Gunther Tulip Filter Strut Penetration: Benign Long-Term Follow-up.

Purpose: To describe the natural history of Gunther Tulip filter (GTF) strut penetration based on the computed tomography (CT)-documented distance penetrated over time and any clinical manifestations.

Materials And Methods: The records of 203 patients (mean age, 59.1 years; 59.

Short-interval recanalization after gelfoam occlusion.

Gelfoam® is a temporary embolization agent often used in trauma where permanent arterial occlusion is not desired. Gelfoam occlusions have been shown to resolve by 2 weeks, but shorter intervals have not been studied. We report a case of spontaneous arterial hemorrhage due to ruptured hepatic malignancy where treatment was Gelfoam slurry occlusion of the right hepatic artery.

Plasma DNA as a "liquid biopsy" incompletely complements tumor biopsy for identification of mutations in a case series of four patients with oligometastatic breast cancer.

Purpose: Circulating tumor DNA in plasma may present a minimally invasive opportunity to identify tumor-derived mutations to inform selection of targeted therapies for individual patients, particularly in cases of oligometastatic disease where biopsy of multiple tumors is impractical. To assess the utility of plasma DNA as a "liquid biopsy" for precision oncology, we tested whether sequencing of plasma DNA is a reliable surrogate for sequencing of tumor DNA to identify targetable genetic alterations.

Methods: Blood and biopsies of 1-3 tumors were obtained from 4 evaluable patients with advanced breast cancer.

Activation of stem cell up-regulation/mobilization: a cardiovascular risk in both mice and humans with implications for liver disease, psoriasis and SLE.

Experimentally induced injury triggers up-regulation and mobilization of stem cells in mice that causes accelerated atherosclerosis. mice have chronic activation of stem cell up-regulation/mobilization and accelerated atherosclerosis. In addition, the mice have elevation of serum cytokines G-CSF, IL-17 and IL-23, each necessary for stem cell mobilization.

Hypersplenism in liver disease and SLE revisited: current evidence supports an active rather than passive process.

Background: Active and passive theories have been advanced to explain splenomegaly and cytopenias in liver disease. Dameshek proposed active downregulation of hematopoiesis. Doan proposed passive trapping of blood components in a spleen enlarged by portal hypertension.

Safety and efficacy of the Gunther Tulip retrievable vena cava filter: midterm outcomes.

Purpose: To evaluate of the medium-term integrity, efficacy, and complication rate associated with the Gunther Tulip vena cava filter.

Methods: A retrospective study was performed of 369 consecutive patients who had infrarenal Gunther Tulip inferior vena cava filters placed over a 5-year period. The mean patient age was 61.

ACR Appropriateness Criteria on percutaneous catheter drainage of infected fluid collections.

Abnormal fluid collections occur throughout the body and represent a wide range of pathologies, including abscesses, pseudocysts, cysts, lymphoceles, seromas, bilomas, hematomas, urinomas, and infected neoplasms. Appropriate management often depends on clinical presentation, location, type of collection, early response to treatment, and the presence of complicating factors such as fistulas, septations, and increased viscosity. Physicians should carefully review clinical and imaging findings and make evidence-based recommendations for the best treatment, which may include antibiotics, needle aspiration, percutaneous drainage, endoscopic drainage, or surgical drainage.

Endovascular recanalization of symptomatic portomesenteric venous obstruction after pancreaticoduodenectomy and radiation.

Intraoperative radiation therapy (RT) may improve outcomes after pancreaticoduodenectomy for periampullary cancer; however, there is a 20% risk of late portomesenteric venous obstruction. This retrospective study evaluated the percutaneous treatment of portomesenteric venous obstruction that occurred a mean of 10 months after pancreaticoduodenectomy and intraoperative RT. Five patients with medically refractory ascites and portomesenteric obstruction on computed tomographic angiography had successful recanalization with elimination of the pressure gradient and no procedural complications.

Roadmap guidance for the safer deployment of an arterial closure device.

Arterial closure devices reduce the time to hemostasis, ambulation, and discharge after percutaneous arterial catheterization, but there is an increased risk of arterial occlusive complications compared with manual compression. As a step toward the elimination of this risk, the authors describe a technique where the movement of a balloon-tipped vessel locator and its final position at the site of closure mechanism deployment are monitored with roadmap fluoroscopic imaging.

Value of immediate preprocedure magnetic resonance imaging in patients scheduled to undergo vertebroplasty or kyphoplasty.

Study Design: Retrospective case series.

Objective: To determine the incidence of additional vertebral compression fractures diagnosed with repeat MRI immediately before vertebroplasty or kyphoplasty.

Summary Of Background Data: Vertebral compression fractures, which occur frequently in the elderly, are more likely in patients with prior vertebral compression fracture.

Summation of CT scans during radiofrequency ablation for assessing target lesion coverage.

Objective: In radiofrequency ablation of lesions that require probe repositioning, distinguishing between treated and untreated regions can be difficult. We describe a method of using existing CT equipment to summate images of a current probe placement with those of earlier placements or scans of transiently enhancing targets.

Conclusion: Summation of CT scans during radiofrequency ablation involving multiple probe placements is feasible and results in a better appreciation of probe positioning relative to the target lesion.

Endovascular stent-graft or open surgical repair for blunt thoracic aortic trauma: systematic review.

Purpose: To evaluate the available data on stent-graft repair of acute blunt traumatic thoracic aortic injury with regard to safety and efficacy compared with conventional open surgical repair.

Materials And Methods: The literature on endovascular repair of acute traumatic aortic injury since 1990 was systematically reviewed. Metaanalysis of publications with open and stent-graft repair cohorts was performed to evaluate whether there was a difference in treatment effect with regard to mortality and paraplegia.

Aspirin treatment is associated with a significantly decreased risk of Staphylococcus aureus bacteremia in hemodialysis patients with tunneled catheters.

Background: Hemodialysis patients with tunneled catheters are at increased risk of bacteremic Staphylococcus aureus infections. In vitro and in vivo studies showed that aspirin has direct antistaphylococcal effects by inhibiting expression of alpha-toxin and matrix adhesion genes through activation of sigma factor B stress-induced operon. We hypothesized that long-term treatment with aspirin may decrease the frequency of S aureus bacteremia in such patients.

Digital three-dimensional modelling of the male pelvis and bicycle seats: impact of rider position and seat design on potential penile hypoxia and erectile dysfunction.

Objective: To digitally model (three-dimensional, 3D) the course of the pudendal arteries relative to the bony pelvis in the adult male, and to identify sites of compression with different bicycle riding positions as a potential cause of penile hypoxia and erectile dysfunction.

Subjects And Methods: 3D models were made from computed tomography scans of one adult male pelvis (a healthy volunteer) and three bicycle seats. Models were correlated with lateral radiographs of a seated rider to determine potential vascular compression between the bony pelvis and seats at different angles of rider positioning.

Sclerosis of postoperative lymphoceles: avoidance of prolonged catheter drainage with use of a fibrin sealant.

Purpose: To review experience with fibrin-based tissue sealant sclerosis of postsurgical lymphoceles at a single institution.

Materials And Methods: Fifteen patients who presented with postsurgical lymphoceles were treated with injection of fibrin tissue sealant. Procedures were performed under fluoroscopic and sonographic guidance.

Tension pneumothorax after placement of a tunneled pleural drainage catheter in a patient with recurrent malignant pleural effusions.

A case of tension pneumothorax developed after placement of a tunneled pleural catheter for treatment of malignant pleural effusion in a patient with advanced lung cancer. The catheter placement was carried out by an experienced operator under direct ultrasound guidance, and the patient showed immediate symptomatic improvement with acute decompensation occurring several hours later. Possible mechanisms for this serious complication of tunneled pleural catheter placement are described, and potential strategies to avoid or prevent it in future are discussed.