• Title/Summary/Keyword: interventional

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Radiation Exposure to Physicians During Interventional Pain Procedures

  • Kim, Tae-Wan;Jung, Jang-Hwan;Jeon, Hyun-Joo;Yoon, Kyung-Bong;Yoon, Duck-Mi
    • The Korean Journal of Pain
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    • v.23 no.1
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    • pp.24-27
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    • 2010
  • Background: Fluoroscopy has been an integral part of modern interventional pain management. Yet fluoroscopy can be associated with risks for the patients and clinicians unless it is managed with appropriate understanding, skill and vigilance. Therefore, this study was designed to determine the amount of radiation received by a primary operator and an assistant during interventional pain procedures that involve the use of fluoroscopy. Methods: In order to examine the amount of radiation, the physicians were monitored by having them wear three thermoluminescent badges during each single procedure, with one under a lead apron, one under the apron collar and one on the leg during each single procedure. The data obtained from each thermoluminescent badge was reviewed from September 2008 to November 2008 and the annual radiation exposure was subsequently calculated. Results: A total of 505 interventional procedures were performed with C-arm fluoroscopy during three months. The results of this study revealed that the annual radiation exposure was relatively low for both the operator and assistant. Conclusions: With proper precautions, the use of fluoroscopy during interventional pain procedures is a safe practice.

Assessment of Occupational Dose to the Staff of Interventional Radiology Using Monte Carlo Simulations (몬테카를로 방법을 이용한 중재방사선시술자에 대한 선량평가)

  • Lim, Young-Khi
    • Journal of Radiation Protection and Research
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    • v.39 no.4
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    • pp.213-217
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    • 2014
  • Medical operations and diagnosis using interventional radiology techniques have been increased. The management and monitoring of occupational radiation exposure to the staff of interventional radiology become important, specially because they stand in close proximity to the patient. The operational radiation protection quantity, Hp(10) which can be obtained from personal dosimeter do not always represent the effective dose to the staff. So, in this study, to estimate the critical organ doses to the staff of interventional radiology, Monte Carlo calculations with mathematical human phantom and dose measurements with personal dosimeters were carried out for the major interventional radiology procedures using C-arm. Results showed that the values of Hp(10) measured by personal dosimeters were higher than critical organ doses which were calculated. And the calculated dose to thyroids was much higher than those of other critical organ doses. For the proper radiation protection of the medical staff of interventional radiology, additional radiation protection for thyroids as well as for whole body shielding like wearing a lead apron should be considered.

Interventional Management for Pelvic Trauma (골반 외상 인터벤션)

  • Jung Han Hwang;Jeong Ho Kim;Suyoung Park
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.835-845
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    • 2023
  • Traumatic pelvic injuries usually include high-energy crush injuries and are associated with significant morbidity and mortality. Mortality rates range from 6% to 15% and increase to 36%-54% in cases of fractures that result in increased pelvic volume. Therefore, retroperitoneal hemorrhage can spiral and progress to hemorrhagic shock. Pelvic hemorrhage most commonly occurs secondary to disrupted pelvic veins or fractured bones, and 10%-20% of cases involve arterial injuries. Owing to extensive bleeding and limitations of surgery for pelvic hemorrhage, interventional treatment is at the forefront of pelvic hemorrhage management. CT is an accurate indicator of active hemorrhage in patients with pelvic trauma that affects the diagnosis and management, including interventions. Identification of the site of hemorrhage is necessary for focused interventional treatment. The current trend toward a more conservative approach for treatment of pelvic trauma and advances in interventional radiology in the field of pelvic trauma may favor widespread use of interventional treatment for patients with pelvic injuries. In this review, we discuss therapeutic modalities available to the interventional radiologist and common angiographic treatment strategies and techniques.

Sorafenib Continuation after First Disease Progression Could Reduce Disease Flares and Provide Survival Benefits in Patients with Hepatocellular Carcinoma: a Pilot Retrospective Study

  • Fu, Si-Rui;Zhang, Ying-Qiang;Li, Yong;Hu, Bao-Shan;He, Xu;Huang, Jian-Wen;Zhan, Mei-Xiao;Lu, Li-Gong;Li, Jia-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.7
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    • pp.3151-3156
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    • 2014
  • Background: Sorafenib is a promising drug for advanced hepatocellular carcinoma (HCC); however, treatment may be discontinued for multiple reasons, such as progressive disease, adverse events, or the cost of treatment. The consequences of sorafenib discontinuation and continuation are uncertain. Materials and Methods: We retrospectively analyzed 88 HCC patients treated with sorafenib from July 2007 to January 2013. Overall survival (OS), post-disease progression overall survival (pOS), and time to disease progression (TTP) were compared for survival analysis. Cox proportional hazard regression was performed to assess the effect of important factors on OS in the overall patient population and on pOS in patients who continued sorafenib treatment. Results: Sorafenib was discontinued and continued in 24 and 64 patients, respectively. The median OS (355 vs 517 days respectively; p=0.015) and median post-PD OS (260 vs 317 days, respectively; p=0.020) were statistically different between the discontinuation and continuation groups. Neither the median time to first PD nor the time to second PD were significantly different between the 2 groups. In the discontinuation group, 3 of the 24 patients (12.5%) suffered disease outbreaks. In Cox proportional hazard regression analysis after correction for confounding factors, BCLC stage (p=0.002) and PD site (p=0.024) were significantly correlated with pOS in patients who continued sorafenib treatment. Conclusions: Sorafenib discontinuation may cause HCC flares or outbreaks. It is advisable to continue sorafenib treatment after first PD, particularly in patients with Barcelona Clinic Liver Cancer stage B disease or only intrahepatic PD.

Recent advances in pediatric interventional cardiology

  • Kim, Seong-Ho
    • Clinical and Experimental Pediatrics
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    • v.60 no.8
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    • pp.237-244
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    • 2017
  • During the last 10 years, there have been major technological achievements in pediatric interventional cardiology. In addition, there have been several advances in cardiac imaging, especially in 3-dimensional imaging of echocardiography, computed tomography, magnetic resonance imaging, and cineangiography. Therefore, more types of congenital heart diseases can be treated in the cardiac catheter laboratory today than ever before. Furthermore, lesions previously considered resistant to interventional therapies can now be managed with high success rates. The hybrid approach has enabled the overcoming of limitations inherent to percutaneous access, expanding the application of endovascular therapies as adjunct to surgical interventions to improve patient outcomes and minimize invasiveness. Percutaneous pulmonary valve implantation has become a successful alternative therapy. However, most of the current recommendations about pediatric cardiac interventions (including class I recommendations) refer to off-label use of devices, because it is difficult to study the safety and efficacy of catheterization and transcatheter therapy in pediatric cardiac patients. This difficulty arises from the challenge of identifying a control population and the relatively small number of pediatric patients with congenital heart disease. Nevertheless, the pediatric interventional cardiology community has continued to develop less invasive solutions for congenital heart defects to minimize the need for open heart surgery and optimize overall outcomes. In this review, various interventional procedures in patients with congenital heart disease are explored.

3D CACT-assisted Radiofrequency Ablation Following Transarterial Chemoembolization for Hepatocellular Carcinoma: Early Experience

  • Jiao, De-Chao;Han, Xin-Wei;Wu, Gang;Ren, Jian-Zhuang
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.17
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    • pp.7897-7903
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    • 2015
  • Background: To explored the value of 3D C-arm CT (CACT) guidance system in performing radiofrequency ablation (RFA) following transarterial chemoembolizationon (TACE) for hepatocellular carcinomas. Materials and Methods: RFA of hepatocellular carcinomas (HCC) were performed on 15 patients (21 lesions) with the assistance of CACT guidance system. Technical success, procedure time, complications and patient radiation exposure were investigated. The puncture performance level was evaluated on a five-point scale (5-1: excellent-poor). Complete ablation rate was evaluated after two months follow-up using enhanced CT scans. Results: The technical success rate of RFA procedure under CACT navigation system was 100 %. Mean total procedure time was $24.24{\pm}6.53min$, resulting in a mean effective exposure dose of $15.4{\pm}5.1mSv$. The mean puncture performance level rated for CACT guided RFA procedure was $4.87{\pm}0.35$. Complete ablation (CA) was achieved in 20 (95.2%) of the treated 21 tumors after the first RFA session. None of patients developed intra-procedural complications. Conclusions: 3D CACT guidance system enables reliable and efficient needle positioning by providing real-time intraoperative guidance for performing RFA on HCCs.

Curcumin Inhibits MHCC97H Liver Cancer Cells by Activating ROS/TLR-4/Caspase Signaling Pathway

  • Li, Pei-Min;Li, Yu-Liang;Liu, Bin;Wang, Wu-Jie;Wang, Yong-Zheng;Li, Zheng
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.5
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    • pp.2329-2334
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    • 2014
  • Curcumin can inhibit proliferation of liver cancer cells by inducing apoptosis, but the specific signaling pathways involved are not completely clear. Here, we report that curcumin inhibited proliferation of MHCC97H liver cancer cells by induction of apoptosis in a concentration dependent manner via stimulating intracellular reactive oxygen species (ROS) generation. Also, we showed that increased intracellular ROS formation activated the TLR-4/MyD-88 signaling pathway, resulting in activation of caspase-8 and caspase-3, which eventually led to apoptosis in MHCC97H cells. These results showed that as an prooxidant, curcumin exerts anti-cancer effects by inducing apoptosis via the TLR-4/MyD-88 signaling pathway.

A Study on the Interventional Needs for Relapse Pevention Program Among Adult Substance Abusers (성인 약물남용자의 예방 교육프로그램 개발을 위한 교육요구도 분석 -성인 수강명령 약물사범을 중심으로-)

  • 장진경
    • Journal of the Korean Home Economics Association
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    • v.38 no.6
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    • pp.81-100
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    • 2000
  • The purpose of this study was to develop the framework for the relapse prevention program. The study examined interventional needs for a relapse prevention program among adult substance abusers. The total of 107 adult substance abusers were surveyed and asked about their interventional needs for the relapse prevention program. The questionnaire was developed by the researcher on the basis of several theories such as problem behavior theory, ecologica1-developmental theory, social support theory, and coping theory. Results showed that admit substance abusers wanted the program to deal with such issues related with individual, family, social skills, and drugs. The implications of study findings were discussed.

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Real-Time Pleural Elastography: Potential Usefulness in Nonintubated Video-Assisted Thoracic Surgery

  • Tacconi, Federico;Chegai, Fabrizio;Perretta, Tommaso;Ambrogi, Vincenzo
    • Journal of Chest Surgery
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    • v.54 no.5
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    • pp.433-435
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    • 2021
  • Pleural adhesions are a major challenge in standard and nonintubated video-assisted thoracic surgery. The currently available imaging techniques help to assess the presence and extent of pleural adhesions, but do not provide information on tissue deformability, which is crucial for intraoperative management. In this report, we describe the utilization of real-time elastography mapping of pleural adhesions. This technique enabled us to detect areas with softer adhesions, and helped establish the surgical plan in a difficult case of a patient scheduled for nonintubated video-assisted thoracic surgery.

Role of Interventional Radiologists in Trauma Centers (외상센터에서의 인터벤션 영상의학 의사의 역할)

  • Jeong Ho Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.4
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    • pp.784-791
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    • 2023
  • Based on statistics available in Korea, trauma centers play a critical role in treatment of patients with trauma. Interventional radiologists in trauma centers perform various procedures, including embolization, which constitutes the basic treatment for control of hemorrhage, although interventions such as stent graft insertion may also be used. Although emergency interventional procedures have been used conventionally, rapid and effective hemorrhage control is important in patients with trauma. Therefore, it is important to accurately understand and implement the concept of damage control interventional radiology, which has gained attention in recent times, to reduce preventable trauma-induced mortality rates.