Biliary Stenosis and Gastric Outlet Obstruction: Late Complications After Acute Pancreatitis With Pancreatic Duct Disruption.

Objectives: Pancreatic duct disruption (PDD) after acute pancreatitis can cause pancreatic collections in the early phase and biliary stenosis (BS) or gastric outlet obstruction (GOO) in the late phase. We aimed to document those late complications after moderate or severe acute pancreatitis.

Methods: Between September 2010 and August 2014, 141 patients showed pancreatic collections on computed tomography.

Better Outcomes if Percutaneous Drainage Is Used Early and Proactively in the Course of Necrotizing Pancreatitis.

Purpose: To compare outcomes after percutaneous catheter drainage (PCD) for acute necrotizing pancreatitis versus those in a randomized controlled trial as a reference standard.

Materials And Methods: Between September 2010 and August 2014, CT-guided PCD was the primary treatment for 39 consecutive patients with pancreatic necrosis. The indication for PCD was the clinical finding of uncontrolled pancreatic juice leakage rather than infected necrosis.

Direct Percutaneous Repair of Left Ventricular Pseudoaneurysm via Transthoracic Deployment of a Ventricular Septal Defect Closure Device.

In this case report, we describe direct percutaneous delivery of a muscular-ventricular-septal-defect occluder device to close a left ventricular pseudoaneurysm. The occluder was positioned and deployed with the aid of concurrent transthoracic ultrasonography, transesophageal echocardiography, and fluoroscopy. In contrast with previously published reports, we describe and illustrate a direct transthoracic route across the pseudoaneurysmal sac, which obviated the need for indirect transfemoral or transapical approaches.

A percutaneous drainage protocol for severe and moderately severe acute pancreatitis.

Background: According to the revised Atlanta classification, severe and moderately severe acute pancreatitis (AP) includes patients with pancreatic and peripancreatic collections with or without organ failure. These collections suggest the presence of pancreatic juice leakage. The aim of this study was to evaluate the efficacy of a percutaneous catheter drainage (PCD) protocol designed to control leakage and decrease disease severity.

Spontaneous spinal epidural abscess in a 21-month-old child.

Spontaneous epidural abscess formation is a rare finding in all populations and even more so in the pediatric population. Its rarity and varied presentations often lead to misdiagnosis. We present a pediatric case in which the diagnosis of spontaneous spinal epidural abscess was missed upon initial presentation and subsequently identified at a later visit to the emergency department.

Visceral blood flow modulation: potential therapy for morbid obesity.

We present this preliminary investigation into the safety and feasibility of endovascular therapy for morbid obesity in a swine model. A flow-limiting, balloon-expandable covered stent was placed in the superior mesenteric artery of three Yorkshire swine after femoral arterial cutdown. The pigs were monitored for between 15 and 51 days after the procedure and then killed, with weights obtained at 2-week increments.

Patients' perspective about risks and benefits of treatment for peripheral arterial disease.

Purpose: To report the results of a standard gamble-type survey conducted to explore patients' heuristics in regard to therapy for peripheral arterial disease (PAD).

Materials And Methods: Patients presenting to a vascular and interventional radiology practice because of suspected PAD were asked to indicate their threshold for risk of amputation during a curative procedure for intermittent claudication (IC) and for risk of death from a curative medication for critical limb ischemia (CLI). Possible relationships of risk threshold with age, gender, ankle-brachial index (ABI), and functional claudication distance were assessed with univariate statistics followed by multivariable generalized linear mixed models of risk acceptance at various risk levels.

Utilization of lower extremity arterial disease diagnostic and revascularization procedures in Medicare beneficiaries 2000-2007.

Objective: The recent escalation in lower extremity revascularization procedures suggests a concomitant increase in peripheral arterial disease (PAD) screening. We hypothesized that self-referring physicians would show the greatest growth in noninvasive physiologic testing for PAD and similar trends for revascularization procedures. We compared utilization rates for self-referring specialties (vascular surgery, interventional radiology, and cardiology) with the utilization rate for a referral-based specialty (diagnostic radiology), assuming the latter to be "basal"--that is, responsive only to changes in demographics and medical knowledge.

Clearing the cervical spine in obtunded patients.

Study Design: Retrospective cohort study.

Objective: To determine the frequency of injuries missed by initial computed tomography (CT) of the cervical spine in obtunded blunt trauma victims.

Summary Of Background Data: Optimal method for excluding cervical spine injury in obtunded trauma patients remains controversial.