Embolization of angiographically visible type I and II utero-ovarian anastomoses during uterine artery embolization for fibroid tumors: impact on symptom recurrence and permanent amenorrhea.

Purpose: To compare the incidences of symptom recurrence and permanent amenorrhea following uterine artery embolization (UAE) for symptomatic fibroid tumors in patients with type I and II utero-ovarian anastomoses (UOAs) with versus without ovarian artery embolization (OAE).

Materials And Methods: A retrospective, institutional review board-approved study of 99 women who underwent UAE for symptomatic fibroid tumors from April 2005 to October 2010 was conducted to identify patients who had type I or II UOAs at the time of UAE. Based on the embolization technique, patients were categorized into standard (ie, UAE only), combined (ie, UAE and OAE), and control (patients without UOAs who underwent UAE) groups.

Image-guided placement of port catheters: is there an increased risk of infection if the port is immediately accessed and used?

Purpose: To compare complication rates in patients who have port-a-catheters inserted and left accessed for immediate use and those who have ports inserted but not accessed.

Methods: In this retrospective, IRB-approved study, medical records of patients who received a port catheter between 9/2009 and 2/2010 were reviewed. The data collected included patient demographics, diagnosis, procedure and complications.

Angiographic evaluation and management of acute gastrointestinal hemorrhage.

Although most cases of acute nonvariceal gastrointestinal hemorrhage either spontaneously resolve or respond to medical management or endoscopic treatment, there are still a significant number of patients who require emergency angiography and transcatheter treatment. Evaluation with noninvasive imaging such as nuclear scintigraphy or computed tomography may localize the bleeding source and/or confirm active hemorrhage prior to angiography. Any angiographic evaluation should begin with selective catheterization of the artery supplying the most likely site of bleeding, as determined by the available clinical, endoscopic and imaging data.

Image optimization during endovascular aneurysm repair.

Objective: The purposes of this review are to examine various properties of the fluoroscopic imaging equipment used during endovascular aneurysm repair (EVAR) that can be modified to reduce radiation dose while optimizing image acquisition and display, to detail geometric aspects of EVAR intraprocedural imaging used to achieve consistently optimal EVAR results, and to describe acquisition parameters and strategies for minimizing contrast-induced nephropathy.

Conclusion: The outcome of EVAR is strongly linked to image acquisition and interpretation, including the preprocedural, intraprocedural, and postprocedural display of relevant vascular anatomy, positions and configurations of the endograft components, and documentation of successful aneurysm exclusion. Operator familiarity with the imaging equipment, radiation and contrast dose reduction strategies, and image optimization techniques strongly influence the outcome of EVAR.

Wound dehiscence or failure to heal following venous access port placement in patients receiving bevacizumab therapy.

Purpose: To determine the incidence of wound dehiscence or failure to heal after port placement in patients receiving bevacizumab therapy. A hypothesis was tested that the mean interval between bevacizumab administration and port placement was shorter in patients who had dehiscence than in those who did not.

Materials And Methods: Medical records of all patients who had venous access ports placed from July 2006 through December 2007 were retrospectively reviewed.

TIPS: comparison of shunt patency and clinical outcomes between bare stents and expanded polytetrafluoroethylene stent-grafts.

Purpose: To compare shunt patency and clinical outcomes in two groups of patients who received a transjugular intrahepatic portosystemic shunt (TIPS): one group with bare stents and one with expanded polytetrafluoroethylene stent-grafts.

Materials And Methods: TIPS were created with bare stents (n = 41) or stent-grafts (n = 40). Overall TIPS patency rates were compared between these two groups, as were clinical outcomes in patients with variceal bleeding and those with ascites.

Suprarenal inferior vena cava filters: a 20-year single-center experience.

Purpose: To assess the clinical safety and efficacy of suprarenal inferior vena cava (IVC) filters during long-term follow-up.

Materials And Methods: In this retrospective study, the authors collected the following data about patients who underwent suprarenal IVC filter placement at their institution between 1988 and 2007: demographics, clinical presentation, indications for filter placement, reasons for placing the filter in the suprarenal IVC, type of filter, frequency of pulmonary embolism (PE) after filter placement, and filter-related problems during follow-up.

Results: Seventy patients (32 male and 38 female patients; mean age, 60 years) had suprarenal IVC filters.

Discordance between CT and angiography in the PIOPED II study.

Purpose: To retrospectively evaluate the causes of discordant computed tomographic (CT)-angiographic readings from the Prospective Investigation of Pulmonary Embolism Diagnosis, or PIOPED, II study.

Materials And Methods: Institutional review board approval was obtained for this HIPAA-compliant study. Of 1036 patients suspected of having pulmonary embolism who were examined with CT, 226 underwent angiography; 206 patients had concordant results and 20 had discordant results according to two independent readers.

TrapEase vena cava filter: experience in 751 patients.

Purpose: To evaluate the clinical safety and efficacy of the TrapEase vena cava filter in a 4-year single-center experience.

Methods: The clinical and imaging data of 751 patients (384 men; mean age 64 years, range 16-99) who had a TrapEase inferior vena cava (IVC) filter placed between January 1, 2001, and December 31, 2004, were reviewed retrospectively. More than a third of patients (297, 39.

"Recovery" vena cava filter: experience in 96 patients.

The purpose of the study was to assess the clinical safety and efficacy of the "Recovery(TM)" (Bard) inferior vena cava (IVC) filter. We retrospectively evaluated the clinical and imaging data of patients who had a "Recovery(TM)" IVC filter placed between January 2003 and December 2004 in our institution. The clinical presentation, indications, and procedure-related complications during placement and retrieval were evaluated.

Aortoiliac gadolinium-enhanced CT angiography: improved results with a 16-detector row scanner compared with a four-detector row scanner.

Purpose: To assess the level of vascular enhancement of gadolinium-enhanced aortoiliac computed tomographic (CT) angiography with a 16-detector row CT scanner and to compare it with the results of previous similar studies that used four-detector row CT units.

Materials And Methods: Eleven gadolinium-enhanced CT angiograms were obtained in 10 consecutive patients with contraindication to iodinated contrast medium with use of a 16-detector row CT scanner. In the region of interest, attenuation measurements (in HU) were obtained from the proximal abdominal aorta to the common femoral arteries during unenhanced, gadolinium-enhanced, and delayed acquisitions.

Renal perfusion defects after endovascular repair of abdominal aortic aneurysms.

Purpose: To determine the prevalence of new renal perfusion defects and the association of these events with aneurysm neck atheroma during endovascular stent-graft repair of abdominal aortic aneurysm (AAA).

Materials And Methods: A retrospective review was performed of 50 patients who underwent AAA repair with bifurcated endovascular stent-grafts without suprarenal components between June 1998 and May 1999. Pre- and postprocedural computed tomographic (CT) angiograms were reviewed to determine the prevalence of new renal perfusion defects.