CT-Guided Lumbar Sympathectomy as a Last Option for Chronic Limb-Threatening Ischemia of the Lower Limbs: Evaluation of Technical Factors and Long-Term Outcomes

2021 ◽  
pp. 1-10
Author(s):  
Anurag Chahal ◽  
Sundeep Malla ◽  
Sanjay Sharma ◽  
Sunil Chumber ◽  
Kumble S. Madhusudhan
Keyword(s):  
Lower Limbs ◽  
Long Term Outcomes ◽  
Ct Guided ◽  
Lumbar Sympathectomy ◽  
Technical Factors

Muscle-sparing thoracotomy: Anatomy and technique

2021 ◽  
Keyword(s):  
Latissimus Dorsi ◽  
Posterolateral Thoracotomy ◽  
Long Term Outcomes ◽  
Serratus Anterior ◽  
Video Tutorial ◽  
Study Results ◽  
Muscle Sparing ◽  
Technical Factors ◽  
Thoracotomy Incision

The thoracotomy incision is essential for many thoracic surgery procedures. A number of different variations exist, and different techniques can be used, depending both on the patient and on the technical factors. The muscle-sparing technique was first described by Noirclerc et al. in 1973. [1] Initially, it was thought that preservation of the muscular structures compared with the results of a traditional posterolateral thoracotomy, in which the latissimus dorsi and sometimes the serratus anterior are often divided, would benefit long-term outcomes. However, subsequent study results have not demonstrated any difference in postoperative outcomes. The unequivocal benefit of a muscle-sparing approach is to preserve the latissimus dorsi for any future intervention, such as a procedure involving the chest wall and the intrathoracic flaps. In this video tutorial, we describe our approach to this commonly used incision, including the anatomy and the technical aspects used to provide optimal operative exposure and minimal postoperative complications while preserving the underlying musculature.

scholarly journals CLINICAL EFFICACY AND LONG TERM OUTCOMES OF CT GUIDED PERCUTANEUS CORONARY INTERVENTION

2010 ◽  
Vol 55 (10) ◽  
pp. A201.E1894 ◽  
Author(s):  
Michael C.L. Lim ◽  
Catherine G. de Larrazabal ◽  
Levinia M. Devaraj ◽  
June Yang
Keyword(s):  
Clinical Efficacy ◽  
Coronary Intervention ◽  
Long Term Outcomes ◽  
Ct Guided

scholarly journals Abstract No. 579 Percutaneous CT-guided cryoablation for the management of pudendal neuralgia: long-term outcomes

2018 ◽  
Vol 29 (4) ◽  
pp. S241-S242
Author(s):  
J. Prologo ◽  
A. Mittal ◽  
J. Knight ◽  
D. Hsu ◽  
R. Dolan ◽  
...  
Keyword(s):  
Pudendal Neuralgia ◽  
Long Term Outcomes ◽  
Ct Guided

scholarly journals Long-Term Outcomes and Prognostic Analysis of Computed Tomography-Guided Radioactive 125I Seed Implantation for Locally Recurrent Rectal Cancer After External Beam Radiotherapy or Surgery

2021 ◽  
Vol 10 ◽  
Author(s):  
Hao Wang ◽  
Lu Wang ◽  
Yuliang Jiang ◽  
Zhe Ji ◽  
Fuxin Guo ◽  
...  
Keyword(s):  
Adverse Effects ◽  
External Beam Radiotherapy ◽  
Long Term Outcomes ◽  
Ct Guided ◽  
Seed Implantation ◽  
Radiation Induced ◽  
Locally Recurrent ◽  
Grade 3 ◽  
Short Time

BackgroundManagement of locally recurrent rectal cancer (LRRC) after surgery or external beam radiotherapy (EBRT) remains a clinical challenge, given the limited treatment options and unsatisfactory outcomes. This study aimed to assess long-term outcomes of computed tomography (CT)-guided radioactive 125I seed implantation in patients with LRRC and associated prognostic factors.MethodsA total of 101 patients with LRRC treated with CT-guided 125I seed implantation from October 2003 to April 2019 were retrospectively studied. Treatment procedures involved preoperative planning design, 125I seed implantation, and postoperative dose evaluation. We evaluated the therapeutic efficacy, adverse effects, local control (LC) time, and overall survival (OS) time.ResultsAll the patients had previously undergone surgery or EBRT. The median age of patients was 59 (range, 31–81) years old. The median follow-up time was 20.5 (range, 0.89–125.8) months. The median LC and OS time were 10 (95% confidence interval (CI): 8.5–11.5) and 20.8 (95% CI: 18.7–22.9) months, respectively. The 1-, 2-, and 5-year LC rates were 44.2%, 20.7%, and 18.4%, respectively. The 1-, 2-, and 5-year OS rates were 73%, 31.4%, and 5%, respectively. Univariate analysis of LC suggested that when short-time tumor response achieved partial response (PR) or complete response (CR), or D90>129 Gy, or GTV ≤ 50 cm3, the LC significantly prolonged (P=0.044, 0.041, and <0.001, respectively). The multivariate analysis of LC indicated that the short-time tumor response was an independent factor influencing LC time (P<0.001). Besides, 8.9% (9/101) of the patients had adverse effects (≥grade 3): radiation-induced skin reaction (4/101), radiation-induced urinary reaction (1/101), fistula (2/101), and intestinal obstruction (2/101). The cumulative irradiation dose and the activity of a single seed were significantly correlated with adverse effects ≥grade 3 (P=0.047 and 0.035, respectively).ConclusionCT-guided 125I seed implantation is a safe and effective salvage treatment for LRRC patients who previously underwent EBRT or surgery. D90 and GTV significantly influenced prognosis of such patients.

Treatment of Varicose Long Saphenous Veins with Sclerosant in Microfoam Form: Long-Term Outcomes

2000 ◽  
Vol 15 (1) ◽  
pp. 19-23 ◽  
Author(s):  
J. Cabrera ◽  
J. Cabrera ◽  
A. Garcí-Olmedo
Keyword(s):  
Outcome Measure ◽  
Duplex Ultrasound ◽  
Lower Limbs ◽  
Long Term Outcomes ◽  
Vein Thrombosis ◽  
Saphenous Veins ◽  
Deep Vein ◽  
Subsequent Disappearance

Objective: To determine whether the injection of sclerosant in microfoam form offers a clear alternative to surgery in large varices of the lower extremities. Design: Retrospective observational follow-up study (3–6 years). Patients: Five hundred lower limbs in which pretreatment duplex ultrasound demonstrated insufficiency of sapheno-femoral junctions (diameters 9–32 mm) and long saphenous veins. Main outcome measure: Obliteration and subsequent disappearance of treated veins. Results: After ≥ 3 years follow-up, 81% of treated varicose long saphenous veins were obliterated and 96.5% of superficial branches disappeared. The obliteration of saphenous veins required one injection in 86%, two in 10.5% and three in 3.5% of cases. There were no serious complications such as deep vein thrombosis Pulmonary embolism. Conclusion: The quality and stability of outcomes and ease of repeat treatments when required may make sclerotherapy with microfoam a therapeutic approach of choice for the functional and anatomical elimination of extensive pathological venous areas.

scholarly journals Long-term outcomes of CT-guided percutaneous cryoablation of T1a and T1b renal cell carcinoma

2021 ◽  
Author(s):  
Stavros Spiliopoulos ◽  
◽  
Abdelaziz Marzoug ◽  
Hae Ra ◽  
Senthil Kumar Arcot Ragupathy ◽  
...  
Keyword(s):  
Renal Cell Carcinoma ◽  
Cell Carcinoma ◽  
Renal Cell ◽  
Long Term Outcomes ◽  
Ct Guided ◽  
Percutaneous Cryoablation

Traumatic Brain Injury: A Trauma Surgeon's Perspective

2012 ◽  
Vol 22 (3) ◽  
pp. 82-89
Author(s):  
Oscar D. Guillamondegui
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Multidisciplinary Approach ◽  
Trauma Team ◽  
The United States ◽  
Long Term Outcomes ◽  
Term Care ◽  
Injured Brain ◽  
The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

Sign in / Sign up

Export Citation Format

Share Document