Publications by authors named "Maleux Geert"

Background: To compare the diagnostic accuracy and predictive value of aneurysm sac volume measurement versus maximum diameter measurement of abdominal aortic aneurysm sac after endovascular aneurysm repair (EVAR) in patients with type II endoleak.

Patients And Methods: Retrospective study on a cohort of 103 patients who presented with a type II endoleak after EVAR for infrarenal abdominal aortic aneurysm. Maximum diameter and volumetric measurements were calculated on computed tomography follow-up scans at 3 months and 1 year after index surgery.

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Purpose: We described an alternative access for thoracic endovascular aortic repair (TEVAR) deployment using a transjugular intrahepatic portosystemic shunt (TIPS) needle for gaining transcaval access to the abdominal aorta.

Case Report: A 63-year-old man presented with a penetrating atherosclerotic ulcer in the descending aorta. Traditional transfemoral and transaxillary access were not possible.

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Purpose: To evaluate the outcomes of resin-based yttrium-90 (Y) transarterial radioembolization (TARE) for hepatocellular carcinoma (HCC) as a bridging or downstaging therapy to liver transplantation (LT) in terms of safety, tumor response, recurrence, and survival.

Materials And Methods: A single-center retrospective analysis of patients with HCC treated with resin-based TARE as bridging or downstaging treatment to LT between January 2006 and April 2021 was performed. TARE-related liver toxicity was assessed.

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Background: Sarcopenia is an acknowledged risk factor for individuals with chronic liver disease, however, the influence on outcomes in patients receiving transjugular intrahepatic portosystemic shunt (TIPS) remains underexplored.

Aims: This study aimed to investigate the association between sarcopenia and incidence of complications and mortality post-TIPS.

Methods: A retrospective analysis was performed on 175 patients who underwent TIPS between 2011-2021 at a Belgian tertiary care center.

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Cavoportal hemitransposition (CPHT) is a rarely performed treatment technique in liver transplantation in cases of extensive splanchnic thrombosis, in which the inferior vena cava of the recipient is used to perfuse the portal vein of the allograft. A case of a 65-year-old liver transplantation patient with an acutely thrombosed cavoportal anastomosis is presented. After unsuccessful medical treatment, recanalization was obtained with transfemoral catheter directed thrombolysis, angioplasty and stent placement.

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Article Synopsis
  • - Spontaneous isolated dissection of the superior mesenteric artery is uncommon and can show various clinical symptoms, with treatment tailored to the symptoms and imaging results.
  • - A case study details a 51-year-old man who experienced ongoing abdominal pain, and imaging revealed an isolated dissection of the superior mesenteric artery with severe narrowing and a thrombosed false lumen.
  • - The patient received a definitive treatment using a coronary covered stent to restore blood flow in the true lumen and effectively close off the false lumen.
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Introduction And Objectives: TIPS placement is an effective, possibly life-saving, treatment for complications of portal hypertension. The pressure shift induced by the stent can lead to cardiac decompensation (CD). We investigated the incidence of CD, possible variables associated with CD and the validity of the Toulouse algorithm for risk prediction of CD post-TIPS.

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Background: This study evaluated the technical and clinical outcomes of transcatheter arterial embolization (TAE) in patients with acute small-bowel bleeding (SBB) and aimed to identify potential risk factors for early recurrent bleeding after TAE.

Methods: Thirty-one patients with SBB managed with TAE between January 2006 and December 2021 were included. Technical and clinical success was defined as angiographic occlusion of the bleeding artery and disappearance of clinical or laboratory signs of persistent bleeding without major complications.

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Purpose: To retrospectively analyze the technical and long-term clinical outcome of angioplasty and stenting using the Venovo™ venous stent for the treatment of malignant and benign superior vena cava (SVC) occlusive disease.

Materials And Methods: Consecutive patients treated with the Venovo™ venous stent for SVC occlusive disease were included. SVC obstruction symptoms were classified according to the Kishi score.

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Background: Our aim was to analyse abdominal aneurysm sac thrombus density and volume on computed tomography (CT) after endovascular aneurysm repair (EVAR).

Methods: Patients who underwent EVAR between January 2005 and December 2010 and had at least four follow-up CT exams available over the first five years of follow-up were included in this retrospective single-centre study. Thrombus density and aneurysm sac volume were calculated on unenhanced CT scans.

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Purpose: Postpartum haemorrhage (PPH) remains a leading cause of maternal death despite current medical management. Surgical interventions are still needed for refractory bleeding. Interventional radiology (IR) can be a successful intermediary that avoids the need for hysterectomy.

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Background: Patient-specific 3D computational fluid dynamics (CFD) simulations have been used previously to identify the impact of injection parameters (e.g. injection location, velocity, etc.

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Background And Objective: Patient-specific 3D computational fluid dynamics (CFD) models are increasingly being used to understand and predict transarterial radioembolization procedures used for hepatocellular carcinoma treatment. While sensitivity analyses of these CFD models can help to determine the most impactful input parameters, such analyses are computationally costly. Therefore, we aim to use surrogate modelling to allow relatively cheap sensitivity analysis.

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Based on our study, no antithrombotic therapy is significantly associated with bridging stent occlusion, and no evidence of the superiority of other antithrombotic therapy exists. Nevertehless, due to the low number of bridging stent occlusions, this study can neither support nor reject the PRINCE2SS recommendations. Further studies with larger cohorts are needed to determine clear guideliness of the best antithrombotic treatment regimen after complex enfovascular aortic repair.

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Introduction: Lymphoedema is a chronic condition caused by lymphatic insufficiency. It leads to swelling of the limb/midline region and an increased risk of infection. Lymphoedema is often associated with mental and physical problems limiting quality of life.

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Tuberous sclerosis complex (TSC) is an autosomal dominant disorder characterized by the presence of proliferative lesions throughout the body. Management of TSC is challenging because patients have a multifaceted systemic illness with prominent neurological and developmental impact as well as potentially severe kidney, heart and lung phenotypes; however, every organ system can be involved. Adequate care for patients with TSC requires a coordinated effort involving a multidisciplinary team of clinicians and support staff.

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Background And Aims: A complete understanding of disease pathophysiology in advanced liver disease is hampered by the challenges posed by clinical specimen collection. Notably, in these patients, a transjugular liver biopsy (TJB) is the only safe way to obtain liver tissue. However, it remains unclear whether successful sequencing of this extremely small and fragile tissue can be achieved for downstream characterization of the hepatic landscape.

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Purpose: Transarterial radioembolization (TARE) with Yttrium-90 resin microspheres is a treatment option for patients with intrahepatic cholangiocarcinoma (ICC). However, optimising the timing of TARE in relation to systemic therapies and patient selection remains challenging. We report here on the effectiveness, safety, and prognostic factors associated with TARE for ICC in a combined analysis of the prospective observational CIRT studies (NCT02305459 and NCT03256994).

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Article Synopsis
  • Spontaneous portosystemic shunts (SPSS) often develop in patients with cirrhosis, and their progression over time, especially in relation to treatments like alcohol abstinence or antiviral therapy for HCV, was the focus of this study.
  • In a cohort of 617 patients followed over an average of 63 months, there was a noticeable increase in the severity of SPSS, with larger and more frequent shunts observed, particularly among non-cured patients who experienced poorer liver function and more complications.
  • Overall, while interventions like quitting alcohol or successful HCV treatment improved liver health and reduced complications, SPSS continued to exist and worsen, albeit at a slower rate in patients who were cured.
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Background: Endoleaks represent the most common complication after EVAR. Some types are associated with ongoing risk of aneurysm rupture and necessitate long-term surveillance and secondary interventions.

Purpose: This document, as with all CIRSE Standards of Practice documents, will recommend a reasonable approach to best practices of managing endoleaks.

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Purpose: to assess the safety and efficacy of APERTO-Paclitaxel-coated balloon angioplasty versus standard angioplasty for the treatment of dysfunctional hemodialysis shunts and native arteriovenous fistulae.

Methods: consecutive patients with dysfunctional dialysis related to underlying efferent vein stenosis were included and randomized 1:1 to either APERTO-paclitaxel drug-coated balloon (study arm) or standard percutaneous transluminal angioplasty (control arm). Primary endpoint is time from treatment until dialysis access dysfunction according to standardized Kidney Disease Outcomes Quality Initiative (KDOQI)-guidelines and assessed by Kaplan-Meier survival curves and tested for significance with log-rank analysis.

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Objective: Computational fluid dynamics (CFD) models can potentially aid in pre-operative planning of transarterial radioactive microparticle injections to treat hepatocellular carcinoma, but these models are computationally very costly. Previously, we introduced the hybrid particle-flow model as a surrogate, less costly modelling approach for the full particle distribution in truncated hepatic arterial trees. We hypothesized that higher cross-sectional particle spread could increase the match between flow and particle distribution.

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