Predictors of Active Extravasation and Complications after Conventional Angiography for Acute Intraabdominal Bleeding

Besides current development of the new diagnostic procedures conventional angiography still represents the golden standard in the diagnosing of intracranial aneurysms. Since it gives a two-dimensional image if the presentation of the third dimension is wanted it is necessary to apply appropriate algorithm structures and computers. In this study we show our experience in the application of space reconstruction of blood vessels and aneurysms of the vertebrobasilary confluence in 6 patients operated at the Institute for Neurosurgery, Clinical Center of Serbia. Intraoperative finding in all patients matched the finding that we got by space reconstruction of the blood vessels, which was possible to observe from different angles. Postoperative course in all patients was satisfying. Upon discharge the patients were without rough lateralization of the pyramidal system. Our initial results and their practical agreement with the interoperative finding give us right to recommend this method as the standard for the preoperative diagnostic protocol.

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Comparison between C-arm cone beam computed tomography and interventional angiography in transarterial chemoembolization of hepatocellular carcinoma

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-019-0053-4 ◽

2019 ◽

Vol 50 (1) ◽

Author(s):

Ibraheim Ahmed Diab ◽

Shaimaa Abdel-hamid Hassanein ◽

Hala Hafez Mohamed

Keyword(s):

Computed Tomography ◽

Hepatocellular Carcinoma ◽

Cone Beam Computed Tomography ◽

Vascular Anatomy ◽

Cone Beam ◽

Focal Lesion ◽

Focal Lesions ◽

Conventional Angiography ◽

Interventional Angiography ◽

Cross Sectional

Abstract Background Hepatocellular carcinoma (HCC) is the most common primary hepatic malignancy of adults. One of the established treatment procedures performed worldwide for HCC is transcatheter arterial chemoembolization (TACE). By using conventional angiography in TACE, we can detect and identify the vascular anatomy of the liver through obtaining 2D images. Recently C-arm cone beam computed tomography (CBCT) is introduced for obtaining cross-sectional and three-dimensional (3D) images for better visualization of small tumors and their feeding arteries. Results The number of detected focal lesions by angiography was 51 compared to 87 focal lesion detected by CBCT; of those, 45 and 77 were active lesions by both procedures respectively. For lesions, less than 1 cm CBCT detected 23 lesions while angiography detected only one lesion. Angiography detected 87 feeding arterial branch while cone beam CT-HA detected 130 branches to the same number of target lesion. Feeder tractability and confidence were better by CBCT. Conclusion CBCT is superior to angiography in tumor detectability, detection of lesions less than 1 cm, feeder detection, and feeder traction; however, conventional angiography and DSA are irreplaceable. Thus, combination of CBCT with angiography during TACE produces better results and less complication.

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Pulmonary arteriovenous malformation (PAVM) embolization: prediction of angiographically-confirmed recanalization according to PAVM Diameter changes on CT

CVIR Endovascular ◽

10.1186/s42155-021-00207-9 ◽

2021 ◽

Vol 4 (1) ◽

Author(s):

Jihoon Hong ◽

Sang Yub Lee ◽

Jung Guen Cha ◽

Jae-Kwang Lim ◽

Jongmin Park ◽

...

Keyword(s):

Arteriovenous Malformation ◽

Case Series ◽

Pulmonary Angiography ◽

Endovascular Embolization ◽

Pulmonary Arteriovenous Malformation ◽

Conventional Angiography ◽

Receiver Operating Characteristic Curves ◽

Vein Diameter ◽

Diameter Reduction

Abstract Background To assess pulmonary arteriovenous malformation (PAVM) recanalization after embolization based on PAVM diameter changes on computed tomography (CT), with pulmonary angiography used as a gold standard. Methods A retrospective review was done of patients from 2008 to 2019 with a PAVM treated with endovascular embolization. The treatment outcome was determined by conventional angiography. Follow-up pulmonary angiography was performed when recanalization was suspected on CT, or embolization of all lesions in multiple PAVM patients could not be completed in a single session. Patients who had no preprocedural or follow-up CT were excluded. Draining vein, feeding artery, and venous sac diameter were measured on CT, and diameter reduction rates were compared with the widely-used, binary 70 % criteria. Results Forty-one patients with 114 PAVMs were treated during the study period. Eight patients with 50 PAVMs met the inclusion criteria. Mean vein, artery, and venous sac diameter reduction rates were as follows: 59.2 ± 9.3 %, 47.5 ± 10.6 %, and 62.6 ± 13.2 %, respectively, in the occluded group and 5.4 ± 19.5 %, 11.3 ± 17.7 %, and 26.8 ± 14.2 %, respectively, in the recanalized group. The area under the receiver operating characteristic curves for PAVM recanalization for the draining vein was 1.00, showing a better result than the artery (0.97) and sac (0.99). Patients showed > 42 % draining vein diameter reduction in the occluded group and < 32 % in the recanalized group. The widely-used 70 % criteria showed low specificity for predicting recanalization (draining vein, 7.3 %; venous sac, 41.7 %) but 100 % sensitivity for both the draining vein and venous sac. Conclusions The widely-used 70 % binary criteria showed limited performance in predicting outcomes in this angiographically-confirmed case series. Further investigations are warranted to establish a strategy for detecting recanalization after PAVM embolization.

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Ultra-widefield versus conventional angiography in a postvitrectomy, partially gas-filled eye

BMJ Case Reports ◽

10.1136/bcr-2016-214477 ◽

2016 ◽

pp. bcr2016214477

Author(s):

Daraius Shroff ◽

Shishir Narain ◽

Charu Gupta ◽

Cyrus Shroff

Keyword(s):

Conventional Angiography

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Safety and efficacy of percutaneous microwave ablation for post-procedural haemostasis: a bi-central retrospective study focusing on safety and efficacy

British Journal of Radiology ◽

10.1259/bjr.20190615 ◽

2020 ◽

Vol 93 (1106) ◽

pp. 20190615

Author(s):

Tian’an Jiang ◽

Alexis Kelekis ◽

Qiyu Zhao ◽

Argyro Mazioti ◽

Jia Liu ◽

...

Keyword(s):

Microwave Ablation ◽

Treatment Algorithm ◽

Doppler Imaging ◽

Percutaneous Ablation ◽

Technical Success ◽

Safety And Efficacy ◽

Contrast Enhanced ◽

Limited Experience ◽

Active Extravasation ◽

Percutaneous Microwave Ablation

Objective: To review safety and efficacy of percutaneous microwave ablation (MWA) for post-procedural haemostasis. Methods: Institutional databases retrospective research identified 10 cases of iatrogenic bleeding who underwent percutaneous MWA for post-procedural haemostasis. Ultrasound examination with Doppler and contrast enhancement identified a source of active bleeding prior to ablation; additionally they were used as guiding modality for antenna insertion whilst, post-ablation, assessed the lack of active extravasation. Target locations included liver intercostal space spleen and thyroid gland. Technical success was defined as positioning of the antenna on the desired location. Treatment end point was considered the disappearance of active extravasation in both Doppler imaging and contrast-enhanced ultrasound. Results: Technical success (i.e. positioning of the antenna on the desired location) was achieved in all cases. No complications were noted. All patients post MWA remained haemodynamically stable with no need for transfusion and were discharged from the hospital the next morning. Imaging and clinical follow-up in all patients before exiting the hospital did not depict any sign of active extravasation or bleeding. Conclusion: Our limited experience reports preliminary data showing that MWA could be added in the armamentarium of percutaneous therapies for iatrogenic bleeding. More prospective studies with larger patient samples are necessary for verification of this technique as well as for drawing broader conclusions in order to evaluate the place of percutaneous ablation in the treatment algorithm of haemorrhage. Advances in knowledge: Percutaneous ablation might have a role in haemostasis in well-selected cases

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