Diagnosis and follow-up of small hepatocellular carcinoma with selective intraarterial digital subtraction angiography

Hepatology ◽  
1993 ◽  
Vol 17 (6) ◽  
pp. 1003-1007 ◽  
Author(s):  
Kenji Ikeda ◽  
Satoshi Saitoh ◽  
Isao Koida ◽  
Akihito Tsubota ◽  
Yasuji Arase ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Digital Subtraction Angiography ◽  
Small Hepatocellular Carcinoma ◽  
Digital Subtraction

scholarly journals Value of Three-Dimensional Digital Subtraction Angiography for Detection and Classification of Intracranial Aneurysm Remnants After Clipping

2021 ◽  
Author(s):  
Serge Marbacher ◽  
Matthias Halter ◽  
Deborah R Vogt ◽  
Jenny C Kienzler ◽  
Christian T J Magyar ◽  
...  
Keyword(s):  
Intracranial Aneurysm ◽  
Digital Subtraction Angiography ◽  
Diagnostic Yield ◽  
Three Dimensional ◽  
P Value ◽  
Digital Subtraction ◽  
Patient Demographics ◽  
Included Patient ◽  
2D And 3D

Abstract BACKGROUND The current gold standard for evaluation of the surgical result after intracranial aneurysm (IA) clipping is two-dimensional (2D) digital subtraction angiography (DSA). While there is growing evidence that postoperative 3D-DSA is superior to 2D-DSA, there is a lack of data on intraoperative comparison. OBJECTIVE To compare the diagnostic yield of detection of IA remnants in intra- and postoperative 3D-DSA, categorize the remnants based on 3D-DSA findings, and examine associations between missed 2D-DSA remnants and IA characteristics. METHODS We evaluated 232 clipped IAs that were examined with intraoperative or postoperative 3D-DSA. Variables analyzed included patient demographics, IA and remnant distinguishing characteristics, and 2D- and 3D-DSA findings. Maximal IA remnant size detected by 3D-DSA was measured using a 3-point scale of 2-mm increments. RESULTS Although 3D-DSA detected all clipped IA remnants, 2D-DSA missed 30.4% (7 of 23) and 38.9% (14 of 36) clipped IA remnants in intraoperative and postoperative imaging, respectively (95% CI: 30 [ 12, 49] %; P-value .023 and 39 [23, 55] %; P-value = <.001), and more often missed grade 1 (< 2 mm) clipped remnants (odds ratio [95% CI]: 4.3 [1.6, 12.7], P-value .005). CONCLUSION Compared with 2D-DSA, 3D-DSA achieves a better diagnostic yield in the evaluation of clipped IA. Our proposed method to grade 3D-DSA remnants proved to be simple and practical. Especially small IA remnants have a high risk to be missed in 2D-DSA. We advocate routine use of either intraoperative or postoperative 3D-DSA as a baseline for lifelong follow-up of clipped IA.

scholarly journals Hepatocellular Carcinoma Segmentation from Digital Subtraction Angiography Videos Using Learnable Temporal Difference

2021 ◽  
pp. 13-22
Author(s):  
Wenting Jiang ◽  
Yicheng Jiang ◽  
Lu Zhang ◽  
Changmiao Wang ◽  
Xiaoguang Han ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Digital Subtraction Angiography ◽  
Temporal Difference ◽  
Digital Subtraction

Abstract 1122‐000107: Charles Bonnet Syndrome Secondary to Massive Dural Arteriovenous Fistula Disguised as Extensive Venous Sinus Thrombosis

2021 ◽  
Vol 1 (S1) ◽  
Author(s):  
Ahmad A Ballout ◽  
Timothy G White ◽  
Athos Patsalides
Keyword(s):  
Digital Subtraction Angiography ◽  
Sinus Thrombosis ◽  
Sigmoid Sinus ◽  
Venous Sinus ◽  
High Grade ◽  
Retrograde Flow ◽  
Digital Subtraction ◽  
Venous Sinus Thrombosis ◽  
Charles Bonnet Syndrome

Introduction : Charles Bonnet Syndrome is characterized by visual hallucinations that can occur following severe visual insult, rarely due to dural arteriovenous fistulas (DAVF) or cerebral venous sinus thrombosis (CVST). Prompt differentiation between DAVF and CVST is important since treatments may differ and inadequate treatment may result in blindness. We highlight a patient who presented with Charles Bonnet Syndrome initially misdiagnosed with CVST by MR venography and later correctly diagnosed with a massive DAVF with superimposed CVST by digital subtraction angiography and underwent DAVF embolization with complete resolution. Methods : Case Report. Results : A 78 year‐old man with hypertension and hyperlipidemia presented with three weeks of bilateral vision loss associated with formed hallucinations exacerbated by dark rooms. Neurological exam revealed decreased visual acuity of 20/400 and grade five papilledema bilaterally. Non‐Contrast (TOF) MR venogram revealed lack of flow in the superior sagittal sinus (SSS), straight sinus (SS) and deep venous system, and partial flow of the left transverse and sigmoid sinus and left jugular vein. MR brain without gadolinium was unremarkable. Cerebral angiography revealed a high‐grade DAVF predominantly supplied by the occipital branch of the left external carotid artery [Figure 1; A‐C], with retrograde flow into the left sigmoid, transverse, superior sagittal, and straight sinuses, as well as retrograde flow into the right vein of Trolard [Figure 1; A‐D]. The left distal sigmoid sinus and left jugular bulb were occluded. The left transverse and proximal left sigmoid venous sinuses were compartmentalized from non‐occlusive thrombus, while the SSS and bilateral transverse sinuses where patent [Figure 1; A, B]. Embolization using coils and onyx was performed with complete occlusion of the left transverse and sigmoid sinuses, the points of main drainage of the fistula, as there was no single trans arterial pedicle suitable for embolization. Postembolization angiography demonstrated a Cognard Grade 1 fistula with some residual fistulous shunting of the occipital artery to the torcula. Follow up angiogram at six weeks showed interval occlusion of the residual shunt. He had minimal improvement in his vision at three months of follow up. Conclusions : This case highlights a patient with Charles Bonnet Syndrome due to a high flow DAVF. The MR venogram failed to capture the DAVF since the retrograde flow was interpreted as thrombosis on MRV. DAVF and CVST have a complex cause‐effect relationship, since thrombosis may open up venous channels that can lead to a fistula and sluggish blood flow from a fistula may stimulate thrombus formation. Treatments between CVST and DAVF differ since high grade DAVF often require endovascular embolization and anticoagulation may increase the risk of intracerebral hemorrhage in a subset of patients. Digital subtraction angiography and/or contrast enhanced MRV should be considered in cases of suspected extensive thrombosis to help differentiate between thrombosis and DAVF.

Single-center experience with the new generation Derivo Embolization Device in ruptured dissecting and blister aneurysms

2019 ◽  
Vol 61 (1) ◽  
pp. 37-46 ◽  
Author(s):  
Marius Georg Kaschner ◽  
Athanasios Petridis ◽  
Bernd Turowski
Keyword(s):  
Digital Subtraction Angiography ◽  
Flow Diverter ◽  
High Morbidity ◽  
Digital Subtraction ◽  
Related Complication ◽  
Single Center Experience ◽  
Flow Diverter Stent ◽  
Aneurysm Occlusion ◽  
New Generation

Background Treatment of ruptured dissecting and blister aneurysms is technically challenging with potentially high morbidity and mortality. The Derivo Embolisation Device (Derivo) is a flow diverter stent designed for the treatment of intracranial aneurysms. Purpose To assess the safety and feasibility of the Derivo in the treatment of ruptured dissecting and blister aneurysms. Material and Methods We retrospectively analyzed all patients with ruptured dissecting and blister aneurysms treated with the Derivo between February 2016 and July 2018. Procedural details, complications, morbidity within 30 days, and angiographic aneurysm occlusion rates, initially and after six months, were assessed. Results In 10 patients 11 ruptured dissecting and blister aneurysms were treated with 12 Derivos as monotherapy. No aneurysm rebleeding was observed at follow-up. One treatment-related complication occurred including a coil perforation of an additionally treated aneurysm. One patient died due to brain edema. Initial digital subtraction angiography revealed complete (O’Kelly–Marotta [OKM] classification D) and favorable (OKM D+C) occlusion rate in three aneurysms. Six-month follow-up for digital subtraction angiography and clinical evaluation was available in 6/9 patients with complete (OKM D) occlusion in all aneurysms (6/6). Favorable (modified Rankin Scale [mRS] ≤ 2) and moderate (mRS 3) clinical outcome after a mean follow-up of 10 months was observed in six and two patients, respectively. Conclusion Endovascular treatment with the Derivo in ruptured dissecting and blister aneurysms revealed a sufficient initial division of aneurysms from the circulation without rebleeding. The Derivo is associated with high procedural and clinical short-term safety.

Small hepatocellular carcinoma: MR follow-up of treatment with percutaneous ethanol injection.

Radiology ◽  
1993 ◽  
Vol 187 (1) ◽  
pp. 119-123 ◽  
Author(s):  
S Sironi ◽  
T Livraghi ◽  
E Angeli ◽  
A Vanzulli ◽  
G Villa ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Percutaneous Ethanol Injection ◽  
Small Hepatocellular Carcinoma ◽  
Ethanol Injection

Intra-Operative Digital Angiography as a Control of the in Situ Saphenous Vein By-Pass Grafts

1988 ◽  
Vol 29 (6) ◽  
pp. 645-648 ◽  
Author(s):  
M. Kehler ◽  
U. Albrechtsson ◽  
A. Alwmark ◽  
H. Lárusdottír ◽  
E. Ribbe ◽  
...  
Keyword(s):  
Digital Subtraction Angiography ◽  
Saphenous Vein ◽  
Digital Angiography ◽  
Digital Subtraction ◽  
Arteriovenous Fistulas

Forty-two patients undergoing in situ saphenous vein by-pass grafting procedures, in two patients bilaterally, were examined intra-operatively with digital subtraction angiography. In 19 (43%) of the examinations the graft and the anastomoses appeared adequate. In 8 cases (18%) significant abnormalities were found, including stenoses (11 %), deficient anastomoses (5%) and graft kinking (2%). Remaining arteriovenous fistulas were found in 17 patients (39%). In most cases immediate correction was possible avoiding later re-operation. At follow up 11 of the 44 grafts were occluded, 10 of these during the first five months and of these five during the first week.

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