Prophylactic Intraoperative Embolization of Abdominal Aortic Aneurysm Sacs Using N-Butyl Cyanoacrylate/Lipiodol/Ethanol Mixture with Proximal Neck Aortic Balloon Occlusion during Endovascular Abdominal Aortic Repair.

Purpose: To determine the feasibility of prophylactic intraoperative abdominal aortic aneurysm (AAA) sac embolization using a mixture of N-butyl cyanoacrylate/Lipiodol/ethanol (NLE) with proximal neck aortic balloon occlusion during endovascular aneurysm repair (EVAR) to prevent the occurrence of endoleak and aneurysm sac expansion.

Materials And Methods: Prophylactic intraoperative AAA sac embolization was performed in 24 patients with an infrarenal neck angulation > 60° (n = 16) or AAA sac diameter > 60 mm (n = 17). AAA sac pressure was continuously measured with a 3-F catheter inserted into the AAA sac.

Systolic Sac Pressure Index for the Prediction of Persistent Type II Endoleak for 12 Months After Endovascular Abdominal Aortic Aneurysm Repair.

Purpose: To assess the relationship between the systolic sac pressure index (SPI) and the presence of endoleaks 12 months after endovascular abdominal aortic aneurysm repair (EVAR).

Materials And Methods: We performed a single-center prospective trial of consecutively treated patients. SPI (calculated as systolic sac pressure/systolic aortic pressure) was measured by catheterization immediately after EVAR.

Balloon-assisted packing of wide-neck aneurysms with a mixture of n-butyl cyanoacrylate, Lipiodol, and ethanol: an experimental study.

Purpose: To evaluate the feasibility of balloon-assisted packing with a mixture of n-butyl cyanoacrylate (NBCA), Lipiodol, and ethanol for wide-neck aneurysms.

Materials And Methods: Of 10 carotid aneurysms with wide necks created in a swine model, 3 aneurysms (long and short diameters 10.9 × 9.

Reactive lymphoid hyperplasia of the liver: Perinodular enhancement on contrast-enhanced computed tomography and magnetic resonance imaging.

We report the case of a 69-year-old woman with reactive lymphoid hyperplasia (RLH) of the liver. She underwent partial hepatectomy under a preoperative diagnosis of hepatocellular carcinoma; however, histopathological analysis revealed RLH. The liver nodule showed the imaging feature of perinodular enhancement in the arterial dominant phase on contrast-enhanced computed tomography and magnetic resonance imaging, which could be a useful clue for identifying RLH in the liver.

Synthesis of 24-h soluble gelatin sponge particles and their effect on liver necrosis following hepatic artery embolization: Results of in vitro and in vivo studies.

Aim: To synthesize 24-h soluble gelatin sponge particles (SGSP) of 200-500 and 500-1000 µm, and to investigate their ischemic potency following hepatic artery embolization (HAE).

Methods: Low-endotoxin gelatin was freeze-dried and heated at 110, 115, 118, 120, 122 and 125°C to form cross-linked gelatin sponge. We prepared 200-500- and 500-1000-µm SGSP by pulverizing and sieving the gelatin sponge.

Effect of transcatheter arterial embolization with a mixture of n-butyl cyanoacrylate, lipiodol, and ethanol on the vascular wall: macroscopic and microscopic studies.

Purpose: To compare the pathologic effect of a mixture of n-butyl cyanoacrylate (NBCA), lipiodol, and ethanol (NLE) with a mixture of NBCA and lipiodol (NL) on the embolized vascular wall.

Materials And Methods: Embolization was performed using four swine with NBCA and lipiodol in a volume ratio of 1:1 (NL11 group) in the common hepatic artery (n = 1) and the internal iliac artery (n = 2); and with NBCA, lipiodol, and ethanol in a volume ratio of 1:1:2 (NLE112 group) in the common hepatic artery (n = 3) and the internal iliac artery (n = 6).

Results: NL11 casts had an intricate appearance in reticular configuration with red thrombus, while NLE112 casts presented in a single round configuration with surrounding ring-like red thrombus.

Risk factors associated with late aneurysmal sac expansion after endovascular abdominal aortic aneurysm repair.

Purpose: We aimed to identify the risk factors associated with late aneurysmal sac expansion after endovascular abdominal aortic aneurysm repair (EVAR).

Methods: We retrospectively reviewed contrast-enhanced computed tomography (CT) images of 143 patients who were followed for ≥6 months after EVAR. Sac expansion was defined as an increase in sac diameter of 5 mm relative to the preoperative diameter.

Change in portal vein hemodynamics after chemoembolization for hepatocellular carcinoma: evaluation through multilevel dynamic multidetector computed tomography during arterial portography.

Objective: This study aimed to clarify the effect of embolization with lipiodol on portal vein hemodynamics.

Methods: Time-density curves of the main portal vein on multilevel dynamic multidetector computed tomography during arterial portography were used to analyze peak computed tomography value (PV), time to PV (TPV), arrival time of contrast medium at the main portal vein (ATMPV), slope [(PV - 150) / (TPV - ATMPV)], and slope ratio (slope after embolization / slope before embolization).

Results: In 20 patients with hepatoma, ATMPV and TPV were significantly prolonged and the time-density curve slope was significantly less after embolization.

Arterial supply to the bleeding diverticulum in the ascending duodenum treated by transcatheter arterial embolization- a duodenal artery branched from the inferior pancreaticoduodenal artery.

We present a case of endoscopically unmanageable hemorrhagic diverticulum in the ascending duodenum. The ventral and dorsal walls of the ascending duodenum were supplied from the first jejunal artery (1JA) and inferior pancreaticoduodenal artery (IPDA), respectively. The hemorrhage mainly occurred from IPDA.

Utility of ⁹⁹mTc-human serum albumin diethylenetriamine pentaacetic acid SPECT for evaluating endoleak after endovascular abdominal aortic aneurysm repair.

Objective: The purpose of this study was to assess the utility of (99m)Tc-human serum albumin diethylenetriamine pentaacetic acid ((99m)Tc-HSAD) SPECT in the detection of endoleaks after endovascular abdominal aortic aneurysm repair.

Subjects And Methods: Fifteen patients (11 men, four women) with aneurysm sac expansion of 5 mm or greater after endovascular abdominal aortic aneurysm repair underwent three-phase CT, (99m)Tc-HSAD SPECT, and CT during aortography. Sensitivity calculations for three-phase CT and (99m)Tc-HSAD SPECT were performed with CT during aortography as the reference standard.

Incorporating GSA-SPECT into CT-based dose-volume histograms for advanced hepatocellular carcinoma radiotherapy.

In single photon emission computed tomography-based three-dimensional radiotherapy (SPECT-B-3DCRT), images of Tc-99m galactosyl human serum albumin (GSA), which bind to receptors on functional liver cells, are merged with the computed tomography simulation images. Functional liver is defined as the area of normal liver where GSA accumulation exceeds that of hepatocellular carcinoma (HCC). In cirrhotic patients with a gigantic, proton-beam-untreatable HCC of ≥ 14 cm in diameter, the use of SPECT-B-3DCRT in combination with transcatheter arterial chemoembolization achieved a 2-year local tumor control rate of 78.

Radiation dose to rectum in high-dose-rate brachytherapy with a single implant and two fractions for prostate cancer, and its prediction by prostate volume.

We aimed to clarify the differences between the estimated rectal dose (ERD) and the first measured dose (FMD) and second measured dose (SMD) to the rectum during high-dose-rate (HDR) brachytherapy, and to predict FMD from the prostate volume (PV) or the rectal dose-volume parameters (RDVPs). ERD, FMD, and SMD were assessed with a rectal dosimeter during HDR brachytherapy of 18 Gy given in two fractions to 110 patients (48 hormone recipients, 62 hormone-naïve patients) with prostate cancer. The correlations between FMD and PV, and between FMD and RDVP (D 2ml-D 5ml) were investigated.

Acute appendicitis with intestinal malrotation: the usefulness of coronal computed tomography.

We herein present a rare case of acute appendicitis with intestinal malrotation. Coronal images of contrast-enhanced computed tomography (CT) revealed the small intestine on the right side and the large intestine on the left side, thus indicating intestinal malrotation (non-rotation type). In addition, an enhanced, tubular, fluid-filled structure was detected attached to the cecum, which was located superior to the urinary bladder, suggesting acute appendicitis.

Creation of cisplatin-adsorbing regenerative-medicine gelatin sponge and its Cisplatin release pattern.

The purpose of this study was to clarify the adsorption of cisplatin on regenerative-medicine (RM) gelatin sponge, and to verify the relationship between the cisplatin release pattern of cisplatin-adsorbed RM gelatin sponge and the dissolving time of RM gelatin sponge. We tested various RM gelatin sponges, one with a molecular weight of 50000 Daltons (RM-50 gelatin sponge) that is 100% saline soluble at 24 h, RM-50-120 (heated at 120°C) that is 54.3% saline soluble at 24 h, and RM-50-140 (heated at 140°C) that is 15.

Guidelines for the use of NBCA in vascular embolization devised by the Committee of Practice Guidelines of the Japanese Society of Interventional Radiology (CGJSIR), 2012 edition.

Cyanoacrylates are a group of fast-acting adhesives. They form low viscosity liquids in the monomer state and instantly polymerize to become adhesive upon contact with ionic substances. Since the 1950s, they have been used around the world for industrial and household purposes.

Inflammatory myofibroblastic tumor of the lung indistinguishable from adenocarcinoma on imaging studies.

We present the case of a right lung nodule discovered on routine chest x-ray in an asymptomatic 62-year-old man. CT revealed a spiculated nodule in segment 1 of the right upper lobe, 2.2 cm in diameter and without calcification.

Prostate-supplying arteriogram created by multidetector-row CT during pelvic arteriography: contribution to the treatment strategy of prostatic artery embolization for prostatic hyperplasia.

We describe an 85-year-old man suffering lower urinary tract symptoms, who underwent prostatic artery embolization (PAE) based on a prostate-supplying arteriogram created with multidetector-row computed tomography during pelvic arteriography. This arteriogram was synthesized from a background bone volume-rendered (VR) image, an aorta-pelvic artery VR image, and a prostate-supplying artery VR image. Because the bone background VR image is combined with the aorta-pelvic artery VR image, the prostate-supplying arteriogram can simultaneously show the pelvic branch arteries present on the ventral side, inside, and the dorsal side of the pelvic bone.

Changes in inflammatory, coagulopathic, and fibrinolytic responses after endovascular repair of an abdominal aortic aneurysm: relationship between fibrinogen degradation product levels and endoleaks.

Purpose: To compare the inflammatory, coagulopathic, and fibrinolytic responses after endovascular aneurysm repair (EVAR) of an abdominal aortic aneurysm between two stent grafts. Fibrinogen degradation product (FDP) levels were compared between patients with or without an endoleak.

Materials And Methods: EVAR was performed in 88 patients using an Excluder (37 patients) or a Zenith (51 patients).

N-butyl cyanoacrylate embolization with blood flow control of an arterioportal shunt that developed after radiofrequency ablation of hepatocellular carcinoma.

We present a case of a patient with rapid deterioration of esophageal varices caused by portal hypertension accompanied by a large arterioportal shunt that developed after radiofrequency ablation of hepatocellular carcinoma. We used n-butyl cyanoacrylate (NBCA) as an embolic material to achieve pinpoint embolization of the shunt, because the microcatheter tip was 2 cm away from the shunt site. Under hepatic arterial flow control using a balloon catheter, the arterioportal shunt was successfully embolized with NBCA, which caused an improvement in the esophageal varices.

The use of technetium-99m-labeled human serum albumin diethylenetriamine pentaacetic acid single-photon emission CT scan in the follow-up of type II endoleak treatment.

An 84-year-old woman presented with persistent type II endoleak with sac expansion from 57 mm to 75 mm during 4-year follow-up after endovascular abdominal aortic aneurysm repair. The patient underwent transabdominal embolization with coils and N-butyl cyanoacrylate/ethiodized oil (Lipiodol; Guerbet, Villepinte, France) mixture (2.5 mL).

Volume-rendered hemorrhage-responsible arteriogram created by 64 multidetector-row CT during aortography: utility for catheterization in transcatheter arterial embolization for acute arterial bleeding.

Aortography for detecting hemorrhage is limited when determining the catheter treatment strategy because the artery responsible for hemorrhage commonly overlaps organs and non-responsible arteries. Selective catheterization of untargeted arteries would result in repeated arteriography, large volumes of contrast medium, and extended time. A volume-rendered hemorrhage-responsible arteriogram created with 64 multidetector-row CT (64MDCT) during aortography (MDCTAo) can be used both for hemorrhage mapping and catheter navigation.

Comparison of air kerma between C-arm CT and 64-multidetector-row CT using a phantom.

Purpose: To compare air kerma after scanning a phantom with C-arm CT and with 64-multidetector row CT (64MDCT).

Materials And Methods: A phantom was scanned using parameters based on data of ten patients with hepatocellular carcinoma who had C-arm CT during hepatic arteriography and 64MDCT during arterial portography. Radiation monitors were used to measure air kerma ten times at each of five points: the center (A), top (B), left side (C), bottom (D), and right side (E).