudoaneurysms were treated by transcatheter embolization at our affiliated hospitals. The locations of the pseudoaneurysms were right hepatic artery (n=3), renal artery (n=5), splenic artery (n=2), gastroduodenal artery (n=2), common hepatic artery (n=1), pancreatic arcade (n=1), external iliac artery (n=1), internal iliac artery (n=1), internal thoracic artery (n=1), and left gastric artery (n=1). We assessed technical success rate, embolization methods, and clinical course in this study. The technical success rate was 94.4% (17/18 cases). Embolization methods were isolation (n=17) and packing (n=1). Only NBCA was used in 14 cases, both coils and NBCA were used in four cases. Six patients were in shock prior to the procedure, but all patients recovered immediately after embolization procedure including transfusion. None of the patients died of procedure-related factors or had notable postoperative complications, but three patients died within a week of the procedure because of deterioration of the underlying disease. In conclusion, transcatheter embolization of pseudoaneurysms with NBCA is a safe and effective technique for treatment.
Minimally invasive therapy & allied technologies: MITAT: official journal of the Society for Minimally Invasive Therapy 01/2009; 18(6):361-5. · 1.33 Impact Factor
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ABSTRACT: Transcatheter embolization using two microcatheters of different shapes was performed to treat a 34-mm-diameter aneurysm that was located near the origin of a splenic artery that originated from the superior mesenteric artery (SMA). The procedure resulted in complete packing of the aneurysm and preserving splenic arterial blood flow.
Minimally invasive therapy & allied technologies: MITAT: official journal of the Society for Minimally Invasive Therapy 01/2009; 18(5):311-4. · 1.33 Impact Factor
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ABSTRACT: The objective of the present study was to determine the frequency of gas retention in the renal vein following carbon dioxide intraosseous venography in the prone position and, while citing references, to examine its onset mechanisms. All percutaneous vertebroplasties performed at our hospital from January to December 2005 were registered and retrospectively analyzed. Of 43 registered procedures treating 79 vertebrae, 28 procedures treating 54 vertebrae were analyzed. Vertebral intraosseous venography was performed using carbon dioxide as a contrast agent in all percutaneous vertebroplasty procedures. In preoperative and postoperative vertebral CT, gas retention in the renal vein and other areas was assessed. Preoperative CT did not show gas retention (0/28 procedures; 0%). Postoperative CT confirmed gas retention in the renal vein in 10 of the 28 procedures (35.7%). Gas retention was seen in the right renal vein in 8 procedures (28.6%), in the left renal vein in 5 procedures (17.9%), in the left and right renal veins in 3 procedures (10.7%), in vertebrae in 22 procedures (78.6%), in the soft tissue around vertebrae in 14 procedures (50.0%), in the spinal canal in 12 procedures (42.9%), and in the subcutaneous tissue in 5 procedures (17.9%). In conclusion, in our study, carbon dioxide gas injected into the vertebra frequently reached and remained in the renal vein.
CardioVascular and Interventional Radiology 04/2008; 31(6):1174-7. · 2.09 Impact Factor
