L Stockx

Publications (52)174.01 Total impact

• Article: Iatrogenic pseudoaneurysm in the upper arm: treatment by transcatheter embolization.

  G Maleux, L Stockx, P Brys, J Lammens, H Lacroix, G Wilms, G Marchal
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  ABSTRACT: A 32-year-old woman presented with a pulsatile, painful mass in her left upper arm, originating several days after removal of an Ilizarov external fixation. The diagnosis of a pseudoaneurysm was made by medical history and by physical and ultrasonographic examination of the mass. Angiography confirmed the presence of the pseudoaneurysm, originating from a branch of the arteria profunda brachii, and definitive treatment was performed by transcatheter embolization. Clinical follow-up showed absence of pulsation and pain in the upper arm and a gradual volume decrease of the mass lesion.
  CardioVascular and Interventional Radiology 04/2012; 23(2):140-2. · 2.09 Impact Factor
• Article: Transcatheter embolization of biopsy-related vascular injuries in renal allografts. Long-term technical, clinical and biochemical results.

  G Maleux, T Messiaen, L Stockx, Y Vanrenterghem, G Wilms
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  ABSTRACT: Biopsy-related vascular injuries in renal transplants are rare, but they can lead to dramatic clinical symptoms prompting immediate treatment. Transcatheter embolization is a known minimally invasive technique to treat some form of arterial bleeding. This study evaluated the efficacy of this technique in iatrogenic biopsy-related vascular lesions in renal allografts. Between 1993 and 2001, 13 patients were treated by percutaneous transcatheter intervention. Indications for embolization were hypovolemic shock due to perinephric hematoma (n = 5), persistent macroscopic hematuria (n = 7) and an asymptomatic large intrarenal pseudoaneurysm in 1 patient. Selective angiography revealed an arteriovenous fistula (n = 7), a pseudoaneurysm (n = 6), and perinephric contrast extravasation (n = 4). In all patients, successful embolization of the feeding artery could be performed; in 11 patients it was performed in one session, in 2 patients an additional session was needed. In 1 patient thrombosis of a segmental artery occurred immediately after embolization, but was successfully treated by short-term in situ thrombolysis. Clinical symptoms disappeared in all patients. Serum creatinine levels (determined 30 and 60 days after embolization, compared to the level before embolization) decreased significantly in 10 patients; a progressive deterioration of the renal function was observed in 3 patients. Transcatheter embolization is a safe and effective endovascular technique to treat biopsy-related vascular injuries in renal transplants. In the vast majority of cases an immediate clinical success and significant benefit in renal function can be obtained and the longevity of the allograft after successful embolization mainly depends on the natural (medical) outcome.
  Acta Radiologica 02/2003; 44(1):13-7. · 1.37 Impact Factor
• Article: Transcatheter Embolization of Biopsy‐Related Vascular Injuries in Renal Allografts

  G. Maleux, T. Messiaen, L. Stockx, Y. Vanrenterghem, G. Wilms
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  ABSTRACT: Purpose: Biopsy-related vascular injuries in renal transplants are rare, but they can lead to dramatic clinical symptoms prompting immediate treatment. Transcatheter embolization is a known minimally invasive technique to treat some form of arterial bleeding. This study evaluated the efficacy of this technique in iatrogenic biopsy-related vascular lesions in renal allografts.Material and Methods: Between 1993 and 2001, 13 patients were treated by percutaneous transcatheter intervention. Indications for embolization were hypovolemic shock due to perinephric hematoma (n = 5), persistent macroscopic hematuria (n = 7) and an asymptomatic large intrarenal pseudoaneurysm in 1 patient. Selective angiography revealed an arteriovenous fistula (n = 7), a pseudoaneurysm (n = 6), and perinephric contrast extravasation (n = 4).Results: In all patients, successful embolization of the feeding artery could be performed; in 11 patients it was performed in one session, in 2 patients an additional session was needed. In 1 patient thrombosis of a segmental artery occurred immediately after embolization, but was successfully treated by short-term in situ thrombolysis. Clinical symptoms disappeared in all patients. Serum creatinine levels (determined 30 and 60 days after embolization, compared to the level before embolization) decreased significantly in 10 patients; a progressive deterioration of the renal function was observed in 3 patients.Conclusions: Transcatheter embolization is a safe and effective endovascular technique to treat biopsy-related vascular injuries in renal transplants. In the vast majority of cases an immediate clinical success and significant benefit in renal function can be obtained and the longevity of the allograft after successful embolization mainly depends on the natural (medical) outcome.
  Acta Radiologica 12/2002; 44(1):13 - 17. · 1.37 Impact Factor
• Article: Late distal perigraft endoleak after endovascular repair of an abdominal aortic aneurysm due to cranial migration of the iliac branch of a modular stent-graft.

  G Maleux, A Nevelsteen, L Stockx
  RöFo - Fortschritte auf dem Gebiet der R 03/2001; 173(2):156-7. · 2.76 Impact Factor
• Article: Postoperative retroperitoneal hemorrhage due to a bleeding ureteric artery: treatment by transcatheter embolization.

  G Maleux, L Stockx, G Wilms, G Bogaert, G Marchal
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  ABSTRACT: We report a case of a postoperative retroperitoneal haemorrhage due to an iatrogenic perioperative injury of an ureteric artery. Transcatheter embolization using microparticles stopped the bleeding and the patient stabilized immediately. Ureteric artery injury is a very rare condition but can be managed successfully by percutaneous interventional techniques.
  European Radiology 02/2001; 11(1):34-6. · 3.22 Impact Factor
• Article: Vascular targeting of solid tumours: a major 'inverse' volume-response relationship following combretastatin A-4 phosphate treatment of rat rhabdomyosarcomas.

  W Landuyt, O Verdoes, D O Darius, M Drijkoningen, S Nuyts, J Theys, L Stockx, W Wynendaele, J F Fowler, G Maleux, W Van den Bogaert, J Anné, A van Oosterom, P Lambin
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  ABSTRACT: Tumour-specific vascularisation may be therapeutically approached in two different ways: by antiangiogenic treatments specifically directed to dividing and migrating endothelial cells, or by agents that target principally the inadequate and ill-structured tumour vasculature. Combretastatin A-4 phosphate (combreAp), a recently synthesised prodrug (OXiGENE, Lund, Sweden), is a vascular targeting agent of the latter kind. We evaluated the effect of a single intraperitoneal (i.p.) combreAp injection on the growth of rhabdomyosarcomas syngeneic in WAG/Rij rats. Different tumour volume groups, ranging between 0.1 and 27 cm(3), were selected to assess the relationship between the size at treatment time and the response to combreAp. A double combreAp treatment (2x25 mg/kg) was investigated within the same overall aim: the relationship between growth delay and tumour size. Our results show that the systemic administration of combreAp induces a clear-cut differential growth delay in the solid rat rhabdomyosarcomas: with very large tumours (>/= 14 cm(3)), a 17.6-fold stronger effect was measured than with very small tumours (<1 cm(3)). This is the 'inverse' of the volume-response seen with the conventional therapeutic approaches (radiotherapy, chemotherapy or surgery). These combreAp antitumour responses were observed without treatment limiting systemic toxicity in the rats. With clinical digital subtraction angiography, using microsurgical cannulation of a major tumour draining vessel, and with histopathology, we demonstrate that growth delay is related to an early (within 3-6 h) and extensive breakdown of tumour blood vessels. The experiments involving a second injection also indicate a volume-dependent effect of combreAp in reducing the regrowth rate of small or large rhabdomyosarcomas. This significant differential volume-response obtained with 'selective' vascular targeting, stronger in larger tumours than smaller ones, suggests the potential of broadening the therapeutic window.
  European Journal of Cancer 10/2000; 36(14):1833-43. · 5.54 Impact Factor
• Article: Outcome and one year follow-up of intra-arterial staphylokinase in 191 patients with peripheral arterial occlusion.

  S Heymans, S Vanderschueren, R Verhaeghe, L Stockx, H Lacroix, A Nevelsteen, Y Laroche, D Collen
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  ABSTRACT: Wild-type or equipotent variants of recombinant staphylokinase (rSak) were given intra-arterially (as a 2 mg bolus injection followed by an infusion of 1 mg/h or 0.5 mg/h overnight, with concomitant heparin [1000 IU/h]) to 191 patients of less than 80 years (62 +/- 1 years, mean +/- SEM), with a peripheral arterial occlusion (PAO) of less than 120 days (mean 14 +/- 1 days, median 11 days, 5 to 95 percentiles 3 to 30 days). Ninety nine patients presented with acute or subacute ischemia, 57 with severe claudication, 33 with chronic rest pain and 2 with gangrene. Occlusion occurred in 122 native arteries and in 69 grafts. Revascularization was complete in 83 percent (158/191), partial in 13 percent (24/191) and absent in 4 percent (7/191) after administration of 12 +/- 0.5 mg rSak over 14 +/- 0.7 h. Complete revascularization of acute occlusions of popliteal or more distal arteries was less frequent (60 percent, 15/25) than of acute occlusions of more proximal native arteries (95 percent, 37/39, p <0.001) or grafts (89 percent, 50/56, p = 0.005). Additional endovascular procedures were performed in 47 percent and subsequent elective bypass surgery in 23 percent of patients. Major bleeding occurred in 12 percent (23/191), one month mortality was 3.1 percent (6/191) and one year mortality was 6.9 percent (12/174). However, four patients (2.1 percent) had an intracranial bleeding following therapy: a 85 year old woman with severe diabetic arteriopathy, who was included in violation of the protocol, a 79 and a 74-year-old woman and a 74-year-old man, all with severe hypertension and limb threatening ischemia; these four patients died within two months after treatment. Amputations were performed within the first year in 16 of 162 surviving patients (9.8 percent): in 7 percent (7/96) with an occluded native artery and 14 percent (9/66) with an occluded graft (p = 0.19). No significant difference in lysis rate, one month mortality or one year amputation-free survival was observed in occlusions of recent onset (< or =14 days, n = 126) as compared to occlusions of longer duration (>14 days, n = 65). Treatment was interrupted prematurely in 4 patients because of a suspected allergic reaction. Fibrinogen levels remained unaffected during treatment (3.3 +/- 0.1 g/l before vs. 3.3 +/- 0.1 g/l after infusion, n = 167). In conclusion, rSak appears to be a highly effective thrombolytic agent in patients with PAO, resulting in a low one month mortality (3.1 percent) and a high one year amputation free survival (84 percent), with an acceptable incidence of major bleedings, but with occasional fatal intracranial hemorrhages.
  Thrombosis and Haemostasis 05/2000; 83(5):666-71. · 5.04 Impact Factor
• Article: Endovascular treatment of a ruptured paraclinoid aneurysm of the carotid syphon achieved using endovascular stent and endosaccular coil placement.

  G Wilms, F van Calenbergh, L Stockx, P Demaerel, J van Loon, J Goffin
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  ABSTRACT: We herein report a case of a ruptured superior hypophyseal aneurysm of the left supraclinoid carotid artery that could not be treated with a Guglielmi detachable coil (GDC), even in combination with a supporting nondetachable balloon. After an unsuccessful attempt at surgical clipping, treatment consisted of the placement of a stent over the neck of the aneurysm, advancement of a microcatheter through the stent mesh, and endosaccular embolization with a GDC. The late clinical outcome was excellent.
  American Journal of Neuroradiology 05/2000; 21(4):753-6. · 2.93 Impact Factor
• Article: Multiple small pseudoaneurysms complicating pancreatitis: angiographic diagnosis and transcatheter embolization.

  G Maleux, W van Steenbergen, L Stockx, D Vanbeckevoort, G Wilms, G Marchal
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  ABSTRACT: We report a case of retroperitoneal hemorrhage due to multiple, small pseudoaneurysms complicating a chronic alcoholic pancreatitis. Cross-sectional imaging with CT and US could not clearly depict these vascular lesions. Selective arteriography of the superior mesenteric and gastroduodenal arteries clearly showed the small pseudoaneurysms and definitive treatment was performed by transcatheter embolization using coils. Eight months after successful embolization, the patient is asymptomatic without any recurrent bleeding.
  European Radiology 02/2000; 10(7):1127-9. · 3.22 Impact Factor
• Article: Magnetic susceptibility artifacts by titanium surgical clips mimicking fibromuscular dysplasia of the renal artery in a kidney transplant.

  G Verswijvel, L Van Hoe, L Stockx, R Oyen
  European Radiology 02/2000; 10(3):543. · 3.22 Impact Factor
• Article: Breath-hold contrast-enhanced three-dimensional MR angiography of the abdomen: time-resolved imaging versus single-phase imaging.

  L Van Hoe, T De Jaegere, H Bosmans, L Stockx, D Vanbeckevoort, R Oyen, R Fagard, G Marchal
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  ABSTRACT: To evaluate a technique for time-resolved breath-hold contrast material-enhanced three-dimensional magnetic resonance (MR) angiography of the abdomen. In a prospective study, 43 patients underwent time-resolved MR angiography (acquisition time per data set, 7 seconds). The patients also underwent single-phase high-spatial-resolution MR angiography (acquisition time, 27 seconds) (n = 6), conventional angiography (n = 7), or both (n = 30). No bolus timing study was performed for time-resolved MR angiography. Image quality (presence of artifacts, ability to prevent venous overlap on arterial phase images, contrast enhancement) and demonstration of anatomic variants (renal arterial and venous variants, vena caval anomaly, visceral arterial variants) and vascular diseases were assessed. Time-resolved MR angiographic images were characterized by fewer and less severe artifacts, less overlap of enhancing veins, and better contrast enhancement than were single-phase MR angiographic images (P < .05). The mean sensitivity and specificity were 90% (nine of 10) and 100% (1 73 of 1 73), respectively, for detection of arterial anatomic variants and 93% (28 of 30) and 100% (324 of 325), respectively, for detection of disease. The technique also proved to be reliable for demonstration of venous disease. In comparison with current non-time-resolved MR angiographic techniques, time-resolved MR angiography is more robust and easier to perform and allows simultaneous evaluation of arterial and venous disease.
  Radiology 02/2000; 214(1):149-56. · 5.73 Impact Factor
• Article: Complications in the endovascular repair of abdominal aortic aneurysms: a risk factor analysis.

  P Cuypers, A Nevelsteen, J Buth, J Hamming, L Stockx, H Lacroix, A Tielbeek
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  ABSTRACT: to identify risk factors for complications following endovascular repair of abdominal aortic aneurysms (AAAs). endovascular AAA exclusion was attempted in 64 patients. Patient characteristics, anatomic features of the aneurysm, operative technical aspects, and the experience of the teams were correlated with mortality, occurrence of endoleak, and other complications. Perioperative complications were graded following the recommendations of the Ad Hoc Committee on reporting standards. For the assessment of correlation between risk factors and outcomes a logistic regression analysis was used. complications were observed in 43% of the procedures and were classified as mild (24%), moderate (55%) or severe (21%). American Society of Anaesthesiology (ASA) risk class 3 or 4, and advanced age were independent risk factors for perioperative death and complications. Adjuvant procedures or overstenting of the renal arteries with the uncovered part of the stent were not associated with increased risk of complications. Nevertheless, in four of 24 overstented renal orifices, a renal infarction or ischaemia of the kidney was observed on a postoperative CT scan. Advanced experience was associated with less complications, less endoleaks, and shorter operating time. high age and medical co-morbidity were associated with increased risk for perioperative complications and death. Additional perioperative procedures are usually well tolerated. With greater experience in endovascular AAA grafting the incidence of complications and endoleaks decreased.
  European Journal of Vascular and Endovascular Surgery 10/1999; 18(3):245-52. · 2.99 Impact Factor
• Article: Arterial occlusion and thrombus aspiration after total knee arthroplasty.

  J Bellemans, L Stockx, K Peerlinck, J Vermylen, H Lacroix, R Suy
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  ABSTRACT: Arterial occlusion after total knee arthroplasty is an uncommon complication. In the literature only a few cases have been reported, and non consensus exists on the optimal management for this condition. The authors report two patients with popliteal artery thrombosis in the early postoperative period. Both patients were treated with percutaneous thrombus aspiration, a technique that has not been reported previously for this indication. In both patients complete restoration of arterial perfusion and limb salvage was achieved, although ischemic necrosis of the anterior compartment muscles of the lower leg could not be prevented.
  Clinical Orthopaedics and Related Research 10/1999; · 2.53 Impact Factor
• Article: Repositioning and leaving in situ the central venous catheter during percutaneous treatment of associated superior vena cava syndrome: a report of eight cases.

  L Stockx, H Raat, J Donck, G Wilms, G Marchal
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  ABSTRACT: To describe a combined procedure of repositioning and leaving in situ a central venous catheter followed by immediate percutaneous treatment of associated superior vena cava syndrome (SVCS). Eight patients are presented who have central venous catheter-associated SVCS (n = 6 Hickman catheters, n = 2 Port-a-cath) caused by central vein stenosis (n = 4) or concomitant thrombosis (n = 4). With the use of a vascular snare introduced via the transcubital or transjugular approach, the tip of the central venous catheter could be engaged, and repositioned after deployment of a stent in the innominate or superior vena cava. In all patients it was technically feasible to reposition the central venous catheter and treat the SVCS at the same time. In one patient flipping of the Hickman catheter in its original position provoked dislocation of the released Palmaz stent, which could be positioned in the right common iliac vein. Repositioning of a central venous catheter just before and after stent deployment in SVCS is technically feasible and a better alternative than preprocedural removal of the vascular access.
  CardioVascular and Interventional Radiology 04/1999; 22(3):224-6. · 2.09 Impact Factor
• Article: Inflammatory abdominal aortic aneurysm and bilateral complete ureteral obstruction: treatment by endovascular graft and bilateral ureteric stenting.

  A Nevelsteen, H Lacroix, L Stockx, L Baert, P Depuydt
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  ABSTRACT: Inflammatory abdominal aortic aneurysms may present a challenge to the surgeon, especially because of associated retroperitoneal fibrosis and possible ureteral complications. We present a case of inflammatory abdominal aortic aneurysm with bilateral ureteral entrapment and complete anuria, successfully treated by endovascular grafting and temporary ureteral stenting.
  Annals of Vascular Surgery 04/1999; 13(2):222-4. · 1.03 Impact Factor
• Article: Endovascular stent-grafts for superficial femoral artery disease: results of 1-year follow-up.

  D O Kessel, L D Wijesinghe, I Robertson, D J Scott, H Raat, L Stockx, A Nevelsteen
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  ABSTRACT: To document a preliminary study to assess the deployment and outcomes of endoluminal stent grafting in the superficial femoral artery (SFA) with use of a prototype device. Twenty patients with lifestyle-limiting intermittent claudication were selected for treatment with a balloon-mounted expansive polytetrafluoroethylene graft. All patients had angiographically proven SFA disease (median length, 17 cm) with normal arterial inflow and at least two calf vessels patent to the ankle. Follow-up was by means of ankle brachial pressure index (ABPI), duplex ultrasound, and angiography. Fourteen patients were successfully treated. Six patients were excluded: five by the study protocol and one because the procedure was a technical failure. ABPI rose from 0.6 before treatment to 1.0. The treated limbs became asymptomatic. Twelve-month primary, primary assisted, and secondary patency rates of treated patients were 29%, 50%, and 64%. Endovascular stent grafting of SFA lesions is technically feasible, but the patency rates obtained with this design are inferior to those obtained with conventional surgical bypass.
  Journal of Vascular and Interventional Radiology 04/1999; 10(3):289-96. · 2.08 Impact Factor
• Article: Transcatheter embolization of hepatic arteriovenous fistulas in Rendu-Osler-Weber disease: a case report and review of the literature.

  L Stockx, H Raat, B Caerts, E Van Cutsem, G Wilms, G Marchal
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  ABSTRACT: A patient with hereditary hemorrhagic telangiectasia and diffuse intrahepatic arteriovenous fistulas developed secondary high-output ventricular failure and pulmonary hypertension. A serial staged hepatic arterial coil embolization was performed with long-term resultant haemodynamic and clinical improvement. The methods of this procedure and related complications are discussed.
  European Radiology 02/1999; 9(7):1434-7. · 3.22 Impact Factor
• Article: Percutaneous embolization of a splenic arteriovenous fistula related to acute necrotizing pancreatitis.

  H Raat, L Stockx, X De Meester, W Van Steenbergen, G Marchal
  European Radiology 02/1999; 9(4):753. · 3.22 Impact Factor
• Article: Stent-grafts in the superficial femoral artery.

  L Stockx
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  ABSTRACT: Superficial femoral artery disease is still cumbersome to treat. While percutaneous transluminal angioplasty (PTA) and stent replacement are well established treatment modalities for occlusive iliac or renal artery diseases, less favorable results are obtained with these techniques in the superficial femoral artery. Bypass surgery with the use of an autologous vein still gives the best results. A less invasive alternative is therefore desirable. The use of stent-grafts seems promising as it combines the technology of a less invasive endovascular treatment with the advantages of creating an anatomical endoprosthetic smooth conduit. This article gives an overview of the different types of stent-grafts and their clinical applications.
  European Journal of Radiology 11/1998; 28(3):182-8. · 2.61 Impact Factor
• Article: Arterial bleeding after biliary drainage catheter placement: diagnosis and treatment.

  G Maleux, L Stockx, W Van Steenbergen, G Marchal
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  ABSTRACT: A case of hepatic arterial haemorrhage after percutaneous biliary drainage catheter placement is presented. Temporary control of the haemorrhage was obtained by placement of a larger drainage catheter which tamponaded the bleeding artery. Hepatic angiography followed by transcatheter embolotherapy provided a definitive control of bleeding.
  Journal belge de radiologie 09/1998; 81(4):176-7.