Assuntos
Empiema Pleural/terapia , Fibrinolíticos/administração & dosagem , Intubação Intratraqueal/normas , Pediatria/normas , Melhoria de Qualidade/normas , Indicadores de Qualidade em Assistência à Saúde/normas , Radiografia Intervencionista/normas , Radiologia Intervencionista/normas , Cirurgia Torácica Vídeoassistida/normas , Fatores Etários , Tubos Torácicos/normas , Pré-Escolar , Consenso , Técnica Delphi , Empiema Pleural/diagnóstico por imagem , Humanos , Lactente , Intubação Intratraqueal/instrumentação , Pediatria/educação , Radiologia Intervencionista/educação , Resultado do TratamentoRESUMO
Renal transplantation is the treatment of choice for most patients with end-stage renal disease. However, in spite of continuous progress in surgical techniques and immunosuppressive therapy, a wide variety of vascular and nonvascular complications can arise postoperatively. Vascular complications include transplant renal artery stenosis, arteriovenous fistulas or intrarenal pseudoaneurysms following renal transplant biopsy, extrarenal pseudoaneurysms, and graft thrombosis. Nonvascular complications include urologic complications (eg, ureteral obstruction, urine leak) and perigraft fluid collections (eg, lymphocele, abscess, hematoma, urinoma). These postoperative complications can be diagnosed and managed with minimally invasive techniques; however, an understanding of renal transplant anatomy and the risks of posttransplantation immunosuppressive therapy unique to this patient population is essential to their successful application. In addition, familiarity with the indications for and limitations of these techniques as well as collaboration between the radiologist and the transplantation surgeon are vital for maximizing the chances of renal allograft survival.
Assuntos
Rejeição de Enxerto/etiologia , Rejeição de Enxerto/cirurgia , Nefropatias/etiologia , Nefropatias/cirurgia , Transplante de Rim/efeitos adversos , Radiologia Intervencionista/métodos , Adulto , Criança , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Padrões de Prática Médica , Doenças Vasculares/etiologia , Doenças Vasculares/cirurgiaRESUMO
Hepatic arterial therapy with yttrium-90 microspheres exploits the avenue provided by the neoplastic microvasculature to deliver high-energy, low-penetrating therapeutic doses of radiation. Variant hepatic arterial anatomy, collateral vessels, and changes in flow dynamics during treatment can affect particle dispersion and lead to nontarget particle distribution and subsequent gastrointestinal morbidity. Awareness of these variances and techniques to prevent gastrointestinal tract microsphere delivery is essential in mitigating this serious complication. Our aim is to increase the understanding of the role of various imaging and preventative techniques in minimizing this undesired effect.
Assuntos
Adenocarcinoma/radioterapia , Braquiterapia/efeitos adversos , Embolização Terapêutica/efeitos adversos , Artéria Hepática , Neoplasias Hepáticas/radioterapia , Úlcera Péptica Hemorrágica/etiologia , Úlcera Péptica/etiologia , Radioisótopos de Ítrio/efeitos adversos , Adenocarcinoma/diagnóstico por imagem , Adenocarcinoma/secundário , Adulto , Idoso , Trato Gastrointestinal/irrigação sanguínea , Humanos , Injeções Intra-Arteriais , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/secundário , Masculino , Microesferas , Úlcera Péptica/complicações , Úlcera Péptica/patologia , Úlcera Péptica Hemorrágica/patologia , Cintilografia , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Agregado de Albumina Marcado com Tecnécio Tc 99m , Radioisótopos de Ítrio/administração & dosagemRESUMO
As the prevalence of obesity in the United States continues to increase, the volume of endovascular and fluoroscopically guided procedures is also increasing. With obese patients, it often seems the only consideration is whether the table weight tolerance can accommodate the patient. This is a naive approach to performing procedures in obese patients, as there are multiple considerations involved in providing state-of-the-art endovascular and interventional care to obese patients. A growing collection of literature is beginning to surface regarding the appropriate modifications in the interventional care of these patients. This article reviews the relevant literature on this important subject.