scholarly journals Percutaneous Transhepatic Biopsy for Extrahepatic Lesions

2021 ◽  
Author(s):  
Yasuyuki Onishi ◽  
Yasuaki Arai ◽  
Miyuki Sone ◽  
Shunsuke Sugawara ◽  
Chihiro Itou ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Needle Biopsy ◽  
Inferior Vena ◽  
Vena Cava ◽  
Major Complication ◽  
Ct Fluoroscopy ◽  
Technical Success ◽  
Porta Hepatis ◽  
Maximal Diameter ◽  
Kidney Lesion

Abstract Purpose The purpose was to assess the diagnostic accuracy and safety of percutaneous transhepatic biopsy for extrahepatic lesions. Materials and Methods Between January 2008 and December 2019, 26 patients (17 men and 9 women; median age, 60 years) underwent percutaneous transhepatic needle biopsy for extrahepatic lesions at our institution. Transhepatic biopsy was deemed appropriate compared with other biopsy routes or methods (i.e., endoscopic or surgical). The lesions were in the porta hepatis (n = 9), retroperitoneum (n = 6), right adrenal gland (n = 4), right kidney (n = 3), lesser omentum (n = 2), duodenum (n = 1), pleura (n = 1), and inferior vena cava (n = 1). The median maximal diameter of the lesions was 45.5 mm (range, 18–148 mm). Core-needle biopsy was performed in all patients. Eighteen-gauge and 21-G needles were used in 25 and one patient, respectively. Ultrasound was used for biopsy in 21 patients, and CT fluoroscopy was used in five patients. Postbiopsy tract embolization was performed in three patients. Technical success and diagnostic accuracy of the biopsy were evaluated. Complications were recorded using the systemic inflammation response (SIR) criteria. Results The pathological results of biopsy were carcinoma (n = 10), lymphoma (n = 9), and other diagnoses (n = 7). Technical success was obtained in all patients. The accurate diagnosis was achieved in 24 of the 26 patients (92.3%). A major complication, a bladder tamponade, was observed in one patient (3.8%) after biopsy of a right kidney lesion. A hematoma caused by iatrogenic renal injury likely obstructed the bladder outlet. Minor complications were observed in three patients (11.5%). Conclusions Percutaneous transhepatic biopsy for extrahepatic lesions is feasible with acceptable safety.

Diagnostic accuracy and complication rate of image-guided percutaneous transthoracic needle lung biopsy for subsolid pulmonary nodules: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Junghoon Kim ◽  
Choong Guen Chee ◽  
Jungheum Cho ◽  
Youngjune Kim ◽  
Min A Yoon
Keyword(s):  
Diagnostic Accuracy ◽  
Complication Rate ◽  
Needle Biopsy ◽  
Meta Analysis ◽  
Pulmonary Nodules ◽  
Major Complication ◽  
Needle Aspiration ◽  
Fine Needle ◽  
Major Complication Rate ◽  
Higher Sensitivity

Objectives: To determine the diagnostic accuracy and complication rate of percutaneous transthoracic needle biopsy (PTNB) for subsolid pulmonary nodules and sources of heterogeneity among reported results. Methods: We searched PubMed, EMBASE, and Cochrane libraries (until November 7, 2020) for studies measuring the diagnostic accuracy of PTNB for subsolid pulmonary nodules. Pooled sensitivity and specificity of PTNB were calculated using a bivariate random-effects model. Bivariate meta-regression analyses were performed to identify sources of heterogeneity. Pooled overall and major complication rates were calculated. Results: We included 744 biopsies from 685 patients (12 studies). The pooled sensitivity and specificity of PTNB for subsolid nodules were 90% (95% confidence interval [CI]: 85–94%) and 99% (95% CI: 92–100%), respectively. Mean age above 65 years was the only covariate significantly associated with higher sensitivity (93% vs  85%, p = 0.04). Core needle biopsy showed marginally higher sensitivity than fine-needle aspiration (93% vs  83%, p = 0.07). Pooled overall and major complication rate of PTNB were 43% (95% CI: 25–62%) and 0.1% (95% CI: 0–0.4%), respectively. Major complication rate was not different between fine-needle aspiration and core needle biopsy groups (p = 0.25). Conclusion: PTNB had acceptable performance and a low major complication rate in diagnosing subsolid pulmonary nodules. The only significant source of heterogeneity in reported sensitivities was a mean age above 65 years. Advances in knowledge: This is the first meta-analysis attempting to systemically determine the cause of heterogeneity in the diagnostic accuracy and complication rate of PTNB for subsolid pulmonary nodules.

scholarly journals Total endovenous recanalization and stent reconstruction for naïve non-inferior vena cava filter-associated chronic iliocaval occlusive disease: Placement of 352 venous stents in 69 debilitated patients

2019 ◽  
Vol 24 (4) ◽  
pp. 349-358 ◽  
Author(s):  
Joseph L McDevitt ◽  
Ravi N Srinivasa ◽  
Anthony N Hage ◽  
Jacob J Bundy ◽  
Joseph J Gemmete ◽  
...  
Keyword(s):  
Adverse Events ◽  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Clinical Success ◽  
Vena Cava ◽  
Ivc Filter ◽  
Technical Success ◽  
Stent Patency ◽  
Ceap Classification ◽  
Venous Stents

The aim of this study was to report the technical success, adverse events, clinical outcomes, and long-term stent patency of iliocaval stent reconstruction for naïve, non-inferior vena cava (IVC) filter-related, chronic iliocaval thrombosis. A total of 69 patients, including 47 (68%) men, with a mean age of 36 years (range: 8–71 years), underwent first-time iliocaval stent reconstruction for non-IVC filter-associated iliocaval thrombosis. The mean number of prothrombotic risk factors was 2.2 (range: 0–5), including 30 (43%) patients with IVC atresia. Upon initial presentation, the Clinical, Etiology, Anatomy, and Pathophysiology (CEAP) classification was C3 in 55 (80%) patients, C4 in four (5.8%) patients, C5 in one (1.4%) patient, and C6 in seven (10%) patients. Technical aspects of stent reconstruction, technical success, adverse events, 2-week and 6, 12, and 24-month clinical response, and 6, 12, and 24-month primary, primary-assisted, and secondary stent patency rates were recorded. Technical success was defined as recanalization and stent deployment. Adverse events were reported according to the Society of Interventional Radiology classification system. Clinical success was defined as a 1-point decrease in CEAP classification and stent patency was defined by the Cardiovascular and Interventional Radiological Society guidelines. The technical success rate was 100%. There were 352 venous stents deployed during stent reconstructions. One (1.4%) severe, four (5.8%) moderate, and four (5.8%) minor adverse events occurred and median post-procedure hospitalization was 1 day (range: 1–45 days). Clinical success at 2 weeks and 6, 12, and 24 months was 76%, 85%, 87%, and 100%, respectively. The estimated 6, 12, and 24-month primary patency rates were 91%, 88%, and 62%, respectively. The estimated 6, 12, and 24-month primary-assisted patency rates were 98%, 95%, and 81%, respectively. The estimated 6, 12, and 24-month secondary-assisted patency rates were all 100%. In conclusion, iliocaval stent reconstruction is an effective treatment for non-IVC filter-associated chronic iliocaval thrombosis with high rates of technical success, clinical responses, and stent patency.

CT-Guided Translumbar Placement of Permanent Catheters in the Inferior Vena Cava: Description of the Technique with Technical Success and Complications Data

2018 ◽  
Vol 41 (9) ◽  
pp. 1356-1362 ◽  
Author(s):  
Gerd Grözinger ◽  
Ulrich Grosse ◽  
Roland Syha ◽  
Rüdiger Hoffmann ◽  
Sasan Partovi ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Technical Success ◽  
Ct Guided

scholarly journals Surgical Resection and Inferior Vena Cava Reconstruction for Treatment of the Malignant Tumor: Technical Success and Outcomes

2014 ◽  
Vol 7 (2) ◽  
pp. 120-126 ◽  
Author(s):  
Hitoshi Goto ◽  
Munetaka Hashimoto ◽  
Daijiro Akamatsu ◽  
Takuya Shimizu ◽  
Noriyuki Miyama ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Surgical Resection ◽  
Malignant Tumor ◽  
Inferior Vena ◽  
Vena Cava ◽  
Technical Success

Caval pseudoaneurysms following complex inferior vena cava filter removal: Clinical significance and patient outcomes

Vascular ◽  
2020 ◽  
pp. 170853812096121
Author(s):  
Mohamad Omar Hadied ◽  
Mark Hieromnimon ◽  
Jordan Kapke ◽  
Karan Nijhawan ◽  
Thuong Van Ha ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Clinical Significance ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Major Complication ◽  
Vena Cava Filter ◽  
Invasive Treatment ◽  
Filter Retrieval ◽  
Treatment Type

Objectives To investigate the incidence and clinical significance of caval pseudoaneurysm and extravasation post-complex inferior vena cava filter retrieval. Methods A total of 83 patients (70% female, average age 56) underwent complex inferior vena cava filter retrieval between January 2015 and December 2019 utilizing either rigid endobronchial forceps ( n = 69, 83%) and/or excimer laser ( n = 20, 24%). Procedural variables were recorded. The incidence and size of caval pseudoaneurysms and extravasation along with treatment type and clinical outcomes were analyzed. Results Technical success in all cases was 96% (n = 80). Average fluoroscopy time was 23 min (median: 20.2, range: 0.9–129.5). Average filter dwell time was 85 months (range: 2–316 months). Caval pseudoaneurysm was detected on post-retrieval venography in 10 patients (12%) and frank extravasation occurred in 1 case (1%). Average pseudoaneurysm length and width was 20.4 mm (range: 5–45 mm) and 12.9 mm (range: 4–24 mm), respectively. Pseudoaneurysms occurred most frequently during the removal of Optease ( n = 5) and Celect ( n = 2) filters. The pseudoaneurysms completely resolved with prolonged (>5 min) balloon angioplasty in all but one instance where a small portion of the pseudoaneurysm persisted. This patient was admitted and observed overnight before being discharged without complication. The solitary case of significant extravasation was effectively managed with immediate stent placement and the patient remained hemodynamically stable. Conclusions Radiographically detectable caval pseudoaneurysm and extravasation is not uncommon in complex inferior vena cava filter retrieval and, despite being considered a major complication by Society of Interventional Radiology guidelines, can often be managed without stenting or other invasive treatment.

Recovery G2 Inferior Vena Cava Filter: Technical Success and Safety of Retrieval

2008 ◽  
Vol 19 (6) ◽  
pp. 884-889 ◽  
Author(s):  
Vincent L. Oliva ◽  
Pierre Perreault ◽  
Marie-France Giroux ◽  
Louis Bouchard ◽  
Eric Therasse ◽  
...  
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena Cava Filter ◽  
Inferior Vena ◽  
Vena Cava ◽  
Vena Cava Filter ◽  
Technical Success

scholarly journals Management of inferior vena cava injury and secondary thrombosis after percutaneous nephrolithotomy: a case report

2021 ◽  
Vol 49 (11) ◽  
pp. 030006052110588
Author(s):  
Pan Li ◽  
Dengjiu Mao ◽  
Jie Zhou ◽  
Hongmei Sun
Keyword(s):  
Inferior Vena Cava ◽  
Percutaneous Nephrolithotomy ◽  
Open Surgery ◽  
Inferior Vena ◽  
Vena Cava ◽  
Urinary Calculi ◽  
Major Complication ◽  
Peripheral Vascular ◽  
Treatment Regimens ◽  
Repeated Infection

Percutaneous nephrolithotomy (PCNL) remains an important method for treating upper urinary calculi. However, bleeding and peripheral vascular injury are serious complications of PCNL. Injury of the inferior vena cava accompanied by secondary thrombosis has rarely been reported clinically. We treated a patient who experienced bleeding during PCNL to establish a channel. A catheter was used to make a renal fistula, and the inferior vena cava was implanted. The wound was fixed and compressed by balloon injection, and secondary thrombosis and repeated infection occurred after the operation. A filter was then placed, the water balloon was released, and the fistula was removed. The anti-bacterial and anticoagulant filter was removed. This major complication was successfully managed. In our patient, during PCNL, the renal fistula entered the inferior vena cava by mistake. If this issue cannot be treated in time, it can easily lead to the formation of secondary thrombosis. A fistula can be extracted through an inferior vena cava filter, and anticoagulant treatment and other conservative treatment regimens can be used to treat patients in this situation. These treatments avoid the possibility of further damage from open surgery.

Sign in / Sign up

Export Citation Format

Share Document