Clinical evaluation of in silico planning and real-time simulation of hepatic radiofrequency ablation (ClinicIMPPACT Trial).

Objectives: To evaluate the accuracy and clinical integrability of a comprehensive simulation tool to plan and predict radiofrequency ablation (RFA) zones in liver tumors.

Methods: Forty-five patients with 51 malignant hepatic lesions of different origins were included in a prospective multicenter trial. Prior to CT-guided RFA, all patients underwent multiphase CT which included acquisitions for the assessment of liver perfusion.

GPU-based RFA simulation for minimally invasive cancer treatment of liver tumours.

Purpose: Radiofrequency ablation (RFA) is one of the most popular and well-standardized minimally invasive cancer treatments (MICT) for liver tumours, employed where surgical resection has been contraindicated. Less-experienced interventional radiologists (IRs) require an appropriate planning tool for the treatment to help avoid incomplete treatment and so reduce the tumour recurrence risk. Although a few tools are available to predict the ablation lesion geometry, the process is computationally expensive.

Computer oriented image acquisition of the liver: Toward a better numerical model for radiofrequency ablation.

Simulating physiological interventions for planning purposes requires an accurate virtual liver model as computation input. To best meet the demands the data acquisition has to be oriented on image processing purposes. We provide a CT imaging protocol which makes it possible to extract much more vessels with the same segmentation algorithms than when using them on data sets from the clinical routine.

Towards validation for physiological models in intervention planning.

Computer supported treatment planning systems aim at predicting treatment results. Recently attacked challenges base not only on anatomical findings, but include physiological processes. This way, interventions which are highly depending on patient physiology become predictable and can be supported in computer based planning.

Graz Endocrine Causes of Hypertension (GECOH) study: a diagnostic accuracy study of aldosterone to active renin ratio in screening for primary aldosteronism.

Background: Primary aldosteronism (PA) affects approximately 5 to 10% of all patients with arterial hypertension and is associated with an excess rate of cardiovascular complications that can be significantly reduced by a targeted treatment. There exists a general consensus that the aldosterone to renin ratio should be used as a screening tool but valid data about the accuracy of the aldosterone to renin ratio in screening for PA are sparse. In the Graz endocrine causes of hypertension (GECOH) study we aim to prospectively evaluate diagnostic procedures for PA.

Fatal hemobilia resulting from an iatrogenic arteriobiliary fistula as a rare complication of transjugular liver biopsy.

Transjugular liver biopsy is an important tool for diagnosing and/or staging of advanced liver disease. This procedure is considered safe even in the presence of severe coagulopathy, although rare fatal complications have been described. We herein report the first case of fatal hemobilia after transjugular liver biopsy.

Partial splenic embolization in children with hereditary spherocytosis.

Objectives: Although total splenectomy is able to reduce clinical symptoms in patients with hereditary spherocytosis (HS), splenectomized patients are at risk to develop overwhelming bacterial infections and, to a lesser extent, thromboembolic complications. In contrast, partial splenectomy or partial splenic embolization (PSE) may also decrease the rate of hemolytic complications while maintaining residual splenic function. The aim of this study was to investigate the benefit of PSE in children with moderate to severe HS.

Hepatic encephalopathy following transjugular intrahepatic portosystemic shunt (TIPS): management with L-ornithine-L-aspartate and stent reduction.

Hepatic encephalopathy (HE) is a common problem after insertion of a trans-jugular intrahepatic portosystemic shunt (TIPS), which may be difficult to manage. We present a case of severe post-TIPS HE unresponsive to high doses of L-ornithine-L-aspartate (LOLA) despite reduction of venous ammonia levels in a dose-dependent fashion. Ultimately, high-grade HE was successfully treated by a reduction stent and the patient subsequently underwent successful liver transplantation.

Routine use of three-dimensional contrast-enhanced moving-table MR angiography in patients with peripheral arterial occlusive disease: comparison with selective digital subtraction angiography.

Purpose: To compare the diagnostic accuracy of contrast-enhanced (CE) three-dimensional (3D) moving-table magnetic resonance (MR) angiography with that of selective digital subtraction angiography (DSA) for routine clinical investigation in patients with peripheral arterial occlusive disease.

Methods: Thirty-eight patients underwent CE 3D moving-table MR angiography of the pelvic and peripheral arteries. A commercially available large-field-of-view adapter and a dedicated peripheral vascular phased-array coil were used.

Percutaneous nephrostomy and antegrade ureteral stenting: technique-indications-complications.

In this review the technique, indication for and complications of percutaneous nephrostomy (PCN) and antegrade ureter stent insertion are described. In the majority of the cases PCN is performed to relieve urinary obstruction, which can be of benign or malignant nature. Another indication for PCN is for treatment of urinary fistulas.

Crimping and repositioning of a maldeployed balloon-expandable arterial stent using a gooseneck snare.

Purpose: To describe a technique for repositioning a fully deployed iliac stent from the infrarenal aorta into the common iliac artery (CIA).

Case Report: A 58-year-old man was undergoing treatment for a significant right CIA stenosis when a 7x24-mm Palmaz Genesis medium stent was mistakenly deployed in the infrarenal aorta. With the stent still over the guidewire, an 8x60-mm balloon catheter was placed coaxially in the stent.

Frequency and significance of lumbar and inferior mesenteric artery perfusion after endovascular repair of abdominal aortic aneurysms.

Purpose: To evaluate the frequency and influence of perfused side branches (lumbar arteries [LA] and inferior mesenteric artery trunks) on development of type II endoleaks (EL-II) and on volume changes of abdominal aortic aneurysms (AAA) after endovascular repair.

Methods: Of 114 patients undergoing EVR of AAA, 89 patients (83 men; mean age 72+/-7.5 years, range 51-88) with >6 months' follow-up and no type I endoleaks were retrospectively analyzed to determine any relationships between retrograde perfusion, endoleaks, and sac volume.

Multislice spiral CT angiography in peripheral arterial occlusive disease: a valuable tool in detecting significant arterial lumen narrowing?

The aim of this study was to evaluate the potential of multislice CT angiography (CTA) in detecting hemodynamically significant (> or =70%) lesions of lower extremity inflow and runoff arteries. Fifty patients (42 men, 8 women; mean age 68 years) with peripheral arterial occlusive disease underwent multislice spiral CTA and digital subtraction angiography (DSA) from the infrarenal aorta to the supramalleolar region. CT parameters were 4x2.

Aortoiliac enhancement during computed tomography angiography with reduced contrast material dose and saline solution flush: influence on magnitude and uniformity of the contrast column.

Rationale And Objectives: To compare the magnitude and uniformity of aortoiliac contrast enhancement obtained from uniphasic contrast material injections versus contrast material injections with reduced iodine dose followed by a saline flush in aortoiliac multislice CT angiography (CTA).

Methods: Twenty-nine patients with abdominal aortic aneurysms underwent aortoiliac CTA using protocols A and B. With protocol A, 120 mL contrast material (300 mgI/mL), and with protocol B, 100 mL contrast material followed by a 40-mL saline solution flush were administered at a flow rate of 4 mL/s.

Semitransparent volume-rendering CT angiography for lesion display in aortoiliac arteriosclerotic disease.

Purpose: The potential of semitransparent volume-rendering (STVR) computed tomographic (CT) angiography was evaluated for the assessment of hemodynamically significant stenoses in aortoiliac arteriosclerotic disease.

Materials And Methods: In a prospective study, 76 patients (57 men, 19 women; mean age, 70 years) underwent single-detector (n = 26) or multidetector (n = 50) CT angiography of the aortoiliac region. Intraarterial digital subtraction angiography (DSA) was performed in each patient.