scholarly journals Review of Applied Anatomy, Hemodynamics, and Endovascular Management of Ectopic Varices

2021 ◽  
Author(s):  
Sitaram Barath ◽  
Dharav Kheradia ◽  
Shakti Parvathy Gopalkrishnan ◽  
Rahul K. R. ◽  
Mohammed Rafeeque P. K.
Keyword(s):  
Gastric Varices ◽  
Portal System ◽  
Endovascular Management ◽  
Applied Anatomy ◽  
Ectopic Varices ◽  
Contrast Enhanced ◽  
Collateral Pathways ◽  
Low Incidence ◽  
Enhanced Computed Tomography ◽  
Radiological Procedures

AbstractPortal hypertension leads to the opening up of collateral pathways to bypass the occlusion or resistance in the portal system. Ectopic varices are formed by such collaterals at many various sites along the gastrointestinal tract other than the usual location, that is, gastroesophageal region. Early diagnosis of ectopic varices needs strong clinical suspicion and contrast-enhanced computed tomography scan as endoscopy may often fail to pinpoint a source. In contrast to gastric varices where the understanding of the disease, as well as endovascular management, is widely studied and documented, the same is not true for ectopic varices due to low incidence. Understanding the applied anatomy and hemodynamic classification is important to decide the most suitable therapy. Interventional radiological procedures are aimed at either decompressing the varices or obliterating them and depend on the patency of the portal system, underlying etiology, and local expertise.

Clip-assisted endoscopic cyanoacrylate injection for gastric varices with a gastrorenal shunt: a multicenter study

Endoscopy ◽  
2019 ◽  
Vol 51 (10) ◽  
pp. 936-940 ◽  
Author(s):  
Mingyan Zhang ◽  
Ping Li ◽  
Haijun Mou ◽  
Yongjun Shi ◽  
Biguang Tuo ◽  
...  
Keyword(s):  
Gastric Varices ◽  
Safe Procedure ◽  
Technical Success ◽  
Technical Success Rate ◽  
Gastrorenal Shunt ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Lost To Follow Up ◽  
Contrast Enhanced Computed Tomography

Abstract Background The aim of this study was to evaluate the safety and efficacy of clip-assisted endoscopic cyanoacrylate injection for gastric varices with a gastrorenal shunt. Methods Records were reviewed of patients with gastric varices and concomitant gastrorenal shunts who underwent clip-assisted endoscopic cyanoacrylate injection at three tertiary centers between April 2016 and October 2018. The assessed outcomes were technical success rate, eradication of gastric varices, cyanoacrylate embolization, and all-cause rebleeding. Results A total of 61 patients were analyzed. The procedure was successful in all patients (100 %). Gastric varices were eradicated in 30 of 33 patients (90.9 %) according to contrast-enhanced computed tomography re-examination within 1 month after the procedure. No symptoms or signs of cyanoacrylate embolization related to the procedure were observed. Four patients (6.6 %) were lost to follow-up. All-cause rebleeding occurred in 13/57 patients (22.8 %) during a median follow-up period of 225 days (interquartile range 114 – 507 days). Conclusions Clip-assisted endoscopic cyanoacrylate injection appeared to be a safe procedure that was convenient and efficacious in the treatment of gastric varices with concomitant gastrorenal shunt.

scholarly journals Porcine Ex Vivo Liver Phantom for Dynamic Contrast-Enhanced Computed Tomography

2011 ◽  
Vol 46 (9) ◽  
pp. 586-593 ◽  
Author(s):  
Scott M. Thompson ◽  
Juan C. Ramirez-Giraldo ◽  
Bruce Knudsen ◽  
Joseph P. Grande ◽  
Jodie A. Christner ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ex Vivo ◽  
Dynamic Contrast Enhanced ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Liver Phantom ◽  
Contrast Enhanced Computed Tomography

scholarly journals Contrast enhanced computed tomography findings in 105 horse distal extremities.

2021 ◽  
pp. 103704
Author(s):  
Frederik Pauwels ◽  
Angela Hartmann ◽  
John Al-Alawneh ◽  
Paul Wightman ◽  
Jimmy Saunders
Keyword(s):  
Computed Tomography ◽  
Contrast Enhanced ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

scholarly journals Self-navigated 3D whole-heart MRA for non-enhanced surveillance of thoracic aortic dilation: a comparison to CTA

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
P Poskaite ◽  
M Pamminger ◽  
C Kranewitter ◽  
C Kremser ◽  
M Reindl ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Image Quality ◽  
Aortic Aneurysm ◽  
Thoracic Aortic Aneurysm ◽  
Aortic Dilation ◽  
Subjective Image Quality ◽  
Contrast Enhanced ◽  
Whole Heart ◽  
Enhanced Computed Tomography ◽  
Contrast Enhanced Computed Tomography

Abstract Funding Acknowledgements Type of funding sources: None. Background The natural history of thoracic aortic aneurysm (TAA) is one of progressive expansion. Asymptomatic patients who do not meet criteria for repair require conservative management including ongoing aneurysm surveillance, mostly carried out by contrast-enhanced computed tomography angiography (CTA). Purpose To prospectively compare image quality and reliability of a prototype non-contrast, self-navigated 3D whole-heart magnetic resonance angiography (MRA) with contrast-enhanced computed tomography angiography (CTA) for sizing of thoracic aortic aneurysm (TAA). Methods Self-navigated 3D whole-heart 1.5 T MRA was performed in 20 patients (aged 67 ± 8.6 years, 75% male) for sizing of TAA; a subgroup of 18 (90%) patients underwent additional contrast-enhanced CTA on the same day. Subjective image quality was scored according to a 4-point Likert scale and ratings between observers were compared by Cohen’s Kappa statistics. Continuous MRA and CTA measurements were analyzed with regression and Bland-Altman analysis. Results Overall subjective image quality as rated by two observers was 1 [interquartile range (IQR) 1-2] for self-navigated MRA and 1.5 [IQR 1-2] for CTA (p = 0.717). For MRA a perfect inter-observer agreement was found for presence of artefacts and subjective image sharpness (κ=1). Subjective signal inhomogeneity correlated highly with objectively quantified inhomogeneity of the blood pool signal (r = 0.78-0.824, all p <0.0001). Maximum diameters of TAA as measured by self-navigated MRA and CTA showed excellent correlation (r = 0.997, p < 0.0001) without significant inter-method bias (bias -0.0278, lower and upper limit of agreement -0.74 and 0.68, p = 0.749). Inter- and intraobserver correlation of aortic aneurysm as measured by MRA was excellent (r = 0.963 and 0.967, respectively) without significant bias (all p ≤ 0.05). Conclusion Self-navigated 3D whole-heart MRA enables reliable contrast- and radiation free aortic dilation surveillance without significant difference to standardized CTA while providing predictable acquisition time and by offering excellent image quality. Abstract Figure.

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