scholarly journals Shape memory polymer ovarian vein embolisation in a patient with nickel allergy

2021 ◽  
Vol 4 (1) ◽  
Author(s):  
Davide Castellano ◽  
Andrea Boghi ◽  
Luca Di Maggio ◽  
Alessandro Rapellino ◽  
Daniele Savio
Keyword(s):  
Shape Memory ◽  
Shape Memory Polymer ◽  
Ovarian Vein ◽  
Resonance Imaging ◽  
Nickel Allergy ◽  
Embolic Material ◽  
Case Presentation ◽  
Metallic Implants ◽  
Pelvic Congestion

Abstract Background Ovarian vein embolization in pelvic varicocele is usually obtained using nitinol coils. These devices can not be used in patients with proven nickel allergy. Case presentation Shape memory polymer is a new embolic material available to interventionalists. A patient presented with pelvic congestion syndrome requiring embolisation of the left ovarian vein. The target vessel consisted of two twisted branches, each 5–6 mm in diameter. The patient also had a known allergy to nickel. Considering the anatomy and allergy status, embolisation with polyurethane shape memory polymer vascular plugs was considered a good case strategy. The embolisation procedure was technically successful with the deployment of two shape memory polymer plugs into each of the two left ovarian vein branches. Follow-up magnetic resonance imaging at 4 months showed sustained occlusion of the treated vessels and the patient showed no signs of allergy to the implanted material. Conclusions In conclusion, our case presented an opportunity to utilise a new embolic material and achieve a good outcome in a patient with an allergy that may have resulted in complications when using metallic implants.

scholarly journals Shape memory polymer ovarian vein embolisation in a patient with nickel allergy

2021 ◽  
Author(s):  
Davide Castellano ◽  
Andrea Boghi ◽  
Luca Di Maggio ◽  
Alessandro Rapellino ◽  
Daniele Savio
Keyword(s):  
Shape Memory ◽  
Shape Memory Polymer ◽  
Ovarian Vein ◽  
Resonance Imaging ◽  
Nickel Allergy ◽  
Embolic Material ◽  
Case Presentation ◽  
Metallic Implants ◽  
Pelvic Congestion

Abstract Background: ovarian vein embolization in pelvic varicocele is usually obtained using nitinol coils. These devices can not be used in patients with proven nickel allergy.Case presentation: shape memory polymer is a new embolic material available to interventionalists. A patient presented with pelvic congestion syndrome requiring embolisation of the left ovarian vein. The target vessel consisted of two twisted branches, each 5-6 mm in diameter. The patient also had a known allergy to nickel. Considering the anatomy and allergy status, embolisation with polyurethane shape memory polymer vascular plugs was considered a good case strategy. The embolisation procedure was technically successful with the deployment of two shape memory polymer plugs into each of the two left ovarian vein branches. Follow-up magnetic resonance imaging at 4 months showed sustained occlusion of the treated vessels and the patient showed no signs of allergy to the implanted material.Conclusions: in conclusion, our case presented an opportunity to utilise a new embolic material and achieve a good outcome in a patient with an allergy that may have resulted in complications when using metallic implants.

scholarly journals Chemical Modifications of Porous Shape Memory Polymers for Enhanced X-ray and MRI Visibility

Molecules ◽  
2020 ◽  
Vol 25 (20) ◽  
pp. 4660
Author(s):  
Grace K. Fletcher ◽  
Landon D. Nash ◽  
Lance M. Graul ◽  
Lindy K. Jang ◽  
Scott M. Herting ◽  
...  
Keyword(s):  
Shape Memory ◽  
Medical Devices ◽  
Shape Memory Polymer ◽  
Shape Memory Polymers ◽  
Tissue Scaffolds ◽  
Resonance Imaging ◽  
Clinical Imaging ◽  
X Ray ◽  
Device Development ◽  
Magnetic Resonance Imaging Mri

The goal of this work was to develop a shape memory polymer (SMP) foam with visibility under both X-ray and magnetic resonance imaging (MRI) modalities. A porous polymeric material with these properties is desirable in medical device development for applications requiring thermoresponsive tissue scaffolds with clinical imaging capabilities. Dual modality visibility was achieved by chemically incorporating monomers with X-ray visible iodine-motifs and MRI visible monomers with gadolinium content. Physical and thermomechanical characterization showed the effect of increased gadopentetic acid (GPA) on shape memory behavior. Multiple compositions showed brightening effects in pilot, T1-weighted MR imaging. There was a correlation between the polymeric density and X-ray visibility on expanded and compressed SMP foams. Additionally, extractions and indirect cytocompatibility studies were performed to address toxicity concerns of gadolinium-based contrast agents (GBCAs). This material platform has the potential to be used in a variety of medical devices.

scholarly journals Culture-negative chronic hematogenous osteomyelitis in a two months old girl: a case report

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Cheng-he Qin ◽  
Rui Tao ◽  
Ji-wei Luo ◽  
Liang Hong ◽  
Lei Xu ◽  
...  
Keyword(s):  
Chronic Osteomyelitis ◽  
Bone Destruction ◽  
Good Recovery ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Negative Culture ◽  
Hematogenous Osteomyelitis ◽  
Acute Hematogenous Osteomyelitis ◽  
Culture Negative

Abstract Background Previous articles have focused on the diagnosis and treatment of acute hematogenous osteomyelitis. Here, we present a case of chronic hematogenous osteomyelitis in a 2-month-old girl. The diagnostic procedure was unusual and difficult due to negative culture results. Case presentation A girl aged 2 months and 23 days had fever and swelling in her right lower leg for 7 days. On the basis of her medical history, physical, and histological examination results; and radiologic and magnetic resonance imaging findings, a diagnosis of chronic osteomyelitis was made. The patient underwent surgical treatment and was discharged successfully. The patient showed good recovery and no sequelae at the 12-month follow-up. Conclusion Hematogenous osteomyelitis in babyhood is different from that at any other age. Hematogenous osteomyelitis-related bone destruction in babyhood is more serious and occurs faster. The transition from acute hematogenous osteomyelitis to chronic hematogenous osteomyelitis takes only 7 days. To the best of our knowledge, this chronic hematogenous osteomyelitis patient is the youngest ever reported.

scholarly journals Ovarian Vein Embolization With N-butyl-2 Cyanoacrylate Glubran-2® for the Treatment of Pelvic Venous Disorder

2021 ◽  
Vol 8 ◽  
Author(s):  
Maofeng Gong ◽  
Xu He ◽  
Boxiang Zhao ◽  
Jie Kong ◽  
Jianping Gu ◽  
...  
Keyword(s):  
Symptom Relief ◽  
Duplex Ultrasound ◽  
Attractive Alternative ◽  
Ovarian Vein ◽  
Post Intervention ◽  
Embolic Material ◽  
Multislice Computer Tomography ◽  
Glubran 2 ◽  
The Mean

Background: There are few reports in the literature on the use of Glubran-2 for the embolization of ovarian veins in patients with pelvic venous disorder (PeVD). In addition, a consensus on the efficacy and safety of Glubran-2 has not been reached.Purpose: To investigate the safety and efficacy of ovarian vein embolization (OVE) with N-butyl-2 cyanoacrylate (NBCA) Glubran-2 for the treatment of PeVD.Material and Methods: Between January 2013 and January 2020, 21 women (mean age, 43.9 ± 13.3 years) with PeVD who underwent OVE with Glubran-2 were evaluated. Of those patients, ovarian vein or pelvic venous plexus insufficiency was verified by duplex ultrasound and/or multislice computer tomography (MSCT). The symptoms and signs of PeVD included chronic pelvic pain (CPP) (21/21; 100%), dyspareunia (12/21; 57.1%), dysmenorrhea (10/21; 47.6%), and vulvar varices (3/21; 14.3%). The medical data were retrospectively reviewed.Results: Glubran-2 was employed as the sole embolic material in 18 cases (85.7%) and used to perform rescue embolization in 3 cases (14.3%) due to CPP recurrence 1 month after initial embolization using microcoils. Technically successful embolization was achieved using Glubran-2 in all patients. No Glubran-2 related complications were noted. Neither persistent nor recurrent CPP was observed during follow-up, for which the mean was 62 ± 38 months (range, 12–102 months). Clinical efficacy was evaluated, and all patients exhibited complete or slight improvement of CPP after embolization. The visual analog scale (VAS) score significantly decreased from pre-intervention to post-intervention (p < 0.001). Six patients (28.6%) gave birth to healthy babies during follow-up after embolization with Glubran-2.Conclusions: Ovarian vein embolization with Glubran-2 is a feasible and safe treatment for CPP secondary to PeVD. This treatment may represent a potential and attractive alternative when patients desire symptom relief and want to continue reproducing. Larger studies are warranted to confirm the findings of this study.

scholarly journals Musculoskeletal actinomycosis in children: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yani Mou ◽  
Qin Jiao ◽  
Yizhong Wang ◽  
Xiaolu Li ◽  
Yongmei Xiao ◽  
...  
Keyword(s):  
Infectious Disease ◽  
Bacterial Culture ◽  
Surgical Debridement ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Oral Amoxicillin ◽  
Amoxicillin Clavulanate ◽  
Magnetic Resonance Imaging Mri ◽  
The Right

Abstract Background Actinomycosis is a rare infectious disease caused by Actinomyces, especially in children. Here, we present a case of musculoskeletal actinomycosis in a 5-year-old girl from China. Case presentation A 5-year-old girl presented with recurrent episodes of fever, pain, erythema, swelling, and festering sores on the right lower extremity, and pus was discharged from a sinus in the right foot. Magnetic resonance imaging (MRI) suggested subcutaneous soft tissue infection and osteomyelitis of the right crus. A bacterial culture of pus extracted from a festering sore on the right popliteal fossa detected the growth of Actinomycetes europaeus. The patient was cured with 7 weeks of treatment with intravenous ampicillin-sulbactam, followed by 6 weeks of treatment with oral amoxicillin-clavulanate with surgical debridement and drainage. There were no symptoms of recurrence during the 15-month period of follow-up. Conclusions Pediatric actinomycosis is a rare and challenging infectious disease. Early accurate diagnosis and optimal surgical debridement are important for the management of pediatric actinomycosis.

scholarly journals Conservative Management of Placenta Percreta: Three Cases and a Review of the Literature regarding Conservative Management of Placenta Accreta Spectrum (PAS) Disorders.

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
M. Patabendige ◽  
J. M. P. Sanjeewa ◽  
A. M. A. K. G. Amarasekara ◽  
R. P. Herath
Keyword(s):  
Conservative Management ◽  
Placenta Accreta ◽  
Expectant Management ◽  
Placenta Percreta ◽  
Resonance Imaging ◽  
Case Presentation ◽  
Beta Hcg ◽  
Obstetric Haemorrhage ◽  
Placenta Accreta Spectrum

Background. The incidence of placenta accreta spectrum (PAS) disorders has risen over the last decades, and there has been a gradual shift towards expectant management. Conservative management of PAS is known to reduce major obstetric haemorrhage and salvage hysterectomy. There is a lack of consensus on the follow-up of patients undergoing conservative approaches. Here, we describe the follow-up of three patients with placenta percreta who were conservatively managed and review the literature for the conservative management of PAS. Case Presentation. We have successfully managed three cases of placenta percreta expectantly using combined methods involving symphysial-fundal height, serum beta-HCG, and ultrasonographic volume of placental mass. Conclusions. Use of a combined approach with symphysial-fundal height, serum beta-HCG, and ultrasonographic volume of placental mass with colour Doppler may guide the surveillance of these conservatively managed cases. However, at least one magnetic resonance imaging three months postoperatively may predict a further risk of delayed haemorrhage.

scholarly journals A case report of congenital cholesteatoma in adult patient mimicking as Bell palsy and proposed follow-up schedule for Bell palsy

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Iylia Ajmal Othman ◽  
Asma Abdullah ◽  
Noor Dina Hashim
Keyword(s):  
Facial Asymmetry ◽  
Complete Removal ◽  
Resonance Imaging ◽  
High Resolution Computed Tomography ◽  
Case Presentation ◽  
Congenital Cholesteatoma ◽  
Contrast Enhanced ◽  
Magnetic Resonance Imaging Mri ◽  
Bell Palsy

Abstract Background Making the diagnosis of congenital cholesteatoma in adult patients still pose a challenge even among experienced otologists. Case presentation We are discussing a case of a young adult who was initially treated as Bell palsy in a different center. Two years later, she presented with marked unilateral hearing loss in addition to her ipsilateral non-resolving facial asymmetry. Conclusions Considering the delayed pattern of otological presentation in congenital cholesteatoma, as seen in our case, we proposed monthly follow up in patients diagnosed with Bell palsy for at least 6 months, and those who do not show noticeable recovery after 3 months warrant referral to neurologist or otorhinolaryngologist for further investigations. Contrast-enhanced, high-resolution computed tomography (HRCT) of the temporal bone complemented by magnetic resonance imaging (MRI) supported our diagnosis. Mastoid exploration and complete removal of the disease was imperative.

scholarly journals Ovarian Vein Embolization with N-butyl-2 Cyanoacrylate Glubran-2® for the Treatment of Chronic Pelvic Pain Secondary to Pelvic Congestion Syndrome

2020 ◽  
Author(s):  
Maofeng Gong ◽  
Xu He ◽  
Boxiang Zhao ◽  
Jie Kong ◽  
Haobo Su
Keyword(s):  
Pelvic Pain ◽  
Chronic Pelvic Pain ◽  
Symptom Relief ◽  
Attractive Alternative ◽  
Ovarian Vein ◽  
Medical Database ◽  
Pelvic Congestion Syndrome ◽  
Glubran 2 ◽  
Pelvic Congestion

Abstract Objective: To evaluate the safety and efficacy of ovarian vein embolization using N- butyl-2 cyanoacrylate (NBCA) Glubran-2® in the treatment of chronic pelvic pain (CPP) secondary to pelvic congestion syndrome (PCS).Materials and Methods: Between January 2013 and June 2019, seven wo-men (mean age, 45.6±15.9 y) presenting with CPP secondary to PCS were evaluated for ovarian vein embolization with Glubran-2®. PCS was initially diagnosed by transva-ginal Doppler Ultrasound or CT and further confirmed by pelvic venography. Medical database was retrospectively reviewed.Results: Glubran-2 was employed as a sole embolic material in two cases, four cases subsequently underwent added microcoils in the opening of varicose ovarian vein trunk during the same procedure. Secondary embolization was achieved in one case due to CPP recurrence one month after initial embolization with microcoils. Technical success of ovarian vein embolization with Glubran-2 was achieved in all patients. There were no Glubran-2 related complications mid procedure and postintervention. With mean 62±40 months (range, 12-102 months) follow-up, neither persistent nor recurrent CPP was observed. Clinical efficacy was evaluated on the 1st, 3rd, 6th, 12th months, complete or slight improvement of CPP after embolization were achieved in all patients. VAS score used to identify preintervention and postintervention significantly decreased (p<0.001). Two patients after Glubran-2 embolization gave birth to a healthy baby during follow-up.Conclusions: Ovarian vein embolization with Glubran-2 is a feasible and safe treatment of CPP secondary to PCS. In particularly, it appears to be a potential and attractive alternative when patients with the desires of symptom relief and reproduction.

Pelvic congestion syndrome and left renal compression syndrome - clinical features and therapeutic approaches

VASA ◽  
2016 ◽  
Vol 45 (4) ◽  
pp. 275-282 ◽  
Author(s):  
Christina Jeanneret ◽  
Konstantin Beier ◽  
Alexander von Weymarn ◽  
Jürg Traber
Keyword(s):  
Varicose Veins ◽  
Left Renal Vein ◽  
Standing Position ◽  
Ovarian Vein ◽  
Pelvic Congestion Syndrome ◽  
Compression Syndrome ◽  
Abstract Knowledge ◽  
Increased Risk ◽  
Definition Of ◽  
Pelvic Congestion

Abstract. Knowledge of the anatomy of the pelvic, gonadal and renal veins is important to understand pelvic congestion syndrome (PCS) and left renal vein compression syndrome (LRCS), which is also known as the nutcracker syndrome. LRCS is related to PCS and to the presence of vulvar, vaginal and pudendal varicose veins. The diagnosis of the two syndromes is difficult, and usually achieved with CT- or phlebography. The gold standard is the intravenous pressure measurement using conventional phlebography. The definition of PCS is described as pelvic pain, aggravated in the standing position and lasting for more than 6 months. Pain in the left flank and microhaematuria is seen in patients with LRCS. Women with multiple pregnancies are at increased risk of developing varicose vein recurrences with pelvic drainage and ovarian vein reflux after crossectomy and stripping of the great saphenous vein. The therapeutic options are: conservative treatment (medroxyprogesteron) or interventional (coiling of the ovarian vein) or operative treatment (clipping of the ovarian vein). Controlled prospective trials are needed to find the best treatment.

Hilar cholangiocarcinoma

2018 ◽  
Vol 1 (3) ◽  
pp. 28-30
Author(s):  
Tanita Suttichaimongkol
Keyword(s):  
Magnetic Resonance ◽  
Hilar Cholangiocarcinoma ◽  
Critical Role ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Resonance Imaging ◽  
Extrahepatic Cholangiocarcinoma ◽  
Case Presentation ◽  
Duct Epithelium ◽  
Bile Duct Epithelium ◽  
High Degree

Cholangiocarcinoma is a primary biliary tract tumor arising from the bile duct epithelium. Classically, these tumors have been categorized according to their anatomic location as intrahepatic and extrahepatic. Hilar cholangiocarcinoma is the most common type of extrahepatic cholangiocarcinoma. It is the most difficult cancer to diagnose and therefore carries a poor prognosis with a 5-year survivalrate of less than 10%. Diagnostic imaging, coupled with a high degree of clinical suspicion, play a critical role in timely diagnosis, staging, and evaluation for surgical resectability. The most common imagingmodalities used for diagnosis and staging of hilar cholangiocarcinoma include ultrasound (US), computed tomography (CT), magnetic resonance imaging/magnetic resonance cholangiopancreatography(MRI/MRCP). This article showed a case presentation and reviewed the imaging appearance of hilar cholangiocarcinoma.   Figure 1  Greyscale sonography at the level of hepatic hilum revealed an ill-defined hilar mass (asterisk)resulting in upstream dilatation of right (arrow) and left (arrow head) main intrahepatic duct.  

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