Evaluating patency rates of an ultralow-porosity expanded polytetrafluoroethylene covered stent in the treatment of venous stenosis in arteriovenous dialysis circuits.

Purpose: To evaluate the efficacy of an ultralow-porosity expanded polytetrafluoroethylene (ePTFE) covered stent in the treatment of autogenous arteriovenous fistula (AVF) and prosthetic arteriovenous graft (AVG) venous outflow stenoses.

Materials And Methods: Clinical and angiographic outcomes of 20 consecutive patients with arteriovenous dialysis circuits treated with the endoprosthesis were reviewed following institutional review board approval. Patients were followed routinely at 2 months and 6 months after stent placement, or earlier if clinically warranted.

Individualized therapy of HHT driven by network analysis of metabolomic profiles.

Background: Hereditary Hemorrhagic Telangiectasia (HHT) is an autosomal dominant disease with a varying range of phenotypes involving abnormal vasculature primarily manifested as arteriovenous malformations in various organs, including the nose, brain, liver, and lungs. The varied presentation and involvement of different organ systems makes the choice of potential treatment medications difficult.

Results: A patient with a mixed-clinical presentation and presumed diagnosis of HHT, severe exertional dyspnea, and diffuse pulmonary shunting at the microscopic level presented for treatment.

Exploiting phenotypic plasticity for the treatment of hepatopulmonary shunting in Abernethy malformation.

An 11-year-old boy presented with exercise intolerance due to chronic hypoxemia. Work-up revealed a diagnosis of hepatopulmonary syndrome (HPS) secondary to a congenital extrahepatic portal-venous shunt (Abernethy malformation). Plasticity in the developing liver was exploited as a strategy for the treatment of HPS.

Salvage of a failing dialysis graft by percutaneous creation of a jump bypass graft.

Percutaneous salvage of failing arteriovenous grafts with diffuse disease or occlusion in the venous outflow remains an issue with no ideal solution. The present report describes a method of percutaneous creation of vascular bypasses in a patient with a failing graft. The patient had a long-segment stenosis in the venous outflow of a brachial-cephalic dialysis graft, and the graft was salvaged by conversion to a brachial-basilic graft.

Use of a novel mechanical rinsing and aspiration thrombectomy device for treatment of deep venous and arteriovenous graft thrombosis.

The KPS Rinspirator (Kerberos Proximal Solutions, Cupertino, Calif.) is a new thrombectomy device that operates by manually controlled, simultaneous, intravessel infusion and aspiration of fluid to cause localized clot dissolution. We evaluate the ability of the KPS Rinspirator to treat acute (<3 days) and subacute (3-7 days) deep venous and arteriovenous graft thrombosis in 4 patients and 13 vessels (2 arteriovenous grafts and 11 deep veins).

Endocavitary three-dimensional ultrasonographic assistance for transvaginal or transrectal drainage of pelvic fluid collections.

Purpose: Determine the feasibility of using three-dimensional ultrasonography (3D US) to assist in planning and performing endocavitary drainage of deep pelvic fluid collections.

Materials And Methods: Retrospective review of images and medical records of 16 patients in whom endocavitary 3D US was used during transvaginal or transrectal drainage of 17 deep fluid collections. 3D US was assessed regarding its ability to display the relevant structures, whether new information was provided compared with pelvic computed tomography (CT) and conventional two-dimensional US (2D US) displays, and whether this information altered drainage techniques.

Single-pass percutaneous liver biopsy for diffuse liver disease using an automated device: experience in 154 procedures.

Purpose: To describe our experience with ultrasound (US)-guided percutaneous liver biopsies using the INRAD 18 G Express core needle biopsy system.

Methods: One hundred and fifty-four consecutive percutaneous core liver biopsy procedures were performed in 153 men in a single institution over 37 months. The medical charts, pathology reports, and radiology files were retrospectively reviewed.

Transjugular intrahepatic portosystemic shunt creation as treatment for refractory chylous ascites and chylothorax in a patient with cirrhosis.

The etiology of chylothorax is usually considered to consist of four major categories: tumors, trauma, idiopathic conditions, and miscellaneous conditions. It appears that chylothorax is a rare and underreported manifestation of cirrhosis resulting from transdiaphragmatic passage of chylous ascites. This condition can be debilitating as a result of respiratory compromise from a large volume of pleural fluid, as well as metabolic derangements, malnutrition, and immunologic impairment from loss of vital lymphatic constituents.

Using a peptide inhibitor of the glycoprotein IIb/IIIa platelet receptor: initial experience in patients with acute peripheral arterial occlusions.

Objective: The purpose of this study was to evaluate the efficacy of eptifibatide, an inhibitor of the glycoprotein (GP) IIb/IIIa platelet receptor, in the thrombolytic treatment of patients with acute peripheral arterial occlusive disease.

Materials And Methods: We retrospectively reviewed our experience with the use of a GP IIb/IIIa receptor inhibitor, eptifibatide, during thrombolysis in 17 patients with acute lower extremity arterial occlusions who also received intraarterial recombinant tissue plasminogen activator (rt-PA) and heparin. Four of the 17 patients received their loading dose of eptifibatide by direct intraarterial injection, whereas the remaining 13 received an IV loading dose.