A baffling case of inferior vena cava filter removal in a patient with transposition of the great arteries.

A 47-year-old man with a history of transposition of the great arteries after a Mustard atrial switch procedure and prior inferior vena cava filter placement for venous thromboembolism presented for removal before being listed for orthotopic heart transplantation in anticipation of cardiopulmonary bypass cannulation. The filter was retrieved using a right transjugular approach without disruption of his existing atrial baffle. Contingency planning in the event of unsuccessful baffle navigation included a transfemoral everted filter approach.

Use of doppler ultrasound to predict need for transjugular intrahepatic portosystemic shunt revision.

Background: Transjugular intrahepatic portosystemic shunt (TIPS) is used to treat complications of portal hypertension, such as ascites and variceal bleeding (VB). While liver doppler ultrasound (DUS) is used to assess TIPS patency, trans-shunt venography (TSV) is the gold standard.

Aim: To determine the accuracy of DUS to assess TIPS dysfunction and for need for revision.

Derivation and Validation of a Model to Predict Clinically Significant Portal Hypertension Using Transient Elastography and FIB-4.

Background: Liver biopsy and hepatic venous pressure gradient (HVPG), the gold standard for assessing advanced fibrosis (AF) and clinically significant portal hypertension (CSPH), are invasive, costly, and time-consuming.

Goal: We investigated if the combination of fibrosis index based on 4 factors (FIB-4) and liver stiffness measure (LSM) can identify AF and more importantly, CSPH.

Patients And Methods: Patients with chronic liver disease referred for transjugular liver biopsy were analyzed retrospectively.

Management of hepatic artery aneurysm: A case series.

Hepatic artery aneurysms are rare, but their diagnosis is important because of high mortality and complications. Common risk factors for developing these aneurysms include hypertension, vascular disease, pancreatitis, diabetes, tobacco use, autoimmune diseases, and previous transplantation. Frequent imaging for trauma and tumor surveillance has increased the incidence of naive hepatic aneurysms.

Percutaneous transhepatic vs. endoscopic retrograde biliary drainage for suspected malignant hilar obstruction: study protocol for a randomized controlled trial.

Background: The optimal approach to the drainage of malignant obstruction at the liver hilum remains uncertain. We aim to compare percutaneous transhepatic biliary drainage (PTBD) to endoscopic retrograde cholangiography (ERC) as the first intervention in patients with cholestasis due to suspected malignant hilar obstruction (MHO).

Methods: The INTERCPT trial is a multi-center, comparative effectiveness, randomized, superiority trial of PTBD vs.

Prolonged Delayed Renal Graft Function Secondary to Venous Hypertension.

The case of a 39-year-old highly sensitized woman who underwent second renal transplantation after being on warfarin because of a history of frequent thromboses of her left femoral arteriovenous graft (AVG) is reported here. The patient received a flow cytometric positive crossmatch kidney transplant from a deceased donor. Her posttransplant course was complicated by prolonged delayed graft function (DGF) lasting for 9 months.

A randomized prospective long-term (>1 year) clinical trial comparing the efficacy and safety of radiofrequency ablation to 980 nm laser ablation of the great saphenous vein.

Purpose To compare the short- and long-term (>1 year) efficacy and safety of radiofrequency ablation (ClosureFAST™) versus endovenous laser ablation (980 nm diode laser) for the treatment of superficial venous insufficiency of the great saphenous vein. Materials and methods Two hundred patients with superficial venous insufficiency of the great saphenous vein were randomized to receive either radiofrequency ablation or endovenous laser ablation (and simultaneous adjunctive therapies for surface varicosities when appropriate). Post-treatment sonographic and clinical assessment was conducted at one week, six weeks, and six months for closure, complications, and patient satisfaction.

Comparison of MDCT protocols in trauma patients with suspected splenic injury: superior results with protocol that includes arterial and portal venous phase imaging.

Purpose: We aimed to determine which intravenous contrast-enhanced multidetector computed tomography (MDCT) protocol produced the most accurate results for the detection of splenic vascular injury in hemodynamically stable patients who had sustained blunt abdominal trauma.

Methods: We retrospectively reviewed 88 patients from 2003 to 2011 who sustained blunt splenic trauma and underwent contrast-enhanced MDCT and subsequent angiography. Results of MDCT scans utilizing single phase (portal venous only, n=8), dual phase (arterial + portal venous or portal venous + delayed, n=42), or triple phase (arterial + portal venous + delayed, n=38) were compared with results of subsequent splenic angiograms for the detection of splenic vascular injury.

Central aortic wire confirmation for emergent endovascular procedures: As fast as surgeon-performed ultrasound.

Background: Uncontrolled hemorrhage is the leading cause of preventable death after trauma. Resuscitative endovascular balloon occlusion of the aorta (REBOA) is an evolving technique for controlling noncompressible torso hemorrhage. A challenge limiting REBOA use is the dependence on fluoroscopy for confirmation of intra-aortic positioning of a guide wire, a necessary component for safe and accurate balloon deployment.

Alcohol-related emergency department visits among people ages 13 to 25 years.

Objective: Data from a large, nationally representative sample of hospital emergency departments (EDs) were used to assess the prevalence and characteristics of alcohol-related ED visits among people ages 13 to 25 years in the United States.

Method: Emergency department visits recorded in the National Electronic Injury Surveillance System-All Injury Program were coded for alcohol involvement based on alcohol product codes and abstractions of chart narratives. National estimates and confidence intervals were calculated using SUDAAN statistical software.