Computed Tomography (CT)-Guided Needle Biopsy of Lung Lesions: A Single Center Experience.

(1) : Lung cancer is one of the leading causes of cancer death among men and women across the globe. The accurate and timely diagnosis of lung lesions is of paramount importance for prognosis. This single-center study is the first to assess the diagnostic yield and complication rate of a computed tomography (CT)-guided needle biopsy of pulmonary parenchymal and pleural nodules in an academic training center in the United States.

Percutaneous microwave ablation for early-stage intrahepatic cholangiocarcinoma: A single-institutional cohort.

Objectives: Cholangiocarcinoma (CCA) is the second-most common primary hepatic malignancy with an increasing incidence over the past two decades. CCA arises from the epithelial cells lining the bile ducts and can be classified as intrahepatic, perihilar, or distal based on the site of origin in the biliary tree. Surgical resection is the definitive curative therapy for early-stage intrahepatic CCA; however, only a minority of patients may be ideal surgical candidates.

Recurrent hepatic artery pseudoaneurysm repair with overlapping tapered stent-graft technique.

Hepatic artery pseudoaneurysms (HAPs) are rare but life-threatening complications associated with hepatic artery infusion pump (HAIP) therapy for unresectable liver metastases. Traditional management options include open surgery or stent placement, but these approaches have drawbacks. We present a unique case of a dislodged stent embedded in a HAP, resulting in delayed type-I endoleak.

Pulmonary artery-bronchus fistula treated with coil embolization.

Bronchopulmonary arterial fistula consists of an abnormal connection between the bronchus and the vascular tree and is a rare but serious complication associated with a variety of lung interventions. We present a case of a 61-year-old female with a history of metastatic breast cancer treated with lumpectomy and radiation 20 years prior, who was found to have a fistula between the right pulmonary artery and the right mainstem bronchus. Our patient was treated endovascularly with coil embolization in the setting of massive hemoptysis flooding the trachea, which was successful in controlling the acute bleed, although care was withdrawn in the following days following a discussion with the family given the presence of advanced metastatic disease.

Seurat Spleen: A Pathognomonic Sign in Angiography.

Splenic injury commonly occurs following abdominal trauma and can result in severe complications and death if it goes unrecognized. The Seurat spleen is a term used to describe the angiographic appearance of splenic injury following blunt trauma, given its resemblance to the pointillistic artwork of French neo-impressionist Georges Seurat. We present a case of a 43-year-old man who presented following a motor vehicle collision and was found to have multiple punctate foci of contrast extravasation in the spleen consistent with the Seurat spleen angiographic sign.

Uterine-sparing management of pyomyoma after uterine fibroid embolization.

Uterine fibroid embolization (UFE) is an increasingly popular treatment for uterine fibroids. One extremely rare complication after fibroid embolization is pyomyoma, which is the localized infection of the leiomyoma after embolization. Only 10 cases of pyomyoma after UFE have been reported in the literature.

Manual on-the-fly physician postprocessing of computed tomographic angiography data guides embolotherapy of atypical bleeding following paracentesis; a case report.

Major bleeding, typically due to laceration of abdominal wall arteries or venous varices, is a rare but serious complication of paracentesis. We report a case of major bleeding post paracentesis to evidence that a sequence of 1) customized post processing of computed tomographic angiography data for periprocedural guidance, followed by 2) transcatheter cyanoacrylate glue embolotherapy, is the optimal treatment of this complication.

Impending fibroid expulsion on MRI after uterine fibroid embolization.

Uterine fibroids are common benign tumors seen in women and can be managed with a variety of treatment options, including hysterectomy, myomectomy, and uterine fibroid embolization (UFE). UFE is an acceptable alternative to surgical treatment in well-selected cases and offers the added benefit of decreased hospital stay and avoidance of general anesthesia risk. Like any other procedure, UFE carries risks and complications.

Gastrointestinal bleeding from supraduodenal artery with aberrant origin.

Angiography and endovascular embolization play an important role in controlling acute arterial upper gastrointestinal hemorrhage, particularly when endoscopic intervention fails to do so. In our case, the patient presented with recurrent life-threatening bleed in spite of multiple prior endoscopic interventions and gastroduodenal artery embolization. Our teaching points focus on the role of angiography in acute upper gastrointestinal bleed and when to conduct empiric embolization, while reviewing the supraduodenal artery as an atypical but important potential culprit for refractory upper gastrointestinal bleed.

Retrieval of TRAPEASE and OPTEASE Inferior Vena Cava Filters with Extended Dwell Times.

Purpose: To demonstrate that OPTEASE and TRAPEASE filters can be removed after dwell times greater than 60 days.

Materials And Methods: A retrospective review was performed of patients who underwent an attempted removal of a TRAPEASE or OPTEASE filter with a greater than 60-day dwell time between 2009 and 2015 at a single institution. Eleven patients within that time span were identified, and 10 were included in the review.

Vascular Closure Devices: Technical Tips, Complications, and Management.

Vascular closure devices (VCDs) are used to obtain hemostasis at the vascular access site while limiting the need for manual compression. They have gained significant popularity since their introduction in the mid-1990s. In the past 20 years, there has been a multitude of different devices introduced with various mechanisms of action.

Placenta previa-accreta: risk factors and complications.

Objective: The purpose of this study was to identify risk factors and complications of placenta previa-accreta (PA).

Study Design: Patients with placenta previa (n = 347) delivered over 20 years were reviewed, divided into PA (cases, n = 22) and no accreta (controls, n = 325), and compared.

Results: Cases were older with a higher incidence of smoking and previous cesarean delivery (CS).