• Title/Summary/Keyword: interventional

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Role of interventional endoscopic ultrasound in a developing country

  • Hasan Maulahela;Nagita Gianty Annisa;Achmad Fauzi;Kaka Renaldi;Murdani Abdullah;Marcellus Simadibrata;Dadang Makmun;Ari Fahrial Syam
    • Clinical Endoscopy
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    • v.56 no.1
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    • pp.100-106
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    • 2023
  • Background/Aims: Endoscopic ultrasound (EUS) has become an essential diagnostic and therapeutic tool. EUS was introduced in 2013 in Indonesia and is considered relatively new. This study aimed to describe the current role of interventional EUS at our hospital as a part of the Indonesian tertiary health center experience. Methods: This retrospective study included all patients who underwent interventional EUS (n=94) at our center between January 2015 and December 2020. Patient characteristics, technical success, clinical success, and adverse events associated with each type of interventional EUS procedure were evaluated. Results: Altogether, 94 interventional EUS procedures were performed at our center between 2015 and 2020 including 75 cases of EUS-guided biliary drainage (EUS-BD), 14 cases of EUS-guided pancreatic fluid drainage, and 5 cases of EUS-guided celiac plexus neurolysis. The technical and clinical success rates of EUS-BD were 98.6% and 52%, respectively. The technical success rate was 100% for both EUS-guided pancreatic fluid drainage and EUS-guided celiac plexus neurolysis. The adverse event rates were 10.6% and 7.1% for EUS-BD and EUS-guided pancreatic fluid drainage, respectively. Conclusions: EUS is an effective and safe tool for the treatment of gastrointestinal and biliary diseases. It has a low rate of adverse events, even in developing countries.

Is Interventional Therapy Superior to Medical Treatment in Chronic Low Back Pain?: No (만성요통의 치료에서 중재적인 치료가 보존적 치료보다 우세한가?: 부정적인 입장에서)

  • Bae, Jong-Seok
    • Annals of Clinical Neurophysiology
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    • v.12 no.1
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    • pp.7-10
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    • 2010
  • Chronic low back pain (CLBP) is a distinct disease entity in that its clinical course and response to the treatment are quite different from acute low back pain (ALBP). CLBP is also closely related with systemic or preexisting psychosocial factors rather than focal or localized factors. Since there has been little consensus in practice regarding the proper management of CLBP, clinicians tend to approach and manage patients with CLBP in an empirical manner rather than an evidence-based one. In this article, I will review the difficulties of therapeutic choice in CLBP and provide superior aspects of medical treatment over invasive interventional treatments.

Spontaneously Resolved Lumbar Artery Injury after Blunt Trauma

  • Nam, Seung Hyuk;Ryu, Je Il;Cheong, Jin Hwan;Park, Ki-Chul;Ro, Sun Kyun
    • Journal of Trauma and Injury
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    • v.33 no.2
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    • pp.124-127
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    • 2020
  • Major bleeding caused by vascular injuries of the abdominal aorta or its branches after blunt trauma often leads to mortality or major morbidity. We report a case that lumbar artery injury following blunt trauma was spontaneously resolved without any surgical or interventional treatment. Lumbar artery injury after blunt trauma could be treated conservatively without surgical or interventional treatment in a selected case. When an aortic or its branch injury was suspicious, diagnostic angiograms in the setting of interventional treatment may be helpful to decide an appropriate treatment modality.

Endovascular Closure Resolves Trimethylaminuria Caused by Congenital Portosystemic Shunts

  • Ponce-Dorrego, Mar?a Dolores;Garzon-Moll, Gonzalo
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.22 no.6
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    • pp.588-593
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    • 2019
  • This study aimed to report three new cases of an association between two rare conditions, congenital portosystemic shunts (CPSS) and trimethylaminuria (TMAU), and the efficacy of endovascular closure of the CPSS for resolving TMAU. Between November 2014 and April 2017, 15 patients with CPSS were enrolled in this prospective study to assess the efficacy of percutaneous endovascular shunt closure. Three patients presented with clinical symptoms of TMAU that were confirmed by urine analysis of trimethylamine (TMA) and TMA n-oxide. One year after endovascular closure of the congenital portosystemic shunt, the same parameters were evaluated were obtained and the values were compared to the pretreatment values. The results indicated the disappearance of clinical symptoms of TMAU and normalization of the urine test parameters in two patients and no changes in one patient, who developed new portosystemic communications.

Pulmonary Arteriovenous Malformation and Its Vascular Mimickers

  • Hyoung Nam Lee;Dongho Hyun
    • Korean Journal of Radiology
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    • v.23 no.2
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    • pp.202-217
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    • 2022
  • Pulmonary arteriovenous malformation (AVM) is a congenital vascular disease in which interventional radiologists can play both diagnostic and therapeutic roles in patient management. The diagnosis of pulmonary AVM is simple and can usually be made based on CT images. Endovascular treatment, that is, selective embolization of the pulmonary artery feeding the nidus of the pulmonary AVM, and/or selectively either the nidus or draining vein, has become a first-line treatment with advances in interventional devices. However, some vascular diseases can simulate pulmonary AVMs on CT and pulmonary angiography. This subset can confuse interventional radiologists and referring physicians. Vascular mimickers of pulmonary AVM have not been widely known and described in detail in the literature, although some of these require surgical correction, while others require regular follow-up. This article reviews the clinical and radiologic features of pulmonary AVMs and their mimickers.

A Study of Drug Content and Cell Cytotoxicity of Paclitaxel-eluting Stents Coated with Various Biopolymer (다양한 생체고분자로 코팅된 Paclitaxel Eluting Stent의 약물함량과 세포독성 연구)

  • Kim, Dong-Gon;Shin, Il-Gyun;Kim, Gi-Han;Kim, Seong-Hyeon;Lee, Ju-Ho;Ki, Byoyng-Yun;Nah, Jae-Woon;Suh, Tae-Suk;Kim, Sang-Ho
    • Progress in Medical Physics
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    • v.20 no.3
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    • pp.125-131
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    • 2009
  • In this study, the paclitaxel eluting stent (PES) was prepared by coating a biliary stent with paclitaxel using various biopolymer such as poly (vinyl acetate) (PVAc), poly (lactic-co-glycolic acid) (PLGA), Silicone rubber for restenosis prevention in gastrointestinal disease by a dip-coating method. Drug contents of PES were increased as surface area of stent, concentration and molecular weight of coating polymer increase. In $^1H-NMR$ specta, we know that drug did not change by confirming specific peaks of paclitaxel in PES. As shown in SEM image, PES prepared using various biopolymer is coated clearly and regularly except Silicone rubber coating polymer. In in vitro cell cytotoxicity test, bare stent showed low cytotoxic effect against CT-26 colon carcinoma cell line on 3 day. However, PES coated with PLGA 502H showed the highest cytotoxicity because PLGA 502H is biodegradable polymer and has less molecular weight than other coating polymer. These results suggest that PES coated various biopolymer can be prevented restenosis in gastrointestinal disease.

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A Study on Fatigue Characteristic of Stent Using Finite Element Analysis (나이티놀 와이어 스텐트의 피로도 특성에 대한 유한요소 해석)

  • Kim, Han-Ki;Shin, Il-Gyun;Kim, Dong-Gon;Kim, Seong-Hyeon;Lee, Ju-Ho;Ki, Byoyng-Yun;Suh, Tae-Suk;Kim, Sang-Ho
    • Progress in Medical Physics
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    • v.20 no.3
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    • pp.119-124
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    • 2009
  • Stents are frequently used throughout the human body. They keep pathways open in vascular or nonvascular duct for a long time. Therefore its stability is very important factor. In recent years, aconsiderable amount of research has been carried out in order to estimate mechanical properties of the stent such as expansion pressure behavior, radial recoil and longitudinal recoil using FEM (Finite element analyses). However, published works on simulation of stent fatigue behavior using FEM are relatively rare. In this paper, a nonlinear finite-element methodwas employed to analyses the compression of a stent using external pressure and fatigue behavior. Finite element analyses for the stent system were performed using NASTRAN FX. In conclusion this paper shows how the stent is behaved in the body, and its fatigue behavior.

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Differentiation of Benign from Malignant Adnexal Masses by Functional 3 Tesla MRI Techniques: Diffusion-Weighted Imaging and Time-Intensity Curves of Dynamic Contrast-Enhanced MRI

  • Malek, Mahrooz;Pourashraf, Maryam;Mousavi, Azam Sadat;Rahmani, Maryam;Ahmadinejad, Nasrin;Alipour, Azam;Hashemi, Firoozeh Sadat;Shakiba, Madjid
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.8
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    • pp.3407-3412
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    • 2015
  • Background: The aim of this study was to evaluate and compare the accuracy of diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC) value, and time-intensity curve (TIC) type analysis derived from dynamic contrast-enhanced MR imaging (DCE-MRI) in differentiating benign from malignant adnexal masses. Materials and Methods: 47 patients with 56 adnexal masses (27 malignant and 29 benign) underwent DWI and DCE-MRI examinations, prior to surgery. DWI signal intensity, mean ADC value, and TIC type were determined for all the masses. Results: High signal intensity on DWI and type 3 TIC were helpful in differentiating benign from malignant adnexal masses (p<0.001). The mean ADC value was significantly lower in malignant adnexal masses (p<0.001). An ADC value< $1.20{\times}10^{-3}mm^2/s$ may be the optimal cutoff for differentiating between benign and malignant tumors. The negative predictive value for low signal intensity on DWI, and type 1 TIC were 100%. The pairwise comparison among the receiver operating characteristic (ROC) curves showed that the area under the curve (AUC) of TIC was significantly larger than the AUCs of DWI and ADC (p<0.001 for comparison of TIC and DWI, p<0.02 for comparison of TIC and ADC value). Conclusions: DWI, ADC value and TIC type derived from DCE-MRI are all sensitive and relatively specific methods for differentiating benign from malignant adnexal masses. By comparing these functional MR techniques, TIC was found to be more accurate than DWI and ADC.

POSTOPERATIVE COMPLICATIONS IN LIVER TRANSPLANTATION DONORS AND USEFULNESS OF INTERVENTIONAL MANAGEMENT (생체 간이식 수술 후 공여자의 합병증 및 중재적 시술의 유용성)

  • Lee In Sick;Lee Hyeong Jin;Ryoo Myung Sun;Ko Gi Young
    • Journal of The Korean Radiological Technologist Association
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    • v.28 no.1
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    • pp.83-89
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    • 2002
  • To evaluate the incidence of postoperative complication,』 following living liver donation and the effectiveness of interventional management for treating postoperative complications. Between January 1997 and December 2001, 386 consecutive healthy honors f

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Interventional Radiology Treatment for Postoperative Chylothorax

  • Jun, Hoyong;Hur, Saebeom
    • Journal of Chest Surgery
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    • v.53 no.4
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    • pp.200-204
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    • 2020
  • Postoperative chylothorax is a rare occurrence after various thoracic surgical procedures, but it poses a substantial risk of morbidity and mortality. Thoracic duct embolization (TDE) is currently deemed the optimal treatment due to its safety and efficacy. This review offers an introduction to interventional options in this setting, detailing the steps of TDE for the edification of those engaged in postoperative care.