A Pilot Study Assessing the Impact of 3-D Printed Models of Aortic Aneurysms on Management Decisions in EVAR Planning.

Introduction: Endovascular repair of aortic aneurysms with difficult anatomy is challenging. There is no consensus for planning such procedures.

Methods: Six cases of aortic aneurysms with challenging anatomical features, such as short, angulated, and conical necks and tortuous iliacs were harvested.

Transjugular intrahepatic portosystemic shunt in liver transplant recipients: indications, feasibility, and outcomes.

The role of transjugular intrahepatic portosystemic shunt (TIPS) for treating complications of portal hypertension after orthotopic liver transplantation (OLT) is unclear. In this review of 13 retrospective studies and 8 case reports comprising 213 patients, we assessed the indications, technical success, and clinical outcomes of TIPS procedures performed in patients who had undergone OLT. Indications for TIPS were refractory ascites (n = 168), variceal hemorrhage (n = 36), and hydrothorax (n = 9).

3-D printouts of the tracheobronchial tree generated from CT images as an aid to management in a case of tracheobronchial chondromalacia caused by relapsing polychondritis.

This report concerns a 67 year old male patient with known advanced relapsing polychondritis complicated by tracheobronchial chondromalacia who is increasingly symptomatic and therapeutic options such as tracheostomy and stenting procedures are being considered. The DICOM files from the patient's dynamic chest CT in its inspiratory and expiratory phases were used to generate stereolithography (STL) files and hence print out 3-D models of the patient's trachea and central airways. The 4 full-sized models allowed better understanding of the extent and location of any stenosis or malacic change and should aid any planned future stenting procedures.

3D printing of an aortic aneurysm to facilitate decision making and device selection for endovascular aneurysm repair in complex neck anatomy.

Purpose: To describe rapid prototyping or 3-dimensional (3D) printing of aneurysms with complex neck anatomy to facilitate endovascular aneurysm repair (EVAR).

Case Report: A 75-year-old man had a 6.6-cm infrarenal aortic aneurysm that appeared on computed tomographic angiography to have a sharp neck angulation of ~90°.

Functional lengths of the lower limb arterial tree measured by CT angiography centreline analysis: implications for catheter lengths in peripheral angioplasty.

Purpose: Lower limb angioplasty is a common procedure. However, arterial lengths have not been well studied and there is no evidence base for the optimum catheter lengths required for the various applications of femoral or distal below-the-knee angioplasty. The industry standard catheter measures 80 cm.

Gelfoam-assisted amplatzer vascular plug technique for rapid occlusion in proximal splenic artery embolization.

Objective: The objective of this study was to prospectively investigate the role of rapid Gelfoam-assisted occlusion of the splenic artery with an Amplatzer Vascular Plug (AVP). Ten consecutive proximal splenic artery embolizations were performed with AVP as the primary embolic agent and Gelfoam slurry as an adjunct. These cases were then compared with 10 retrospective cases of splenic artery embolization performed with AVP and augmented with coils or additional AVPs, or both, in patients with similar indications.

3-D printout of a DICOM file to aid surgical planning in a 6 year old patient with a large scapular osteochondroma complicating congenital diaphyseal aclasia.

A 6 year old girl presented with a large osteochondroma arising from the scapula. Radiographs, CT and MRI were performed to assess the lesion and to determine whether the lesion could be safely resected. A model of the scapula was created by post-processing the DICOM file and using a 3-D printer.

The amplatzer vascular plug: a review of the device and its clinical applications.

The Amplatzer Vascular Plug (AVP) is an established embolic device that can be an excellent alternative to coils or detachable balloons to embolize medium to large vessels with high flow. The device is easy to use and can be precisely deployed in the target vessel with high resistance to migration and a low recanalization rate. The technical success of this device is high, indications for use are expanding, and no absolute contraindications have been reported.

Use of an Amplatzer vascular plug II for aortic sac occlusion after failed surgical ligation.

Purpose: To present a case of aortic sac occlusion using an Amplatzer vascular plug II (AVP).

Case Report: A patient with sigmoid malignancy and an infrarenal aortic aneurysm ultimately required an axillobifemoral graft for acute limb ischemia. The sac was ligated at subsequent laparotomy.

Fracture and distant migration of the Bard Recovery filter: a retrospective review of 363 implantations for potentially life-threatening complications.

Purpose: To report the occurrence of fracture of the Recovery filter and incidence of potentially life-threatening complications associated with fractured fragment migration.

Materials And Methods: A retrospective study of images obtained after placement of Recovery inferior vena cava (IVC) filters from 2003 to 2006 was conducted at a single tertiary-care center. Images were reevaluated for fracture and migration; complications related to filter fracture were investigated.

The effect of skin entry site, needle angulation and soft tissue compression on simulated antegrade and retrograde femoral arterial punctures: an anatomical study using Cartesian co-ordinates derived from CT angiography.

Purpose: Safe femoral arterial access is an important procedural step in many interventional procedures and variations of the anatomy of the region are well known. The aim of this study was to redefine the anatomy relevant to the femoral arterial puncture and simulate the results of different puncture techniques.

Methods: A total of 100 consecutive CT angiograms were used and regions of interest were labelled giving Cartesian co-ordinates which allowed determination of arterial puncture site relative to skin puncture site, the bifurcation and inguinal ligament (ING).

Retrievability and device-related complications of the G2 filter: a retrospective study of 139 filter retrievals.

Purpose: To evaluate the retrievability and safety of the G2 filter.

Materials And Methods: A retrospective study of all G2 filter retrievals at a single institution was conducted. Hospital records and imaging studies were reviewed for complications, and factors affecting retrieval were analyzed.

Acute abdominal pain after retrievable inferior vena cava filter insertion: case report of caval perforation by an option filter.

Symptomatic caval injury is rare after inferior vena cava (IVC) filter insertion. A 39-year-old woman developed acute abdominal pain after uneventful placement of a retrievable Option IVC Filter (Angiotech Pharmaceuticals, Vancouver, British Columbia, Canada). Two days after placement, computed tomography showed a right-sided retroperitoneal hematoma, and three-dimensional C-arm rotational venography confirmed limb penetration beyond the caval wall.

Prophylactic antibiotic guidelines in modern interventional radiology practice.

Modern interventional radiology practice is continuously evolving. Developments include increases in the number of central venous catheter placements and tumor treatments (uterine fibroid therapy, radio- and chemoembolization of liver tumor, percutaneous radiofrequency and cryoablation), and new procedures such as abdominal aortic aneurysm stent-graft repair, vertebroplasty, kyphoplasty, and varicose vein therapies. There have also been recent advancements in standard biliary and urinary drainage procedures, percutaneous gastrointestinal feeding tube placement, and transjugular intrahepatic portosystemic shunts.

Building virtual models by postprocessing radiology images: A guide for anatomy faculty.

Radiology and radiologists are recognized as increasingly valuable resources for the teaching and learning of anatomy. State-of-the-art radiology department workstations with industry-standard software applications can provide exquisite demonstrations of anatomy, pathology, and more recently, physiology. Similar advances in personal computers and increasingly available software can allow anatomy departments and their students to build their own three-dimensional virtual models.

Utility of the Amplatzer Vascular Plug in splenic artery embolization: a comparison study with conventional coil technique.

Purpose: To retrospectively evaluate the role of the Amplatzer Vascular Plug (AVP) in proximal splenic artery embolization (SAE) compared with coils.

Materials And Methods: Forty patients had proximal SAE performed with AVP(s) or coils as the primary embolic agent for splenic artery steal syndrome (n=23), trauma (n=5), portal hypertension (n=5), bleeding due to pancreatic pathology (n=4), and pre-splenectomy (n=3). Comparisons were made of occlusion and procedure time, cost, and radiation dose.

Training on a vascular interventional simulator: an observational study.

Radiology registrars were observed performing a left renal artery angioplasty using a proprietary training simulator up to five times during their first year of training. Total procedure time, fluoroscopy times, and metric information from the machine were recorded. Each step of the procedure was judged by an observer and a mistake profile was generated.