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Arterio-biliary fistula as rare complication of chemoradiation therapy for intrahepatic cholangiocarcinoma

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World Journal of Radiology 2010年第9期2卷 374-376页

作者： Koichi Hayano Fumihiko Miura Hodaka Amano Naoyuki Toyota Keita Wada Kenichiro Kato Tadahiro Takada Takehide Asano Department of Surgery Teikyo University School of Medicine

Significant hemobilia due to arterio-biliary fistula is a very rare complication of chemoradiation therapy(CRT) for unresectable intrahepatic cholangiocarcinoma(ICC).Here we report a case of arterio-biliary fistula after CRT for unresectable ICC demonstrated by angiographic examinations.This fistula was successfully treated by endovascular embolization.Hemobilia is a rare complication,but arterio-biliary fistula should be considered after CRT of ICC.

关键词： Arterio-biliary fistula Intrahepatic cholangiocarcinoma Endovascular embolization Chemoradiation therapy Hemobilia

Open Surgery for Retrieval of Patent Foramen Ovale Closure Device Embolized into Right Pulmonary Artery

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World Journal of Cardiovascular Surgery 2017年第5期7卷 67-72页

作者： Ahmad Al Khaddour Adelle Dawson Hussein El Shafei FRCS Glasg (C-Th) Damascus University Hospital/Locum Fellow NHS Hospitals Newcastle Underlym UK Damascus University Hospital Damascus Syria

Percutaneous Patent Foramen Ovate PFO/Atrial Septal Defect (ASD) closure has become an increasingly simplified procedure over the past decade. The main advantages of a percutaneous approach include avoidance of surgery, short procedure time and hospital stay. Device embolization is seen rarely but it can be fatal. We report this complication following a percutaneous PFO closure in a 44-year-old man. The device was embolized into the distal part of the right pulmonary artery. We removed the device surgically and closed the PFO/ASD.

关键词： Patent Foramen Ovate Atrial Septal Defect Septal Closure Device embolization of the Right Pulmonary Artery Amplatzer Device Cardiopulmonary Bypass

Giant Serpentine Cerebral Aneurysm of the Middle Cerebral Artery: Case Report

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Open Journal of Medical Imaging 2017年第1期7卷 9-16页

作者： Abdulrahman M. Al Shamy Mohammed D. Alsahafi Muhammed A. Alghamdi Abdullah A. Alshamrani Roaa N. Filfilan Radiology Department KAMC-NG Jeddah KSA College of Medicine Umm Alqura University Makkah KSA

A 43-year-old male presented with severe intermittent headaches since two years accompanied by multiple episodes of generalized seizures and left hand weakness. MRI scan and cerebral angiography confirmed the diagnosis of a giant serpentine cerebral aneurysm arising from the middle cerebral artery. The patient was admitted for a possible cerebral embolization after undergoing a Balloon Occlusion Test (BOT). Since he tolerated the occlusion test, he underwent coil embolization afterwards with successful occlusion followed by an uneventful recovery and no complications. Later on, the patient was discharged home in a stable and good general condition without any neurological deficits. A six-month angiography follow-up revealed a complete occlusion with no re-canalization of the coiled giant serpentine aneurysm. Therefore, we concluded that parent artery occlusion is a good and safe procedure providing that the patient tolerated both the occlusion and the hemodynamic stress tests.

关键词： Aneurysm Giant Interventional Neuroradiology Giant Serpentine Aneurysm Balloon Occlusion Test Parent Artery Sacrifice Coil embolization Endovascular

Pre-transplant treatment of large polycystic kidney

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World Journal of Clinical Urology 2016年第1期5卷 66-71页

作者： Iván D Sáez Juan F de la Llera Andrés Tapia Rodrigo A Chacón Pedro A Figueroa Bruno I Vivaldi Alfredo Domenech Christopher D Horn Fernando Coz Department of Urology Military Hospital Facultad de Medicina Universidad de los Andes

AIM: To evaluate the indications, optimal timing andoutcomes of native nephrectomy and other techniques in pretransplant treatment of autosomal dominant polycystic kidney disease(PKD).METHODS: A literature review was conducted using the Pub Med and Epistemonikos databases. Keywords for pre-transplant surgical management of polycystic kidneys were: Transplant, treatment and PKD. Keywords for pre-treatment embolization of PKD were: embolization, transplant and polycystic kidney disease. The inclusion criterions were all articles found using this search method. The exclusion criterions were articles found to include bias and not attending pre-transplant treatment options. Fifteen articles were included in our final analysis. Ten articles were found regarding embolization of PKD of which three reviews were selected for final analysis. The reviews were divided into pre transplant and intra transplant treatment for the surgical treatment of PKD. All articles meeting inclusion criteria were thoroughly analyzed by two independent reviewers. A third independent reviewer was consulted if the reviewers did not agree upon the inclusion or exclusion of a specific article. No statistical analysis was performed.RESULTS: Studies vary regarding the technique used(open or laparoscopic), laterality(single or bilateral) and temporality of nephrectomy with respect to renal transplant(pre-transplant or simultaneous to transplant). Several groups argue in favor of simultaneous nephrectomy and kidney transplant since it avoids the deleterious effects of being anefric. Long-term results and patient satisfaction are acceptable. However, it is associated with increased operative time, transfusion rate, morbidity and length of hospital stay. Based on small sample studies, bilateral nephrectomy prior to transplant has been associated with a higher risk of morbidity and mortality. Studies on laparoscopic approach report it as a feasible and safe alternative to the open surgery approach, highlighting its lower complication rate, transfusions a

关键词： Polycystic Kidneys Kidney transplant End stage renal disease Kidney embolization

Delayed Lumbar Artery Laceration and Symptomatic Retroperitoneal Hemorrhage Following IVC Filter Placement

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Open Journal of Radiology 2015年第4期5卷 212-216页

作者： Jennifer P. Montgomery Kenneth J. Kolbeck Dotter Interventional Institute Oregon Health & Science University Portland OR USA

Inferior vena cava filters are placed in selected patients to protect against potentially fatal pulmonary embolism. Generally, filter placement is regarded as a safe procedure although rare complications may arise. Recurrent thromboembolic events are the most common complications assoiated with inferior vena cava filters;however, there are multiple reports of filter fracture, migration, embolization, penetration and perforation. The aim of this report is to illustrate a serious potential complication of inferior vena cava filters. We report a rare case of symptomatic retroperitoneal hemorrhage occurring 3 weeks after filter placement treated successfully with selective arterial embolization of a lumbar artery laceration. This case serves to highlight the importance of retrieving filters when they are no longer beneficial.

关键词： Inferior Vena Cava Filter Pulmonary Embolism Hemorrhage Arterial embolization Lumbar Artery Laceration

Immediate and Intermediate Results of Patent Ductus Artriosus Transcatheter Closure in Kurdistan (Multicenter Experience)

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World Journal of Cardiovascular Surgery 2016年第5期6卷 61-72页

作者： Aso F. Salih Abass A. Al-Rabaty Zuhair I. Al-Nasiry Department of Pediatrics School of Medicine Faculty of Medical Sciences University of Sulaimani Kurdistan Iraq Department of Pediatrics School of Medicine Hawler Medical University Hawler Iraq Erbil Cardiac Center Kurdistan Iraq

Background: Patent Ductus Artriosus (PDA) is abnormal vascular communication between aorta and pulmonary artery and it is a common congenital heart anomaly seen in pediatric practice forming 5% - 10% of all congenital heart defects. A retrospective study aims to review our experience and determine the efficacy and safety of transcatheter PDA closure in different age groups and has the procedure replaced the conventional surgical closure of the PDA in the majority of the cases. To assess the results and outcomes of early experience, transcatheter closure of patent ductus Arteriosus in all three cardiac centers in Kurdistan, using the Amplatzer Duct Occluder type I and II (ADO), and Cook coil for the first time in Kurdistan are analyzed. Patients & Methods: A total of three hundred and nine patients which included 228 females & 81 males were diagnosed to have PDA, between March 2008 to February 2011 in all three cardiac centers in Kurdistan, namely Hawler, Sulaimani and Duhok cardiac centers, where they underwent transcatheter closure of the PDA with ADO type I and II. The common age on closure was 1 - 5 years old (range 5.5 months old to 32 years old), and weight ranged from 6 kg to 58 kg. We retrospectively analyzed medical records, echocardiography, angiographic and hemodynamic data and follow-up results of the patients. Patients included in the study were according to standard recommendation for transcatheter closure of PDA, and in any age they should be above 6 kilograms with exclusion of cases with pulmonary hypertension and interrupted IVC. Results: Among 309 cases did catheterization procedures, the ratio of female to male ratio was 2.6:1 and the age of doing PDA closure at time of procedure was between 5.5 months old to 33 years old, the mean age was 6.3 ± 6.5 years old and the weight ranges between 6 kg and 58 kg, mean of 11.5 ± 7.5 kg. The most commonly used device was Amplatzer I PDA device with high closure success rate of 97.1% after 6 and 12 months followup and the first case of Amplatzer II PDA Devi

关键词： Patent Ductus Artriosus Catheterization Amplatzer Device embolization Kurdistan

Etiology and an Integrated Management of Severe Hemoptysis Due to Pulmonary Tuberculosis

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Journal of Tuberculosis Research 2015年第1期3卷 11-18页

作者： Song Yang Zhuanying Mai Xiangzhen Zheng Yueling Qiu Department of Pulmonary Medicine The 175th Hospital of People’s Liberation Army Affiliated Dongnan Hospital of Xia’men University Zhangzhou City China

Background: It is very important to enhance the therapeutic effect and prognosis of severe tuberculous hemoptysis after the determining of its etiological cause and the source of bleeding. The etiology and integrated curative effect of severe hemoptysis due to pulmonary tuberculosis among 112 inpatients were analyzed. Materials and Methods: The cause was retrospectively analysed. The integrated management effect after the follow-up of mean three years in 112 cases with severe hemoptysis being resulted from pulmonary tuberculosis from June 2008 to July 2012 was described. Active pulmonary tuberculosis ranked the first cause of lower respiratory tract bleeding (32/112, 28.5%), followed by old pulmonary tuberculosis (28/112, 25.0%), tuberculous bronchiectasis (25/112, 22.3%), purified tuberculous cavity (12/112, 10.7%), fungal infection in old pulmonary tuberculosis cavity (9/112, 7.1%), or broncholithiasis (6/112, 5.4%). Almost all suffers with severe hemoptysis were treated by an integrated management, including psychology, anticoagulants, vasoconstrictor agents. Etiological treatment including anti-tuberculosis and anti-infection was simultaneously or subsequently involved. Sixty-four inpatients with severe hemoptysis being failed to be cured by medical treatment were then received selective bronchial artery embolization. Four patients were received surgical wedge resection, lobectomy or pneumonectomy. The total cure rate added up to 98.2% after mean three years’ follow-up. The mortality was 1.8%. Conclusions: Active pulmonary tuberculosis was still responsible for the severe hemoptysis in the southeast region of China. Severe hemoptysis of pulmonary tuberculosis was also resulted from stable tuberculosis, tuberculous bronchiectasis, tuberculosis cavity, fungal infection, or broncholithiasis. Better clinical therapeutic effect could be attained by early etiological diagnosis and comprehensive treatment strategy.

关键词： Severe Hemoptysis Pulmonary Tuberculosis Medical Treatment Selective Bronchial Artery embolization Lobectomy Pneumonectomy

Enlarged and Colored Enhanced 3D Printing of Renal Artery Aneurysms for Improved Imaging and Treatment Planning

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World Journal of Cardiovascular Diseases 2016年第1期6卷 1-7页

作者： Aaron Hoffman Samy Nitecki Tony Karram Maxim Leiderman Igor Kogan Guennady Yudkovsky Amos Ofer Department of Vascular Surgery and Transplantation and Department of Radiology Rambam Health Care Campus and Rappaport Faculty of Medicine Technion Haifa Israel

Three dimensional printing (3D printing) technology is increasingly used to improve results in many areas of medicine. Physical models produced by this technology allow better appreciation of complex anatomical and pathologic conditions. In cardiovascular medicine and surgery, 3D modeling has been reported to be of help in treatment planning of abdominal aortic aneurysm, especially in cases of complex angulations and branching at the aneurysm neck. Here we report the use of 3D printing in cases of renal aneurysms. Enhanced 3D models of CTA images of renal aneurysms were prepared in house using common and freely available software programs, and an accurate desktop 3D printer. Eight reconstructed models were enlarged by a factor of 2 or more and then differentially painted to delineate normal arteries and aneurysmatic ones. These enhanced 3D solid models allowed visual and tactile inspection for a better appreciation of complex aneurysms. Color enhancement of these models added another dimension of comprehension, even for experienced surgeons and invasive radiologists, and allowed more accurate measurements of branch numbers, distances, and angles in space even with severe tortuosity. Endovascular use of covered stents and embolization techniques could be easily envisioned preoperatively. We conclude that enhanced, enlarged, and colored 3D printed models are a powerful tool for preoperative endovascular treatment planning of complex renal artery aneurysms.

关键词： 3D Printing Renal Artery Aneurysm Endovascular Covered Stent embolization

Giant Coronary Artery Pseudoaneurysm after Drug-Eluting Stent Implantation

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International Journal of Clinical Medicine 2015年第8期6卷 554-560页

作者： Ashok Bhupali Amit Joshi Sachin Patil Prithiviraj Jadhav Sayi Prasad Tanmay Vora Nirlep Gajiwala Ashok Thakkar Apple Hospitals & Research Institute Ltd. Kolhapur India Aster Aadhar Hospital Kolhapur India Sahajanand Medical Technologies Pvt. Ltd. Surat India

Formation of coronary artery pseudoaneurysm after percutaneous coronary intervention is rarely reported. A close review of available literature indicates a trend of growing incidence in recent times. Here, we present a case of coronary pseudoaneurysm developing in the left circumflex artery within 50 days of sirolimus-eluting stent implantation in a 47-year-old man who was treated for triple-vessel coronary artery disease. Initially, the patient refused any further treatment. However, considering the rapid growth of pseudoaneurysm and increased severity of symptoms at subsequent follow-up, we decided to treat giant pseudoaneurysm with embolization coils. The procedure was successful and the patient remained asymptomatic thereafter.

关键词： Coronary Aneurysm Drug-Eluting Stent embolization Coil Interventional Cardiology Pseudoaneurysm Sirolimus