Chronic abdominal pain and Budd-Chiari syndrome: A relentless quest for an underlying neoplastic etiology.

In this article, we report on a 62-year-old non-cirrhotic male presenting to the emergency department (ED) with chronic abdominal pain, anorexia, and weight loss. Upon initial presentation, physical exam was unremarkable, other than for sarcopenia and splenomegaly. Initial imaging studies revealed a large thrombosis from the iliac vein to the right atrium of the heart.

Utilization of serum D-dimer assays prior to computed tomography pulmonary angiography scans in the diagnosis of pulmonary embolism among emergency department physicians: a retrospective observational study.

Background: A variety of evidence-based algorithms and decision rules using D-Dimer testing have been proposed as instruments to allow physicians to safely rule out a pulmonary embolism (PE) in low-risk patients.

Objective: To describe the prevalence of D-Dimer utilization among emergency department (ED) physicians and its impact on positive yields and utilization rates of Computed Tomography Pulmonary Angiography (CTPA).

Methods: Data was collected on all CTPA studies ordered by ED physicians at three sites during a 2-year period.

Transabdominal Direct Sac Puncture Embolization of Type II Endoleaks after Endovascular Abdominal Aortic Aneurysm Repair.

Purpose: To determine the efficacy and safety of transabdominal direct sac puncture embolization of type II endoleaks after endovascular abdominal aortic aneurysm repair (EVAR).

Materials And Methods: This retrospective review included 30 patients (4 women, 26 men; mean age = 79.1 years) who underwent 33 transabdominal direct sac puncture embolization procedures for type II endoleaks after EVAR.

Direct sac puncture versus transarterial embolization of type II endoleaks: An evaluation and comparison of outcomes.

Purpose To determine the outcomes of type II endoleak embolization with aneurysm sac obliteration and whether the approach - direct sac puncture or transarterial - affects outcome. Methods A retrospective review of patients who underwent endovascular aneurysm repairs and subsequent type II endoleak embolization over 10 years was performed. Twenty-three patients (median age: 73 years, range: 40-88 years) underwent 35 embolizations.

Combined Coil Embolization and Foam Sclerotherapy for the Management of Varicose Veins.

Background: We propose a novel technique for endovenous treatment of varicose veins (VVs) using combined coil embolization and foam sclerotherapy of the great saphenous vein (GSV).

Methods: A retrospective case-series analysis on patients undergoing fluoroscopically guided coil embolization of the GSV and foam sclerotherapy of the GSV and below-knee varices at a single Canadian center.

Results: Twenty-two patients underwent the procedure on 23 legs.

Non-contrast-enhanced MR angiography in critical limb ischemia: performance of quiescent-interval single-shot (QISS) and TSE-based subtraction techniques.

Purpose: The aim of this study was to evaluate diagnostic performance of non-contrast-enhanced 2D quiescent-interval single-shot (QISS) and 3D turbo spin-echo (TSE)-based subtraction magnetic resonance angiography (MRA) in the assessment of peripheral arteries in patients with critical limb ischemia (CLI).

Materials And Methods: Nineteen consecutive patients (74 % male, 72.8 ± 9.

Elastic Recoil after Balloon Angioplasty in Hemodialysis Accesses: Does It Actually Occur and Is It Clinically Relevant?

Purpose To qualify and quantify elastic recoil and determine its effect on access patency. Materials and Methods Research ethics board approval was obtained and all patients signed an informed consent form. This was a prospective, nonrandomized study of mature accesses that underwent balloon percutaneous transluminal angioplasty (PTA) between January 2009 and December 2012.

The in-hospital costs of treating high-risk patients with fenestrated and branched endografts.

Objective: This study determined the 30-day morbidity and mortality and in-hospital costs of elective fenestrated (fEVAR) and branched (bEVAR) endovascular aneurysm repairs at a single academic institution and determined factors that influence them.

Methods: All elective fEVAR or bEVAR patients treated between November 2007 and March 2014 in a Canadian academic hospital were included. Procedural details, 30-day morbidity and mortality rates, and cost of hospitalization were analyzed.

Randomized Trial Comparing Radiologic Pigtail Gastrostomy and Peroral Image-Guided Gastrostomy: Intra- and Postprocedural Pain, Radiation Exposure, Complications, and Quality of Life.

Purpose: To prospectively compare radiologically created pigtail gastrostomy (PG), in which the tube is inserted directly through the abdominal wall, versus peroral image-guided gastrostomy (POG), in which the tube is inserted through the mouth. Pain profiles (primary outcome measure), fluoroscopy times, total room times, technical success, complications, and quality of life (QOL) were measured.

Materials And Methods: Sixty patients were prospectively randomized to receive 14-F PG or 20-F POG tubes.

Efficacy of Ovarian Artery Embolization for Uterine Fibroids: Clinical and Magnetic Resonance Imaging Evaluations.

Purpose: The objective of the study was to assess the efficacy of ovarian artery embolization (OAE) treatment for symptomatic uterine leiomyomas.

Methods: A retrospective review of 17 patients who underwent OAE in conjunction with uterine artery embolization in a 6-year period (2006-2012) was performed. Ten patients had previous failed embolization, while 7 had not received any embolization therapy before.

Evaluation of percutaneous ultrasound-guided biopsies of solid mass lesions of the pancreas: a center's 10-year experience.

Objective: To assess the efficacy and complication rates of percutaneous ultrasound (US)-guided pancreatic mass biopsy and to determine if location of the mass or method of biopsy affects efficacy.

Methods: Imaging, pathology, and clinical records of all patients undergoing percutaneous US-guided pancreatic mass sampling from January 2001 until November 2011 were reviewed. Of 88 pancreatic masses, 13 underwent fine needle aspiration (FNA) only, 60 underwent core needle biopsy only, and 15 underwent both.

Response Evaluation Criteria in Solid Tumors (RECIST) criteria are superior to European Association for Study of the Liver (EASL) criteria at 1 month follow-up for predicting long-term survival in patients treated with transarterial chemoembolization before liver transplantation for hepatocellular cancer.

Purpose: To determine whether response to transarterial chemoembolization can predict survival in patients with hepatocellular carcinoma (HCC) who are candidates for orthotopic liver transplantation (LT) and if either European Association for Study of the Liver (EASL) criteria or Response Evaluation Criteria in Solid Tumors (RECIST) criteria are more accurate for this purpose.

Materials And Methods: A retrospective review of all patients who underwent LT after transarterial chemoembolization between January 2005 and June 2011 was performed. Follow-up imaging with multiphasic computed tomography or magnetic resonance imaging was performed 1 month after transarterial chemoembolization and every 3 months thereafter until LT.

Prevalence and significance of extravascular incidental findings on computed tomographic angiography and magnetic resonance angiography.

Computed tomographic angiography (CTA) and magnetic resonance angiography (MRA) are routinely used to evaluate patients with vascular disease. They have the ability to detect unexpected non-vascular pathology. The purpose of this study was to determine the prevalence and significance of extravascular incidental findings in patients undergoing CTA or MRA.

Venous aneurysms in autogenous hemodialysis fistulas: is there an association with venous outflow stenosis.

Purpose: To determine whether patients with venous aneurysms in their arteriovenous fistulas (AVFs) have associated venous outflow stenoses.

Materials And Methods: A retrospective study was performed, which included all patients presenting with dysfunction and had venous aneurysms in their AVFs. Patient's medical records and imaging studies were examined and data collected including access characteristics, patient demographics and imaging findings.

An en bloc approach to CT perfusion for the evaluation of limb ischemia.

We examine volumetric CT perfusion in soft tissues of the entire foot with an en bloc technique to provide a meaningful measure of differentiation between mild and major vascular impairment. With Institutional Review Board approval, 22 healthy male subjects between the ages of 21 and 50 (mean 37) were enrolled. Volumetric computed tomography using an en bloc technique was conducted on 14 subjects for validation while unilateral vascular obstruction was simulated in the calves of the remaining 8 subjects.

Pathologic assessment of radiofrequency ablation of pulmonary metastases.

Purpose: To evaluate pathologically the effectiveness of radiofrequency (RF) ablation in the treatment of pulmonary metastases.

Materials And Methods: Patients with multiple pulmonary metastases scheduled for surgical resection were prospectively enrolled. Patients underwent RF ablation of one percutaneously accessible tumor and within 2-4 weeks underwent surgical resection of the ablated tumor and any additional lesions.

Perfusion in peripheral musculoskeletal structures from dynamic volumetric computed tomography using an en bloc approach.

Volumetric computed tomography offers improved potential to perform perfusion analysis in peripheral musculoskeletal structures. Despite poor baseline tissue enhancement and artifacts from adjacent bone, reproducible perfusion estimates were attained using a volumetric en bloc technique in the plantar muscle compartment, Achilles tendon, and subcalcaneal adipose tissue of 16 feet in healthy male subjects. Inadequate enhancement prevented perfusion estimates in the second metatarsal head of all cases.

The value of preprocedure computed tomography for planning insertion of inferior vena cava filters.

Purpose: To determine if valuable information could be obtained from abdominal computed tomography (CT) performed before insertion of an inferior vena cava (IVC) filter.

Materials And Methods: A retrospective review was performed on IVC filter insertions with a CT performed before the procedure. Cavagram and CT were compared for renal vein and IVC anatomy, the diameter of the IVC, and the prevalence of iliocaval thrombus.

Needle tract seeding after radiofrequency ablation of hepatic tumors.

Purpose: To determine the incidence and risk factors associated with needle tract seeding after radiofrequency ablation (RFA) of liver tumors.

Materials And Methods: A prospective data base of patients with hepatic tumors treated by RFA from December 1999 until August 2003 was reviewed to identify patients with needle tract seeding. During this period, 200 patients (148 men, 52 women) with 299 lesions underwent 298 treatment sessions.