Radiology-Implanted Arm Ports: A Review of the Literature

2015 ◽  
Vol 20 (2) ◽  
pp. 81-90 ◽  
Author(s):  
Brent Burbridge ◽  
Grant Stoneham ◽  
Hyun J. Lim ◽  
Chel-Hee Lee
Keyword(s):  
Interventional Radiology ◽  
Success Rate ◽  
English Language ◽  
Human Beings ◽  
Review Of The Literature ◽  
Technical Success ◽  
Upper Arm ◽  
Technical Success Rate ◽  
Port Implantation ◽  
Port Systems

Abstract Introduction: Placement of totally implanted venous access devices, or port systems, in the upper arm is becoming a common practice in interventional radiology. To gain a better understanding of the literature in this area, we performed a search for and analysis of previous publications related to upper arm implantation of these devices by members of interventional radiology departments. Methods: A review of the literature pertaining to upper arm port systems implanted in human beings by members of interventional radiology departments was performed, assessing publications between the years 1992 and 2014. Only English-language publications were assessed. Results: Eighteen publications met selection criteria during the time frame reviewed. None of the studies used a prospective, randomized design; rather, all studies consisted of case–cohort descriptions of outcomes for a single device or for multiple devices. Analysis of the available literature for interventional radiology-inserted arm ports was performed. The technical success rate ranged between 93.7% and 100%, with an average of 98.9%. Conclusions: The high technical success rate of arm port implantation and the elimination of the potential for pneumothorax, hemothorax, catheter pinch-off syndrome, and subclavian and carotid artery injury are strengths of the arm implantation strategy. There was wide variation in the rates of complications detected, in addition to inconsistent study design and study implementation strategies.

scholarly journals Endovascular Stenting of Extracranial Carotid and Vertebral Artery Dissections: A Systematic Review of the Literature

Neurosurgery ◽  
2011 ◽  
Vol 68 (4) ◽  
pp. 856-866 ◽  
Author(s):  
Martin H. Pham ◽  
Rudy J. Rahme ◽  
Omar Arnaout ◽  
Michael C. Hurley ◽  
Richard A. Bernstein ◽  
...  
Keyword(s):  
Systematic Review ◽  
Vertebral Artery ◽  
Success Rate ◽  
Artery Dissection ◽  
Endovascular Management ◽  
Review Of The Literature ◽  
Technical Success ◽  
Endovascular Stenting ◽  
Technical Success Rate

Abstract BACKGROUND: Carotid and vertebral artery dissections are a leading cause of stroke in young individuals. OBJECTIVE: To examine the published safety and efficacy of endovascular stenting for extracranial artery dissection. METHODS: We conducted a systematic review of the literature to identify all cases of endovascular management of extracranial carotid and vertebral artery dissections. RESULTS: For carotid dissections, our review yielded 31 published reports including 140 patients (153 vessels). Reported etiologies were traumatic (48%, n = 64), spontaneous (37%, n = 49), and iatrogenic (16%, n = 21). The technical success rate of stenting was 99%, and the procedural complication rate was 1.3%. Mean angiographic follow-up was 12.8 months (range, 2-72 months) and revealed in-stent stenosis or occlusion in 2% of patients. Mean clinical follow-up was 17.7 months (range, 1-72 months), and neurological events were seen in 1.4% of patients. For vertebral artery dissections, our review revealed 8 reports including 10 patients (12 vessels). Etiologies were traumatic (60%, n = 6), spontaneous (20%, n = 2), and iatrogenic (20%, n = 2). There was a 100% technical success rate. The mean angiographic follow-up period was 7.5 months (range, 2-12 months). No new neurological events were reported during a mean clinical follow-up period of 26.4 months (range, 3-55 months). CONCLUSION: Endovascular management of extracranial arterial dissection continues to evolve. Current experience shows that this treatment option is safe and technically feasible. Prospective randomized trials compared with medical management are needed to further elucidate the role of stenting.

Single-center comparison of the efficacy and complications of arterial vascular closure devices in interventional radiology

2017 ◽  
Vol 18 (4) ◽  
pp. 339-344 ◽  
Author(s):  
Matthew A. Elmasri ◽  
Stephen T. Kee ◽  
John M. Moriarty ◽  
Antoinette Gomes ◽  
Edward W. Lee ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Success Rate ◽  
Complication Rates ◽  
Manual Compression ◽  
Single Center ◽  
Technical Success ◽  
Laboratory Parameters ◽  
Technical Success Rate ◽  
Major Complications ◽  
Vascular Closure Devices

Introduction Vascular closure devices (VCDs) are commonly used to achieve hemostasis of arterial access sites, but there is little comparative data on the variety of VCDs currently in clinical use. We reviewed the VCD experience at our institution to determine the safest and most effective VCD. Materials and Methods Retrospective analysis of 907 consecutive arterial procedures in interventional radiology from June 2012 to June 2014 was performed. Five VCDs were used: Angio-Seal (n = 478), FISH (n = 56), Mynx (n = 56), Perclose (n = 61), and Starclose (n = 68). Patients who underwent manual compression (n = 188) without use of VCDs were also studied as a comparison group. Patient demographics and pre-procedural laboratory parameters were recorded. The technical success rate for achievement of hemostasis and complication rates were noted. Results Complete hemostasis rate (aka technical success rate) was 93.5% for Angio-Seal, 83.9% for FISH, 53.6% for Mynx, 73.7% for Perclose, 76.5% for Starclose, and 91.5% for manual compression. The differences among the devices were statistically significant (p<0.001). Fourteen major complications (1.5%) were encountered: nine with Angio-Seal (1.9%), one with Mynx (1.8%), one with Starclose (1.5%), and three with manual compression (1.6%); these differences were not statistically significant. Of the demographic and laboratory parameters studied, none were significantly correlated with hemostasis failure or development of complications. Conclusions In our single-center institutional experience, Angio-Seal is the device with the best technical success rate. Major complications of VCDs were rare, with no statistically significant difference between devices.

Radiology Implanted Forearm Ports: A Review of the Literature

2017 ◽  
Vol 22 (1) ◽  
pp. 22-30
Author(s):  
Brent Burbridge ◽  
Ian Y. M. Chan ◽  
Rhonda Bryce ◽  
Chel-Hee Lee ◽  
Hyun J. Lim
Keyword(s):  
Interventional Radiology ◽  
Venous Access ◽  
Radiology Department ◽  
Success Rates ◽  
Review Of The Literature ◽  
Port Implantation ◽  
Port Systems ◽  
A Prospective Study ◽  
Review Criteria

Abstract Background: Insertion of totally implanted venous access devices; that is, port systems, in the forearm is an option for long-term venous access. To better understand the radiology literature reported for this anatomic location, we performed a search for, and an analysis of, previous publications related to forearm implantation of these devices by interventional radiology department personnel. Materials and Methods: A review of the literature was performed for articles describing radiology implantation of forearm ports. Articles published between 1990 and 2015 were reviewed. Results: Eleven articles were found that met the review criteria. None were randomized studies and only 1 was a prospective study. All of the other studies were retrospective reviews of a variety of different port devices. An analysis of these articles was performed. Conclusions: Forearm port implantation had high technical success rates (range, 98%–100%; mean, 99.7%). A wide variety of complications were encountered, none of which exceeded the Society of Interventional Radiology threshold levels for complications associated with port insertion. A subset of the studies were upper arm venipunctures with the port catheter and housing subsequently implanted in the forearm distal to the antecubital fossa.

scholarly journals The Role of Interventional Radiology in the Management of Late Postpancreaticoduodenectomy Hemorrhage

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Liang Zhang ◽  
Jun Wang ◽  
Jinhua Jiang ◽  
Jialin Shen
Keyword(s):  
Interventional Radiology ◽  
Success Rate ◽  
Technical Success ◽  
Safe Method ◽  
Technical Success Rate ◽  
Index Operation ◽  
Positive Rate ◽  
Rebleeding Rate ◽  
Overall Mortality

Objective. To explore the role of interventional radiology (IR) in the management of late postpancreaticoduodenectomy hemorrhage (PPH). Materials and Methods. Patients who had late PPH (occurring >24 h after index operation) managed by the IR procedure in our institution between 2013 and 2018 were retrospectively analyzed. Result. Hired patients who were diagnosed with grade B ( n = 10 ) and C ( n = 22 ) late PPH underwent 40 transcatheter arterial angiographies (TAA). The overall positive rate of angiography was 45.0% (18/40). Eighteen transcatheter arterial embolizations (TAEs) were performed, and the technical success rate was 88.89% (16/18). The rebleeding rate after embolization was 18.8% (3/16), and no severe procedure-related complications were recorded. The overall mortality of late PPH was 25.0% (8/32). Conclusion. Nearly half of hemorrhagic sites in late PPH could be identified by TAA. TAE is an effective and safe method for the hemostasia of late PPH in patients with positive angiography results.

scholarly journals Evaluation of percutaneous transcatheter embolization for pulmonary arteriovenous malformations

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
ZhengZhong Wu ◽  
JunQing Lin ◽  
WeiZhu Yang ◽  
Na Jiang ◽  
Ning Huang ◽  
...  
Keyword(s):  
New York ◽  
Success Rate ◽  
Arteriovenous Malformations ◽  
Heart Association ◽  
Transcatheter Embolization ◽  
Pulmonary Arteriovenous Malformations ◽  
Technical Success ◽  
Arterial Blood Gas ◽  
Technical Success Rate ◽  
Arterial Blood

Abstract Background The purpose of this study was to assess the safety and efficacy of percutaneous transcatheter embolization (TCE) for the treatment of pulmonary arteriovenous malformations (PAVMs). Methods Forty-three consecutive patients (n = 17 males; n = 26 females) with 72 untreated PAVMs underwent coil and/or plug embolization between January 2010 and February 2018. The mean patient age was 42 ± 14 years (range 19–71 years). The median size of the feeding artery was 7.9 ± 2.9 mm (range 3.5–14.0 mm). The arterial blood gas level and cardiac function of all patients were analysed. The technical success rate, recanalization rate, and complications were evaluated. Computed tomography angiography (CTA) examinations were scheduled for 12 months after treatment and every 2–4 years thereafter. Results Twenty-five PAVMs were treated with coils alone, twenty-one were treated with plugs alone, and twenty-six were treated with both coils and plugs. The technical success rate was 100%. There were no complications during operation. However, one patient (2.3%) had pulmonary thrombosis and embolism post-operation. The patients’ pre-operative and post-operative PaO2 and SaO2 levels were significantly different (p < 0.01). A comparison of the New York Heart Association (NYHA) grade before and after embolization in all patients showed a significant decrease in the post-operative grade (p < 0.01). The 72 PAVMs were divided into three groups (coils only group [n = 25], plugs only group [n = 21], and coils/plugs combined group [n = 26]). After 12 months of follow-up, there were seven reperfusion PAVMs in the coil group, seven reperfusion PAVMs in the plug group, and 1 reperfusion PAVM in the combined group. There were significant differences between the two groups and the combined group. Conclusion Percutaneous TCE is safe and effective for the treatment of PAVMs. A combination of coils and vascular plugs may be useful for preventing recanalization after the embolization of PAVMs.

scholarly journals Modified percutaneous radiologic gastrostomy technique without endoscopic or nasogastric access

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Reda Tabashy ◽  
Amira Darwish ◽  
Ashraf Ibrahim ◽  
Mohamed Gad El-Mola
Keyword(s):  
Esophageal Cancer ◽  
Success Rate ◽  
Nasogastric Tube ◽  
Conventional Technique ◽  
Fluoroscopic Guidance ◽  
Efficacy And Safety ◽  
Technical Success ◽  
Technical Success Rate ◽  
Major Complications ◽  
Percutaneous Radiologic Gastrostomy

Abstract Background The aim of this study is to evaluate the efficacy and safety of a modified percutaneous radiologic gastrostomy (MPRG) technique under ultrasound and fluoroscopic guidance without endoscopic or nasogastric access. Results The study included 24 patients: 10 males and 14 females whose ages ranged from 44 to 80 years old. Ten patients had esophageal cancer and 14 patients had neck cancer. Technical success was achieved in 23 out of the 25 procedures (92%). Two procedures failed (8%) and were converted to the conventional technique by using the nasogastric tube. No major complications were reported. Minor complications were observed in 5 patients (20%): intraperitoneal air and contrast leakage in 4 patients and focal mucosal dissection by the contrast in 1 patient. Conclusion The MPRG has high technical success rate, is safe with no major complications, and is most feasible when endoscopic or nasogastric access cannot be performed.

scholarly journals Feasibility and Techniques of Securing 3D-Safety Margin in Superselective Transarterial Chemoembolization to Improve Local Tumor Control for Small Hepatocellular Carcinoma: An Intend-to-Treat Analysis

Liver Cancer ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 63-71
Author(s):  
Ching Charoenvisal ◽  
Toshihiro Tanaka ◽  
Hideyuki Nishiofuku ◽  
Hiroshi Anai ◽  
Takeshi Sato ◽  
...  
Keyword(s):  
Success Rate ◽  
Tumor Recurrence ◽  
Safety Margin ◽  
Small Hepatocellular Carcinoma ◽  
Technical Success ◽  
Local Tumor ◽  
Local Tumor Recurrence ◽  
3D Images ◽  
Technical Success Rate ◽  
Treat Analysis

<b><i>Introduction:</i></b> The aim of this study was to investigate the technical success rate of obtaining 3D-safety margin in superselective conventional transarterial chemoembolization (cTACE) using 3D images for small hepatocellular carcinoma (HCC). <b><i>Methods:</i></b> Consecutive 48 HCC nodules (diameter, 1–3 cm) in 44 patients were intentionally treated by superselective cTACE in an attempt to achieve 3D-safety margin. Superselective CT during hepatic arteriography (CTHA) was obtained before cTACE. When negative 3D-safety margin was found, branches supplied into the margin area were detected by using a 3D workstation. The technical success rate to obtain 3D-safety margin was investigated by intend-to-treat analysis. Local tumor recurrence rate and adverse events were also evaluated. <b><i>Result:</i></b> Nine of 48 tumors (18.8%) had 3D-safety margin in the initial superselective CTHA. After pulling back of the catheter and/or selection of another branch based on 3D images, 3D-safety margin was finally achieved in 45 (93.8%). There were 8 of 46 tumors (17.4%) with local recurrence after 5-year follow-up. Grade 3–4 of aspartate aminotransferase, alanine aminotransferase, and total bilirubin were found in 38.6, 36.4, and 2.3%, respectively. One portal vein thrombus and 3 biliary dilation or biloma were developed. <b><i>Conclusion:</i></b> Superselective cTACE obtaining 3D-safety margin in small HCC was feasible with a high success rate by using 3D images, which could be tolerable and prevent local tumor recurrence.

scholarly journals Packing Technique with or without Remodeling for Endovascular Coil Embolization of Renal Artery Aneurysms: Safety, Efficacy and Mid-Term Outcomes

2021 ◽  
Vol 10 (2) ◽  
pp. 326
Author(s):  
Grégory Secco ◽  
Olivier Chevallier ◽  
Nicolas Falvo ◽  
Kévin Guillen ◽  
Pierre-Olivier Comby ◽  
...  
Keyword(s):  
Renal Artery ◽  
Success Rate ◽  
Coil Embolization ◽  
Preventive Treatment ◽  
Parent Artery ◽  
Technical Success ◽  
Technical Success Rate ◽  
Endovascular Coil Embolization ◽  
Lower Morbidity

The endovascular treatment of renal artery aneurysms (RAAs) has lower morbidity and shorter stay lengths compared to surgical repair. Here, we describe coil packing with or without remodeling and assess outcomes and complications. We retrospectively identified the 19 consecutive preventive endovascular RAA coil embolizations done in 18 patients at our center in 2010–2020. Patient and aneurysm characteristics, technical success rate, complications, and recurrences were recorded. Mean patient age was 63 ± 13 years. The RAA was >1.5 cm in 11 cases, and in four cases, the aneurysm-to-parent artery size ratio was >2. Simple coiling was performed for 11 (57.9%) aneurysms, stent-assisted coiling for seven (36.8%) aneurysms, and balloon-assisted coiling for one (5.3%) aneurysm. Technical success rate was 100%. Complete definitive RAA exclusion was achieved with a single procedure for 17 (89.5%) aneurysms, whereas two (10.5%) aneurysms required a repeat procedure. Four minor complications occurred but resolved with no long-term consequences. No major complications occurred during the mean follow-up of 41.1 ± 29.7 months. Coil embolization by sac packing or remodeling proved very safe and effective. Together with the known lower morbidity and shorter stay length compared to open surgery, these data indicate that this endovascular procedure should become the preventive treatment of choice for RAAs.

scholarly journals Endoscopic Stricturotomy Is an Efficacious Option for Management of Strictures in Patients With Inflammatory Bowel Disease

2020 ◽  
Vol 2 (4) ◽  
Author(s):  
Nabeeha Mohy-ud-din ◽  
Gursimran S Kochhar
Keyword(s):  
Inflammatory Bowel Disease ◽  
Success Rate ◽  
Bowel Disease ◽  
Chart Review ◽  
Common Complication ◽  
Technical Success ◽  
Technical Success Rate ◽  
Safe Technique ◽  
Inflammatory Bowel ◽  
The Mean

Abstract Background Strictures are a common complication for patients with inflammatory bowel disease. Endoscopic stricturotomy (ESt) is a novel procedure for treatment of these strictures. Methods A chart review was performed for patients with strictures who underwent ESt. Results Eleven patients were included in the study and the total number of strictures treated was 12. The mean length of the strictures was 10.25 ± 4.36 mm. Technical success was achieved in 92% (n = 11) of the procedures. Postprocedural bleeding occurred in 9% (n = 1) of patients, and none of the patients had complications of infection or perforation. Conclusions ESt is a safe technique with high technical success rate.

scholarly journals Percutaneous transhepatic drainage is safe and effective in biliary obstruction—A single-center experience of 599 patients

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0260223
Author(s):  
Bálint Kokas ◽  
Attila Szijártó ◽  
Nelli Farkas ◽  
Miklós Ujváry ◽  
Szabolcs Móri ◽  
...  
Keyword(s):  
Success Rate ◽  
Extrahepatic Bile Duct ◽  
Treatment Algorithm ◽  
Success Rates ◽  
Technical Success ◽  
Tertiary Referral Center ◽  
Technical Success Rate ◽  
Percutaneous Transhepatic Drainage ◽  
First Choice ◽  
Transhepatic Drainage

Background Historically, surgical bilioenteric bypass was the only treatment option for extrahepatic bile duct obstruction, but with technological advancements, percutaneous transhepatic drainage (PTD) and endoscopic solutions were introduced as a less invasive alternative. Endoscopic methods may lead to a decreasing indication of PTD in the future, but today it is still the standard treatment method, especially in hilar obstructions. Methods In our retrospective data analysis, we assessed technical success rate, reintervention rate, morbidity, mortality, and the learning curve of patients treated with PTD over 12 years in a tertiary referral center. Results 599 patients were treated with 615 percutaneous interventions. 94.5% (566/599) technical success rate; 2.7% (16/599) reintervention rate were achieved. 111 minor and 22 major complications occurred including 1 case of death. In perihilar obstruction, cholangitis were significantly more frequent in cases where endoscopic retrograde cholangiopancreatography had also been performed prior to PTD compared to PTD alone, with 39 (18.2%) and 15 (10.5%) occurrences, respectively. Discussion The results and especially the excellent success rates demonstrate that PTD is safe and effective, and it is appropriate for first choice in the treatment algorithm of perihilar stenosis. Ultimately, we concluded that PTD should be performed in experienced centers to achieve low mortality, morbidity, and high success rates.

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