Single-center comparison of the efficacy and complications of arterial vascular closure devices in interventional radiology

2017 ◽  
Vol 18 (4) ◽  
pp. 339-344 ◽  
Author(s):  
Matthew A. Elmasri ◽  
Stephen T. Kee ◽  
John M. Moriarty ◽  
Antoinette Gomes ◽  
Edward W. Lee ◽  
...  
Keyword(s):  
Interventional Radiology ◽  
Success Rate ◽  
Complication Rates ◽  
Manual Compression ◽  
Single Center ◽  
Technical Success ◽  
Laboratory Parameters ◽  
Technical Success Rate ◽  
Major Complications ◽  
Vascular Closure Devices

Introduction Vascular closure devices (VCDs) are commonly used to achieve hemostasis of arterial access sites, but there is little comparative data on the variety of VCDs currently in clinical use. We reviewed the VCD experience at our institution to determine the safest and most effective VCD. Materials and Methods Retrospective analysis of 907 consecutive arterial procedures in interventional radiology from June 2012 to June 2014 was performed. Five VCDs were used: Angio-Seal (n = 478), FISH (n = 56), Mynx (n = 56), Perclose (n = 61), and Starclose (n = 68). Patients who underwent manual compression (n = 188) without use of VCDs were also studied as a comparison group. Patient demographics and pre-procedural laboratory parameters were recorded. The technical success rate for achievement of hemostasis and complication rates were noted. Results Complete hemostasis rate (aka technical success rate) was 93.5% for Angio-Seal, 83.9% for FISH, 53.6% for Mynx, 73.7% for Perclose, 76.5% for Starclose, and 91.5% for manual compression. The differences among the devices were statistically significant (p<0.001). Fourteen major complications (1.5%) were encountered: nine with Angio-Seal (1.9%), one with Mynx (1.8%), one with Starclose (1.5%), and three with manual compression (1.6%); these differences were not statistically significant. Of the demographic and laboratory parameters studied, none were significantly correlated with hemostasis failure or development of complications. Conclusions In our single-center institutional experience, Angio-Seal is the device with the best technical success rate. Major complications of VCDs were rare, with no statistically significant difference between devices.

scholarly journals Modified percutaneous radiologic gastrostomy technique without endoscopic or nasogastric access

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Reda Tabashy ◽  
Amira Darwish ◽  
Ashraf Ibrahim ◽  
Mohamed Gad El-Mola
Keyword(s):  
Esophageal Cancer ◽  
Success Rate ◽  
Nasogastric Tube ◽  
Conventional Technique ◽  
Fluoroscopic Guidance ◽  
Efficacy And Safety ◽  
Technical Success ◽  
Technical Success Rate ◽  
Major Complications ◽  
Percutaneous Radiologic Gastrostomy

Abstract Background The aim of this study is to evaluate the efficacy and safety of a modified percutaneous radiologic gastrostomy (MPRG) technique under ultrasound and fluoroscopic guidance without endoscopic or nasogastric access. Results The study included 24 patients: 10 males and 14 females whose ages ranged from 44 to 80 years old. Ten patients had esophageal cancer and 14 patients had neck cancer. Technical success was achieved in 23 out of the 25 procedures (92%). Two procedures failed (8%) and were converted to the conventional technique by using the nasogastric tube. No major complications were reported. Minor complications were observed in 5 patients (20%): intraperitoneal air and contrast leakage in 4 patients and focal mucosal dissection by the contrast in 1 patient. Conclusion The MPRG has high technical success rate, is safe with no major complications, and is most feasible when endoscopic or nasogastric access cannot be performed.

scholarly journals Tibiopedal and distal femoral retrograde vascular access for challenging chronic total occlusions: predictors for technical success, and complication rates in a large single-center cohort

2020 ◽  
Vol 31 (1) ◽  
pp. 535-542
Author(s):  
Gerd Grözinger ◽  
Jan Hallecker ◽  
Ulrich Grosse ◽  
Roland Syha ◽  
Dominik Ketelsen ◽  
...  
Keyword(s):  
Clinical Outcome ◽  
Success Rate ◽  
Vascular Access ◽  
Chronic Total Occlusion ◽  
Lesion Length ◽  
Complication Rates ◽  
Technical Success ◽  
Total Occlusion ◽  
Femoral Access ◽  
Technical Success Rate

Abstract Objective To evaluate the safety and effectiveness of tibiopedal and distal femoral access for retrograde crossing of chronic total occlusion (CTO) in Rutherford stage III to VI peripheral arterial occlusive disease, and to determine factors that correlate with technical success. Material and methods One hundred seventy-one consecutive patients were included in this retrospective study. Rutherford stages were III, IV, and V/VI in 24%, 8%, and 67% of patients. Inclusion criteria were CTO at the superficial femoral (SFA), popliteal (PA), and/or below-the-knee (BTK) level, and a failed antegrade treatment followed by a distal retrograde approach. The numbers of occluded vascular levels (OVL), lesion length, degree of calcification, technical success rate, complications, and clinical outcome were noted. Results OVL were 1 in 72%, 2 in 20%, and 3 in 8% of patients. CTOs were longer than 20 cm in 45.6% of cases and showed severe calcifications in 50.3%. Target vessels for distal access were the distal SFA/PA in 17% and BTK in 83%. The overall technical success rate was 82%. Severe calcification decreased technical success (p = 0.01) despite lesion length and Rutherford stage. Clinical outcome improved in 123/152 patients with a significant increase of the median ABI (N = 158) from 0.53 (interquartile range 0.39 to 0.61) to 0.85 (0.59 to 1.03; p < 0.001). Complications were reported in 7.6% cases with 2.3% related to the distal vascular access. Conclusion The tibiopedal and distal femoral retrograde access presents a safe and effective treatment option of CTOs at the thigh and/or BTK after a failed antegrade attempt improving clinical outcome. Technical success decreased with lesion’s degree of calcification. Key Points • Safety and effectiveness of the tibiopedal and distal femoral access for retrograde crossing of chronic total occlusion. • Target lesion’s degree of calcification decreases technical success. • Complications related to the distal vascular access were rare.

scholarly journals Safety, Efficacy, and Outcomes of N-Butyl Cyanoacrylate Glue Injection through the Endoscopic or Radiologic Route for Variceal Gastrointestinal Bleeding: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 10 (11) ◽  
pp. 2298
Author(s):  
Olivier Chevallier ◽  
Kévin Guillen ◽  
Pierre-Olivier Comby ◽  
Thomas Mouillot ◽  
Nicolas Falvo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gastrointestinal Bleeding ◽  
Success Rate ◽  
Meta Analysis ◽  
Major Complication ◽  
Technical Success ◽  
Cyanoacrylate Glue ◽  
Technical Success Rate ◽  
Major Complications ◽  
Number Of Patients

We performed a systematic review and meta-analysis of published studies to assess the efficacy, safety, and outcomes of N-butyl cyanoacrylate (NBCA) injection for the treatment of variceal gastrointestinal bleeding (GIB). The MEDLINE/PubMed, EMBASE, and SCOPUS databases were searched for English-language studies published from January 1980 to December 2019 and including patients who had injection of NBCA for variceal GIB. Two independent reviewers extracted and evaluated the data from eligible studies. Exclusion criteria were sample size <5, article reporting the use of NBCA with other embolic agents, no extractable data, and duplicate reports. NBCA was injected during endoscopy in 42 studies and through a direct percutaneous approach for stomal varices in 1 study. The study’s endpoints were: Technical success, 30-day rebleeding, and 30-day overall and major complications. The estimated overall rates were computed with 95% confidence intervals, based on each study rate, weighted by the number of patients involved in each study. In total, 43 studies with 3484 patients were included. The technical success rate was 94.1% (95% CI: 91.6–96.1%), the 30-day rebleeding rate was 24.2% (18.9–29.9%), and 30-day overall and major complications occurred in 15.9% (11.2–21.3%) and 5.3% (3.3–7.8%) of patients, respectively. For treating variceal GIB, NBCA injection is a safe and effective method that demonstrates high technical success rate and very low major complication rate.

Radiology-Implanted Arm Ports: A Review of the Literature

2015 ◽  
Vol 20 (2) ◽  
pp. 81-90 ◽  
Author(s):  
Brent Burbridge ◽  
Grant Stoneham ◽  
Hyun J. Lim ◽  
Chel-Hee Lee
Keyword(s):  
Interventional Radiology ◽  
Success Rate ◽  
English Language ◽  
Human Beings ◽  
Review Of The Literature ◽  
Technical Success ◽  
Upper Arm ◽  
Technical Success Rate ◽  
Port Implantation ◽  
Port Systems

Abstract Introduction: Placement of totally implanted venous access devices, or port systems, in the upper arm is becoming a common practice in interventional radiology. To gain a better understanding of the literature in this area, we performed a search for and analysis of previous publications related to upper arm implantation of these devices by members of interventional radiology departments. Methods: A review of the literature pertaining to upper arm port systems implanted in human beings by members of interventional radiology departments was performed, assessing publications between the years 1992 and 2014. Only English-language publications were assessed. Results: Eighteen publications met selection criteria during the time frame reviewed. None of the studies used a prospective, randomized design; rather, all studies consisted of case–cohort descriptions of outcomes for a single device or for multiple devices. Analysis of the available literature for interventional radiology-inserted arm ports was performed. The technical success rate ranged between 93.7% and 100%, with an average of 98.9%. Conclusions: The high technical success rate of arm port implantation and the elimination of the potential for pneumothorax, hemothorax, catheter pinch-off syndrome, and subclavian and carotid artery injury are strengths of the arm implantation strategy. There was wide variation in the rates of complications detected, in addition to inconsistent study design and study implementation strategies.

Preliminary Dual-Center Experience with the Bolton Treovance Endograft

2017 ◽  
Vol 51 (8) ◽  
pp. 533-537 ◽  
Author(s):  
Arron Thind ◽  
Dhruv Sarma ◽  
Abdel Kader Allouni ◽  
Feras Abdallah ◽  
David Murray ◽  
...  
Keyword(s):  
Aortic Aneurysm ◽  
Success Rate ◽  
Stent Graft ◽  
Type I ◽  
Complication Rates ◽  
Technical Success ◽  
Technical Success Rate ◽  
Average Maximum ◽  
Aneurysm Repair

Purpose: To present the performance and safety of the Treovance stent graft for endovascular aortic aneurysm repair in a “real-world” patient cohort. Methods: Patients from 2 centers, deemed unfit for open repair, were electively treated with the Treovance endograft. Clinical preoperative, operative, and up to 1-year postoperative follow-up data of patients were retrospectively analyzed. Results: This study included 46 patients with abdominal aortic aneurysm (44 male), mean age of 78 years ± 8 standard deviation (SD; range: 58-93 years). All met the manufacturer’s recommended anatomical requirements: average maximum sac diameter 63 mm ± 10 SD (range: 52-86 mm), proximal neck length 29 mm ± 12 SD (range: 11-60 mm), and neck angulation 30° ± 21 SD (range: 0°-70°). Fourteen had moderate to severe iliac tortuosity. A primary technical success rate of 80% was achieved (100% assisted primary technical success rate): 7 patients required adjunctive procedures intraoperatively and 2 successful treatments for type I endoleaks, which occurred within 24 hours postoperatively. There was 100% survival at 1-year follow-up; however, 4 (8.7%) patients required reintervention: 1 for a type I endoleak, 2 for limb stenosis, and 1 for a type II endoleak with an enlarging sac. No other device-related complications were identified. Reintervention and complication rates in hostile versus nonhostile anatomies were not statistically significant ( P = .28 and P = .42, respectively). Conclusion: The Treovance stent graft has a comparable safety profile to other next-generation stent grafts during the first year after endovascular aneurysm repair, which provides a rationale for further interrogation of its outcomes through clinical trials.

scholarly journals Safety and efficacy of arteriovenous fistula angioplasties performed by nephrologists: report from a Brazilian interventional nephrology center

2021 ◽  
Author(s):  
Ricardo P. Franco ◽  
Miguel C. Riella ◽  
Domingos C. Chula ◽  
Marcia T. de Alcântara ◽  
Marcelo M. do Nascimento
Keyword(s):  
Success Rate ◽  
Low Income ◽  
Complication Rates ◽  
Technical Failure ◽  
Success Rates ◽  
Technical Success ◽  
Safety And Efficacy ◽  
Technical Success Rate ◽  
Venous Stenosis ◽  
First Choice

ABSTRACT Introduction: Arteriovenous fistulas (AVF) are the first choice vascular access for hemodialysis. However, they present a high incidence of venous stenosis leading to thrombosis. Although training in interventional nephrology may improve accessibility for treatment of venous stenosis, there is limited data on the safety and efficacy of this approach performed by trained nephrologists in low-income and developing countries. Methods: This study presents the retrospective results of AVF angioplasties performed by trained nephrologists in a Brazilian outpatient interventional nephrology center. The primary outcome was technical success rate (completion of the procedure with angioplasty of all stenoses) and secondary outcomes were complication rates and overall AVF patency. Findings: Two hundred fifty-six angioplasties were performed in 160 AVF. The technical success rate was 88.77% and the main cause of technical failure was venous occlusion (10%). The incidence of complications was 13.67%, with only one patient needing hospitalization and four accesses lost due to the presence of hematomas and/or thrombosis. Grade 1 hematomas were the most frequent complication (8.2%). The overall patency found was 88.2 and 80.9% at 180 and 360 days after the procedure, respectively. Conclusion: Our findings suggest that AVF angioplasty performed by trained nephrologists has acceptable success rates and patency, with a low incidence of major complications as well as a low need for hospitalization.

scholarly journals Stereotactically-navigated percutaneous Irreversible Electroporation (IRE) compared to conventional IRE: a prospective trial

PeerJ ◽  
2016 ◽  
Vol 4 ◽  
pp. e2277 ◽  
Author(s):  
Lukas P. Beyer ◽  
Benedikt Pregler ◽  
Christoph Nießen ◽  
Andreas Schicho ◽  
Michael Haimerl ◽  
...  
Keyword(s):  
Success Rate ◽  
Irreversible Electroporation ◽  
Prospective Trial ◽  
Percutaneous Ablation ◽  
Mean Deviation ◽  
Complication Rates ◽  
Needle Placement ◽  
Technical Success ◽  
Liver Malignancies ◽  
Technical Success Rate

Purpose.The purpose of this study was to compare CT-navigated stereotactic IRE (SIRE) needle placement to non-navigated conventional IRE (CIRE) for percutaneous ablation of liver malignancies.Materials and Methods.A prospective trial including a total of 20 patients was conducted with 10 patients in each arm of the study. IRE procedures were guided using either CT fluoroscopy (CIRE) or a stereotactic planning and navigation system (SIRE). Primary endpoint was procedure time. Secondary endpoints were accuracy of needle placement, technical success rate, complication rate and dose-length product (DLP).Results.A total of 20 IRE procedures were performed to ablate hepatic malignancies (16 HCC, 4 liver metastases), 10 procedures in each arm. Mean time for placement of IRE electrodes in SIRE was significantly shorter with 27 ± 8 min compared to 87 ± 30 min for CIRE (p< 0.001). Accuracy of needle placement for SIRE was higher than CIRE (2.2 mm vs. 3.3 mm mean deviation,p< 0.001). The total DLP and the fluoroscopy DLP were significantly lower in SIRE compared to CIRE. Technical success rate and complication rates were equal in both arms.Conclusion.SIRE demonstrated a significant reduction of procedure length and higher accuracy compared to CIRE. Stereotactic navigation has the potential to reduce radiation dose for the patient and the radiologist without increasing the risk of complications or impaired technical success compared to CIRE.

Efficacy and Safety of Ultrasound-Guided Repeat Access and Repeat Closure With an ExoSeal Vascular Closure System in Patients With Peripheral Arterial Disease

2021 ◽  
pp. 153857442110455
Author(s):  
Taira Kobayashi ◽  
Masaki Hamamoto ◽  
Takanobu Okazaki ◽  
Mayu Tomota ◽  
Takashi Fujiwara ◽  
...  
Keyword(s):  
Success Rate ◽  
Complication Rates ◽  
Efficacy And Safety ◽  
Closure System ◽  
Technical Success ◽  
Ultrasound Guided ◽  
Access Site ◽  
Technical Success Rate ◽  
Significant Difference ◽  
Procedural Success

Objective The purpose of this study was to evaluate the efficacy and safety of ultrasound-guided repeat access and repeat closure with an ExoSeal vascular closure system. Methods A total of 123 endovascular therapy (EVT) procedures were performed in 59 patients (65 limbs) with ultrasound-guided repeat access and repeat implantation of an ExoSeal vascular closure system between January 2019 and March 2021. The procedural details and postprocedural outcomes of EVT with repeat access and use of ExoSeal (RE group) were compared with those of EVT with initial use of ExoSeal (IE group) in the same patients. In a subgroup analysis, these outcomes were also compared in early repeat (within 3 months) and late repeat (over 3 months) cases. Results The technical success rate of ultrasound-guided access in the RE group was 100%. The procedural success rate of EVT and deployment success rate of ExoSeal in the RE group were 93% and 94%, respectively, which were not significantly different to those in the IE group. Access site complications in the RE group occurred in 2 cases (2%), again with no significant difference with the IE group. The median puncture, procedural, and hemostasis times in the RE group were 3 [2-5], 36.5 [29-54], and 7 [5-10] min, respectively, which were not significantly longer than those in the IE group. In the RE group, early and late repeat closure was performed in 66 (54%) and 57 (46%) cases, respectively, and there were no significant differences in the technical success of ultrasound-guided access, procedural success of EVT, deployment success of ExoSeal, and access site complication rates in these cases. Conclusions Ultrasound-guided access facilitated higher technical success of repeat access and fewer access site complications in EVT with repeat use of ExoSeal, regardless of the interval between procedures.

scholarly journals Safety and efficacy of fiducial marker implantation for robotic stereotactic body radiation therapy with fiducial tracking

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Nathaniel Scher ◽  
Marc Bollet ◽  
Gauthier Bouilhol ◽  
Remi Tannouri ◽  
Imane Khemiri ◽  
...  
Keyword(s):  
Radiation Therapy ◽  
Success Rate ◽  
Fiducial Marker ◽  
Complication Rates ◽  
Stereotactic Radiation Therapy ◽  
Technical Success ◽  
Stereotactic Radiation ◽  
Technical Success Rate ◽  
Marker Tracking ◽  
All Treatment

Abstract Purpose The purpose of this study was to assess the feasibility, efficacy and toxicity of fiducial marker implantation and tracking in CyberKnife® stereotactic radiation therapy (SBRT) applied to extracranial locations. Materials and method This is a retrospective, single-centre, observational study to collect the data of all patients treated by stereotactic radiation therapy with fiducial marker tracking at extracranial locations, conducted between June 2014 and November 2017. Information regarding the implantation procedure, the types of toxicity related to marker implantation and the number of markers implanted/tracked during treatment were collected. Complication rates were evaluated using the CTCAE v4 [Common Terminology Criteria for Adverse Events] scale. The technical success rate was based on the ability to optimally track the tumor throughout all treatment fractions. Results Out of 2505 patients treated by stereotactic radiation therapy, 25% received treatment with fiducial marker tracking. The total number of implantation procedures was 616 and 1543 fiducial markers were implanted. The implantation-related complication rate was 3%, with 16 Grade 1 events and 4 Grade 2 events. The number of treated patients and the number of implanted markers has gradually increased since the technique was first implemented. The median treatment time was 27 min (range 10–76). 1295 fiducials were effectively tracked throughout all treatment fractions, corresponding to a technical success rate of 84%. The difference between the number of fiducials implanted and those tracked during treatment decreased significantly as the site’s experience increased. Conclusion Fiducial marker implantation and tracking is feasible, well-tolerated, and technically effective technique in SBRT for extracranial tumors.

scholarly journals The Role of Interventional Radiology in the Management of Late Postpancreaticoduodenectomy Hemorrhage

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Liang Zhang ◽  
Jun Wang ◽  
Jinhua Jiang ◽  
Jialin Shen
Keyword(s):  
Interventional Radiology ◽  
Success Rate ◽  
Technical Success ◽  
Safe Method ◽  
Technical Success Rate ◽  
Index Operation ◽  
Positive Rate ◽  
Rebleeding Rate ◽  
Overall Mortality

Objective. To explore the role of interventional radiology (IR) in the management of late postpancreaticoduodenectomy hemorrhage (PPH). Materials and Methods. Patients who had late PPH (occurring >24 h after index operation) managed by the IR procedure in our institution between 2013 and 2018 were retrospectively analyzed. Result. Hired patients who were diagnosed with grade B ( n = 10 ) and C ( n = 22 ) late PPH underwent 40 transcatheter arterial angiographies (TAA). The overall positive rate of angiography was 45.0% (18/40). Eighteen transcatheter arterial embolizations (TAEs) were performed, and the technical success rate was 88.89% (16/18). The rebleeding rate after embolization was 18.8% (3/16), and no severe procedure-related complications were recorded. The overall mortality of late PPH was 25.0% (8/32). Conclusion. Nearly half of hemorrhagic sites in late PPH could be identified by TAA. TAE is an effective and safe method for the hemostasia of late PPH in patients with positive angiography results.

Sign in / Sign up

Export Citation Format

Share Document