scholarly journals Safety of neuroangiography and embolization in children: complication analysis of 697 consecutive procedures in 394 patients

2015 ◽  
Vol 16 (4) ◽  
pp. 432-438 ◽  
Author(s):  
Ning Lin ◽  
Edward R. Smith ◽  
R. Michael Scott ◽  
Darren B. Orbach
Keyword(s):  
High Volume ◽  
Multivariate Logistic Regression Model ◽  
Morbidity Rate ◽  
Complication Rates ◽  
Arteriovenous Fistulas ◽  
High Volume Center ◽  
Neurological Event ◽  
Neurointerventional Procedures ◽  
Angiography And Embolization

OBJECT The safe treatment of children using catheter-based angiography and embolization poses unique challenges because of the technical factors regarding the size and fragility of access and target vessels, as well as unique pediatric cerebrovascular pathologies. The complication rates for neurointerventional procedures in children have not been established. METHODS The records of a consecutive cohort of pediatric patients who underwent neuroangiography and/or embolization between 2007 and 2013 were reviewed retrospectively to identify both intraprocedural and postprocedural complications. Demographic and clinical risk factors were analyzed with a multivariate logistic regression model. RESULTS The 697 consecutive procedures consisted of 429 diagnostic angiograms and 268 embolizations (mean age of patients 11.1 years; range 4 days to 18 years; 217 females). There were 130 intracranial, 122 extracranial, and 16 spinal embolizations. Pathologies included 28 intracranial arteriovenous malformations (AVMs), 12 spinal AVMs, 19 aneurysms, 29 vein of Galen malformations, 29 dural arteriovenous fistulas, 96 extracranial AVMs, 39 tumors, 3 strokes, and 13 others. Overall, 2 intraprocedural and 1 postprocedural complication (0.7%) occurred in the diagnostic group, all of which were nonneurological events. In the embolization group, 7 intraprocedural and 11 postprocedural complications (6.7%) were observed. Of these complications, 15 were nonneurological events (5.6%), 1 was a short-term neurological event (0.4%), and 2 were long-term neurological events (0.7%). CONCLUSIONS Neither the technical challenges posed by children’s access and target vessels nor the unique neuro-vascular pathologies seen in children need result in an elevated morbidity rate related to neuroangiography and embolization. At a dedicated high-volume center, the complication rates may be lower than those for comparable procedures performed in adults.

Ipsilateral breast cancer recurrence: characteristics, treatment, and long-term oncological results at a high volume center

2020 ◽  
Author(s):  
Andrea Sagona ◽  
Damiano Gentile ◽  
Chiara Annunziata Pasqualina Anghelone ◽  
Erika Barbieri ◽  
Emilia Marrazzo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Cancer Recurrence ◽  
High Volume ◽  
Breast Cancer Recurrence ◽  
Ipsilateral Breast ◽  
High Volume Center ◽  
Oncological Results

scholarly journals Favorable long-term outcomes of one-year adjuvant S-1 monotherapy for pathological stage II or III gastric cancer treated at a high-volume center

2018 ◽  
Vol 21 (6) ◽  
pp. 1024-1030 ◽  
Author(s):  
Yosuke Kano ◽  
Manabu Ohashi ◽  
Naoki Hiki ◽  
Daisuke Takahari ◽  
Keisho Chin ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
High Volume ◽  
Stage Ii ◽  
Pathological Stage ◽  
Long Term Outcomes ◽  
High Volume Center ◽  
One Year

Endovascular extraction of entrapped long-term central feeding catheter: Case series

2018 ◽  
Vol 20 (3) ◽  
pp. 329-332
Author(s):  
Marcin Michalak ◽  
Łukasz Januszkiewicz ◽  
Franciszek Majstrak ◽  
Monika Gawałko ◽  
Grzegorz Opolski ◽  
...  
Keyword(s):  
Vessel Wall ◽  
Balloon Dilatation ◽  
Case Series ◽  
High Volume ◽  
Central Venous Catheters ◽  
Catheter Removal ◽  
Central Venous ◽  
High Volume Center ◽  
Manual Traction

Long-term tunneled central venous catheters are widely used in several clinical indications, that is, hemodialysis, chemotherapy, and total parenteral nutrition. However, central venous catheters are associated with a number of complications, including catheter occlusion and sepsis, which may necessitate earlier catheter removal. In most cases manual traction is sufficient to remove the catheter. Nevertheless, in some cases severe adhesions, formed between the catheter and the vessel wall, complicate simple catheter removal. We present four cases of entrapped long-term central venous catheters and describe methods (e.g. endoluminal balloon dilatation and wire snare) performed by experienced cardiologists at high-volume center to remove them. We claim that permanent central venous catheters removal procedures may be unpredictable and hazardous. Therefore, entrapped central venous catheters should be extracted by experienced operators in specialized high-volume centers.

scholarly journals Long Term Outcomes of The Off-Pump and On-Pump Coronary Artery Bypass Grafting In A High-Volume Center

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Milos Matkovic ◽  
Vladimir Tutus ◽  
Ilija Bilbija ◽  
Jelena Milin Lazovic ◽  
Marko Savic ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Coronary Artery Bypass Grafting ◽  
Artery Bypass ◽  
High Volume ◽  
Bypass Grafting ◽  
Long Term Outcomes ◽  
Off Pump ◽  
High Volume Center ◽  
Pump Coronary Artery Bypass

scholarly journals 195 – Comparison of Short- and Long-Term Outcomes Between Anatomical Subtypes of Resected Biliary Tract Cancer in a Western High-Volume Center

2019 ◽  
Vol 156 (6) ◽  
pp. S-1386
Author(s):  
Eva Roos ◽  
Marin Strijker ◽  
Lotte C. Franken ◽  
Olivier R. Busch ◽  
Jeanin E. Van Hooft ◽  
...  
Keyword(s):  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
High Volume ◽  
Long Term Outcomes ◽  
Tract Cancer ◽  
High Volume Center ◽  
Short And Long Term

scholarly journals Comparison of short- and long-term outcomes between anatomical subtypes of resected biliary tract cancer in a Western high-volume center

HPB ◽  
2020 ◽  
Vol 22 (3) ◽  
pp. 405-414 ◽  
Author(s):  
Eva Roos ◽  
Marin Strijker ◽  
Lotte C. Franken ◽  
Olivier R. Busch ◽  
Jeanin E. van Hooft ◽  
...  
Keyword(s):  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
High Volume ◽  
Long Term Outcomes ◽  
Tract Cancer ◽  
High Volume Center ◽  
Short And Long Term

Outcomes analysis of radioactive iodine and total thyroidectomy for pediatric Graves’ disease

2016 ◽  
Vol 29 (3) ◽  
Author(s):  
Reuven Zev Cohen ◽  
Eric I. Felner ◽  
Kurt F. Heiss ◽  
J. Bradley Wyly ◽  
Andrew B. Muir
Keyword(s):  
Children And Adolescents ◽  
Total Thyroidectomy ◽  
Relapse Rate ◽  
Radioactive Iodine ◽  
High Volume ◽  
Graves Disease ◽  
Complication Rates ◽  
Case Volume ◽  
Definitive Therapy

AbstractThe majority of pediatric patients with Graves’ disease will ultimately require definitive therapy in the form of radioactive iodine (RAI) ablation or thyroidectomy. There are few studies that directly compare the efficacy and complication rates between RAI and thyroidectomy. We compared the relapse rate as well as the acute and long-term complications of RAI and total thyroidectomy among children and adolescents with Graves’ disease treated at our center.Medical records from 81 children and adolescents with a diagnosis of Graves’ disease who received definitive therapy over a 12-year period were reviewed.Fifty one patients received RAI and 30 patients underwent thyroidectomy. The relapse rate was not significantly different between RAI and thyroidectomy (12.1% vs. 0.0%, p=0.28). There were no acute or long-term complications in the RAI group, but there were eight cases of hypoparathyroidism (two transient and six permanent) in the thyroidectomy group. None of the patients developed a recurrent laryngeal nerve injury.RAI is a safe and effective option for treatment of children and adolescents with Graves’ disease. In light of the rate of permanent hypoparathyroidism seen at our center with thyroidectomy and previously published long-term safety of RAI, we recommend RAI as the first line treatment for children and adolescents with Graves’ disease. For those centers performing thyroidectomies, we recommend that each center select 1–2 high-volume pediatric surgeons to perform all thyroid procedures, allowing individuals to increases case volume and potentially decrease long-term complications of thyroidectomy.

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