CT-guided percutaneous drainage within intervertebral space for pyogenic spondylodiscitis with psoas abscess.

Background: Reports on CT-guided percutaneous drainage within the intervertebral space for pyogenic spondylodiscitis with a secondary psoas abscess are limited.

Purpose: To evaluate CT-guided percutaneous drainage within the intervertebral space for pyogenic spondylodiscitis and a secondary psoas abscess in which the two sites appear to communicate.

Material And Methods: Eight patients with pyogenic spondylodiscitis and a secondary psoas abscess showing communication with the intradiscal abscess underwent CT-guided percutaneous drainage within the intervertebral space.

Transcatheter arterial embolization for spontaneous rupture of the omental artery.

We encountered a rare case of spontaneous rupture of the omental artery. A 25-year-old man without any episode of abdominal trauma or bleeding disorders came to the emergency unit with left upper abdominal pain. Hematoma with extravasation of the greater omentum and a hemoperitoneum was confirmed on abdominal contrast-enhanced computed tomography.

Epinephrine-infused CTHA for HCCs.

Background: Changes in the relative arterial flow to hepatocellular carcinomas and adjacent normal liver with hepatic arterial epinephrine infusion were studied with CT hepatic arteriography (CTHA).

Methods: Data from 31 pathologically confirmed hepatocellular carcinomas were retrospectively analyzed in 16 patients who simultaneously underwent CT during arterial portography (CTAP) and CTHA for examination of liver tumors and then CTHA with hepatic arterial epinephrine infusion.

Results: Regarding visual analysis, tumor enhancement of hepatocellular carcinomas on CTHA after hepatic arterial epinephrine injection changed as follows: more clear in 83.

Gunther tulip inferior vena cava filter placement during treatment for deep venous thrombosis of the lower extremity.

Purpose: To evaluate the efficacy and safety of Gunther tulip retrievable vena cava filter (GTF) implantation to prevent pulmonary embolism during intravenously administered thrombolytic and anticoagulation therapy and interventional radiological therapy for occlusive or nonocclusive deep venous thrombosis (DVT) of the lower extremity.

Methods: We evaluated placement of 55 GTFs in 42 patients with lower extremity DVT who had undergone various treatments including those utilizing techniques of interventional radiology.

Results: Worsening of pulmonary embolism in patients with existing pulmonary embolism or in those without pulmonary embolism at the time of GTF insertion was avoided in all patients.

Percutaneous drainage under real-time computed tomography-fluoroscopy guidance.

Background/aims: The goal of our study was to assess the use of real-time computed tomography-fluoroscopy guidance for percutaneous drainage of abnormal thoracic, abdominal, and pelvic fluid collections.

Methodology: The subjects were 32 patients who underwent 36 percutaneous computed tomography-fluoroscopy guided thoracic, abdominal, and pelvic drainage procedures to drain abscess (n=29), fluid collection after pancreatitis (n=3), lymphocyst after gynecological surgery (n=3), and the gallbladder transhepatically (n=1) between September 1997 and August 2003. The patient population was 28-86 years old and consisted of 19 men and 13 women.

Efficacy of manual aspiration immediately after complicated pneumothorax in CT-guided lung biopsy.

Purpose: The goal of this study was to evaluate the efficacy of simple aspiration of air from the pleural space to prevent increased pneumothorax and avoid chest tube placement in cases of pneumothorax after computed tomography (CT)-guided lung biopsy.

Materials And Methods: This retrospective study was based on experience with 283 consecutive percutaneous needle lung biopsies with real-time CT fluoroscopic guidance. While patients were on the CT scanner table, percutaneous manual aspiration was performed in all those with moderate or large pneumothorax demonstrated on postbiopsy chest CT images regardless of symptoms.

Catheter redundancy in the aortic arch increases the risk of stroke in left subclavian arterial port-catheter systems.

Purpose: The stroke rate after left subclavian arterial port-catheter placement was compared in two groups: one with minimal redundancy of the catheter and one with pronounced redundancy in the aortic arch designed to minimize the likelihood of catheter dislocation.

Materials And Methods: One hundred forty-eight patients (102 men, 46 women; age range, 26-83 years; mean age, 64.3 years) with inoperable advanced liver cancers underwent percutaneous implantation of port-catheter systems via the left subclavian artery.

Management of end hole in placement of port-catheter system for continuous hepatic arterial infusion chemotherapy using the fixed catheter tip method.

Objective: The purpose of our study was to compare persistent hepatofugal blood flow in the gastroduodenal artery after implanting a port-catheter system for repeated hepatic arterial infusion chemotherapy using either the original or the modified fixed catheter tip method. With the original method the lumen of the catheter tip is closed with a microcoil; with the modified method it is left open. Persistent hepatofugal blood flow can induce reactive gastric or duodenal mucosal lesions.

Efficacy of the left gastric artery as a route for catheterization of the right gastric artery.

Objective: Our aim was to evaluate the efficacy of the left gastric artery as a route for embolization of the right gastric artery before port-catheter implantation for hepatic artery infusion chemotherapy.

Materials And Methods: In 88 patients (61 men and 27 women; mean age, 63.4 years; range, 25-83 years) with unresectable advanced liver cancer, retrograde catheterization of the right gastric artery through the left gastric artery was performed to embolize the right gastric artery.

Percutaneous needle biopsy for small lung nodules beneath the rib under CT scan fluoroscopic guidance with gantry tilt.

Objectives: The present study was performed to evaluate the efficacy and safety of gantry tilting for the performance of lung biopsy of peripheral small lesions located beneath the rib.

Design: Interventional.

Materials And Methods: Our study was based on 22 of 237 lesions for which percutaneous needle biopsies of the lung were performed under CT scan-fluoroscopic guidance at our institution between January 2000 and August 2002.

Interventional radiologic treatment for hepatic arterial occlusion after repeated hepatic arterial infusion chemotherapy via implanted port-catheter system.

The present study evaluated the feasibility of interventional radiologic treatments for hepatic arterial occlusion after hepatic arterial infusion chemotherapy (HAIC) via an implanted port-catheter system. Treatment for hepatic arterial occlusion was attempted in seven patients with unresectable liver cancer. In six, the obstructed hepatic artery was recanalized.

Value of transcatheter arterial embolization with coils and n-butyl cyanoacrylate for long-term hepatic arterial infusion chemotherapy.

Purpose: To assess the value of transcatheter arterial embolization (TAE) of splanchnic arterial branches to allow continuous application of repeat hepatic arterial infusion chemotherapy (HAIC).

Materials And Methods: In 128 patients with unresectable advanced liver cancer, percutaneous implantation of a port catheter system and TAE of splanchnic arteries with coils and/or n-butyl cyanoacrylate (NBCA) were performed. Parameters included (a) methods selected for catheter placement; (b) embolic materials used (coils and/or NBCA, number of coils, administration rate of NBCA-iodized oil) for TAE of splanchnic arteries, details of embolized arteries, and frequency of recanalization; (c) ability to prevent gastrointestinal symptoms by avoiding inflow of anticancer drugs into extrahepatic adjacent organs and to maintain distribution of contrast agents in liver, as well as management of difficulties encountered; (d) complications related to catheter system implantation or to long-term HAIC and management of such complications; and (e) final success in performing scheduled HAIC while maintaining distribution over liver via a single route without gastrointestinal symptoms caused by inflow of anticancer drugs.

Change in the hemodynamics of the portal venous system after retrograde transvenous balloon occlusion of a gastrorenal shunt.

Objective: The purpose of our investigation was to examine changes in the hemodynamics of the liver after artificial occlusion of a gastrorenal shunt.

Subjects And Methods: Nine patients with portal hypertension underwent splenic arteriography and CT arterial portography during infusion of contrast material via the splenic artery. Images were obtained with the balloon catheter both inflated and deflated in the gastrorenal shunt, and results were compared.

Usefulness of new automated cutting needle for tissue-core biopsy of lung nodules under CT fluoroscopic guidance.

Objectives: The goal of our study was to evaluate the efficacy and safety of a new type of automated cutting needle for tissue-core lung biopsy under real-time CT fluoroscopic guidance.

Design: Observational

Materials And Methods: One hundred ten percutaneous needle tissue-core lung biopsies were performed with the Auto Surecut needle (Create Medic; Yokohama, Japan) under CT fluoroscopic guidance, and the specimens obtained underwent histopathologic evaluation. A final diagnosis was confirmed by independent surgical pathology.

Withdrawal of implanted port-catheter for hepatic arterial infusion chemotherapy with fixed catheter tip technique.

The purpose of the present study is to evaluate the feasibility of a method developed to withdraw a port-catheter system that had been implanted with use of the fixed catheter tip technique. Withdrawal of an implanted catheter was required in four patients with advanced liver cancer in whom port-catheter systems had been implanted for performance of repeated hepatic arterial infusion. In all patients, port-catheter systems were successfully removed without complications.

Technical developments: use of targeting guide wire in left subclavian puncture during percutaneous implantation of port-catheter systems using the catheter tip fixation method.

Our objective was to evaluate the feasibility and safety of a new method in approaching the access route percutaneously for the implantable port-catheter system for repeated hepatic arterial infusion chemotherapy. Fifteen patients underwent port-catheter system placement via the left subclavian artery with the catheter tip fixed within the gastroduodenal artery with embolic materials and a catheter side hole opening to the common hepatic artery. Before port-catheter placement, the right gastric artery was embolized via the femoral catheter access.

Combining fine-needle aspiration and core biopsy under CT fluoroscopy guidance: a better way to treat patients with lung nodules?

Objective: The goal of our study was to evaluate the efficacy of the combined use of fine-needle aspiration and tissue core biopsy under real-time CT fluoroscopy guidance.

Subjects And Methods: One hundred thirty-eight percutaneous needle lung biopsy samples were obtained by two methods. The samples obtained by tissue fine-needle aspiration underwent cytologic evaluation, and those obtained by core biopsy using an automated cutting needle underwent histologic evaluation.

Using n-butyl cyanoacrylate and the fixed-catheter-tip technique in percutaneous implantation of a port-catheter system in patients undergoing repeated hepatic arterial chemotherapy.

Objective: The purpose of our study was to evaluate the usefulness of adding n-butyl cyanoacrylate to microcoils to fix the catheter tip in percutaneous implantation of a port-catheter system for hepatic arterial-infusion chemotherapy.

Subjects And Methods: Ninety-three patients (64 men and 29 women; age range, 38-83 years; mean age, 62.2 years) with unresectable advanced liver cancer underwent percutaneous implantation of a port-catheter system with the catheter tip fixed at the gastroduodenal artery with microcoils and a mixture of n-butyl cyanoacrylate and iodized oil.

Embolization of the right gastric artery before hepatic arterial infusion chemotherapy to prevent gastric mucosal lesions: approach through the hepatic artery versus the left gastric artery.

Objective: The purpose of our study was to evaluate whether the hepatic artery or the left gastric artery is the better route of approach for selective embolization of the right gastric artery before hepatic arterial infusion chemotherapy using a port-catheter system.

Subjects And Methods: Eighty-six patients (56 men, 30 women; mean age, 62.1 years) with unresectable advanced liver cancer underwent percutaneous implantation of a port-catheter system.

Hepatic encephalopathy secondary to intrahepatic portosystemic venous shunt: balloon-occluded retrograde transvenous embolization with n-butyl cyanoacrylate and microcoils.

We report a 70-year-old woman with hepatic encephalopathy due to an intrahepatic portosystemic venous shunt that was successfully occluded by percutaneous transcatheter embolization with n-butyl cyanoacrylate and microcoils.

Management of pneumothorax after percutaneous CT-guided lung biopsy.

Objectives: To evaluate the efficacy of simple aspiration of air from the pleural space to prevent increased pneumothorax and to avoid chest tube placement in cases of pneumothorax following CT-guided lung biopsy.

Design: Observational.

Materials And Methods: One hundred thirty-four consecutive percutaneous needle lung biopsies using real-time CT fluoroscopy guidance formed the basis of our study.

Hemodynamic changes after self-expandable metallic stent therapy for vena cava syndrome.

Objective: We examined changes in hemodynamics after self-expandable metallic stent placement in the vena cava.

Conclusion: The rapid increase in venous return immediately after expandable metallic stent placement influenced the hemodynamics of the circulatory system.

Effects of prostaglandin E(1) injection through the superior mesenteric artery on the hemodynamics of hepatocellular carcinoma.

Objective: The purpose of our study was to assess the effects of portal blood flow on contrast enhancement in hepatocellular carcinoma lesions on CT hepatic arteriography.

Subjects And Methods: We examined 43 tumors in 39 patients who simultaneously underwent CT during arterial portography and CT hepatic arteriography for examination of liver tumors and then CT hepatic arteriography with prostaglandin E(1) injection via the superior mesenteric artery. All lesions pathologically confirmed to be hepatocellular carcinomas exhibited portal perfusion defects on CT during arterial portography.