Endovascular evaluation and treatment of intrahepatic portosystemic shunts in dogs: 100 cases (2001-2011).

Objective: To evaluate short- and long-term outcome following endovascular treatment of intrahepatic portosystemic shunts in dogs.

Design: Retrospective case series.

Animals: 100 dogs.

Creation of a gastroenteric anastomosis with endoscopy and percutaneous gastrostomy in pigs.

The authors have previously shown in pigs an immediate transgastric technique for stapling the stomach and jejunum to allow a functioning gastroenteric anastomosis (GEA) with use of balloons and stent placement. The aim of this approach in six pigs was to replicate this procedure by using a flexible endoscopic technique. All pigs had GEAs that were well attached and fully patent.

Comparison of sequential versus simultaneous methods of adrenal venous sampling.

Purpose: To compare two methods of adrenal venous sampling (AVS) in preoperative localization of adrenal lesions in primary hyperaldosteronism.

Materials And Methods: Twenty-one patients (13 men, eight women) underwent selective adrenal venous sampling between July 2001 and May 2003. One of the 21 patients underwent repeat AVS, for a total of 22 procedures.

Management of chylothorax via percutaneous embolization.

Purpose Of Review: The purpose of this review is to present a novel radiologic percutaneous transabdominal technique for treating high-output chylothorax by thoracic duct embolization, and to demonstrate that it can be potentially safer than the traditional treatment by surgical open-chest thoracic duct ligation.

Recent Findings: Pedal lymphography is initially performed to opacify large retroperitoneal lymph channels; a suitable duct more than 2 mm in diameter is then punctured transabdominally to allow catheterization and embolization of the thoracic duct under fluoroscopic guidance. If feeding lymphatic channels are too small for catheterization, they can often be occluded by needle disruption.

Percutaneous transgastric technique for creating gastroenteric anastomoses in swine.

Purpose: To develop a percutaneous transgastric procedure for creating a stent-containing gastroenteric anastomosis (GEA).

Materials And Methods: Acute experiments were performed on eight pigs. A 10-F gastroduodenostomy sheath was used to insert guide wires and targeting devices in the retrogastric jejunal loop; a 6.

Do simultaneous bilateral tunneled infusion catheters in patients undergoing bone marrow transplantation increase catheter-related complications?

Purpose: Secure venous access with multiple lumens is necessary for the care of allogeneic hematopoietic stem cell transplant (HSCT) recipients. The outcomes associated with simultaneous bilateral tunneled internal jugular infusion catheter placement in the HSCT recipient population were investigated in an attempt to determine whether simultaneous introduction of these catheters compounds or magnifies the risks (infection, venous thrombosis) associated with tunneled catheters.

Materials And Methods: Patients undergoing HSCT and receiving bilateral tunneled infusion catheters in a single procedure were identified using a quality assurance data base.

In vivo evaluation of a new bioabsorbable self-expanding biliary stent.

Background: Bioabsorbable stents may offer advantages for the treatment of benign and malignant biliary strictures, including large stent diameter, decreased biofilm accumulation and proliferative changes, elimination of the need for stent removal and imaging artifacts, and prospects for drug impregnation. However, suboptimal expansion has hampered prior iterations. A new bioabsorbable biliary stent (BioStent) was evaluated in a porcine model.

Usefulness of a percutaneous transhepatic coaxial micropuncture needle technique in patients with nondilated peripheral intrahepatic ducts.

Objective: I sought to develop an efficacious transhepatic technique for localizing normal or minimally dilated biliary radicles using 25- to 27-gauge needles threaded through 21- to 22-gauge needles.

Conclusion: The micropuncture needle is a useful adjunct for performing transhepatic cholangiography in patients whose bile ducts are nondilated or in whom the standard transhepatic needle technique has failed.

Management of unremitting chylothorax by percutaneous embolization and blockage of retroperitoneal lymphatic vessels in 42 patients.

Purpose: To demonstrate the applicability, technique, and efficacy of percutaneous transabdominal catheter embolization or needle disruption of retroperitoneal lymphatic vessels in the treatment of high-output or unremitting chylothorax.

Materials And Methods: Forty-two patients (21 men, 21 women; mean age, 56 y; range, 19-80 y) who had chylothorax with various etiologies were referred from the thoracic surgery department for treatment as soon as chylothorax was documented. The thoracic duct was punctured and catheterized via a peritoneal cannula to facilitate embolization with use of microcoils, particles, or glue; if there were no lymph trunks that could be catheterized, attempts were made to disrupt lymph collaterals with use of needles.