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OBJECTIVE: To describe an ultrasound-guided approach to the dorsal aspect of the quadratus lumborum muscle (D-QL) and to evaluate the spread of methylene blue dye in canine cadavers. STUDY DESIGN: Prospective, experimental anatomical study. ANIMALS: A total of 12 canine cadavers. METHODS: The ultrasonographic landmarks and injection technique for the D-QL approach were determined in two cadavers. Correct needle tip position was confirmed by computed tomography. Bilateral ultrasound-guided injections were performed in 10 cadavers between the QL muscle, the vertebral body and the ventrocaudal aspect of the transverse process of the first lumbar vertebra (L1) using two volumes of methylene blue: low volume (LV) 0.3 mL kg-1 or high volume (HV) 0.5 mL kg-1. Staining of the main thoracolumbar trunk, dorsal and ventral branches of the thoracic (T) and lumbar (L) spinal nerves, sympathetic trunk and epidural space were assessed following dissection. Data between groups were compared using Mann-Whitney U test. Data are presented as median (range). RESULTS: The ventral branches of spinal nerves T12, T13, L1, L2, L3 and L4 were stained in 10%, 70%, 100%, 90%, 60%, 0% and 30%, 100%, 100%, 100%, 50% and 30% after LV and HV injections, respectively. Multisegmental spread of the sympathetic trunk was found on 3 (3-4) and 5 (3-6) vertebral spinal levels following LV and HV injections, respectively (p = 0.005). The T13 segment of the sympathetic trunk was stained after all HV injections. Epidural spread was found in 20% and 30% of LV and HV injections, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: The injection of HV versus LV dye using the D-QL approach provided more consistent staining of the thoracolumbar nerve structures which innervate the abdominal wall and viscera. Clinical studies are required to evaluate the analgesic efficacy of the D-QL block for abdominal procedures in dogs in vivo.
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Doenças do Cão , Bloqueio Nervoso , Músculos Abdominais/diagnóstico por imagem , Animais , Cadáver , Cães , Bloqueio Nervoso/veterinária , Estudos Prospectivos , Ultrassonografia de Intervenção/veterináriaRESUMO
BACKGROUND: Bare metal stents may cause complications like fibrous encapsulation, granulation and tracheal stenosis. We investigated the behaviour of three commercially available stents in vivo (rabbits) and in vitro (coculture of those stents with epithelial and fibroblast cell lines). Also, we investigated whether development of tracheal stenosis could be predicted by any biological marker. MATERIALS AND METHODS: The tracheae of 30 rabbits were implanted with either nitinol stents, with or without paclitaxel elution, or a cobalt-based stent. An additional ten rabbits underwent mock implantation (controls). Serial peripheral venous blood samples were taken throughout the study, and several cytokines measured. Animals were euthanized on day 90, with immediate tracheal endoscopy and lavage performed, then necropsy. RESULTS: Rabbits with cobalt-based stent exhibited more inflammation and the highest stenosis incidence, with reduced survival. Both in vivo and in vitro, this stent induced higher IL-8 levels than nitinol stents. Most important, the presence of stent-induced tracheal stenosis was closely associated to increase in IL-8 expression in blood just 1 day after tracheal stent implantation: a 1·19-fold increase vs. baseline had 83% sensitivity, 83% specificity, 77% positive predictive value, 88% negative predictive value and 83% accuracy to predict development of stenosis. CONCLUSIONS: The cobalt-based stent had the highest incidence of tracheal inflammation and stenosis. On the other hand, the paclitaxel-eluting nitinol stent did not prevent those complications and provoked a marked reaction compared with the bare nitinol stent. Early increase in IL-8 expression in blood after stent implantation could predict development of tracheal stenosis in rabbits.
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Interleucina-8/imunologia , Stents/efeitos adversos , Estenose Traqueal/imunologia , Ligas , Animais , Antineoplásicos/administração & dosagem , Linhagem Celular , Stents Farmacológicos/efeitos adversos , Células Epiteliais/metabolismo , Feminino , Fibroblastos/metabolismo , Humanos , Técnicas In Vitro , Interleucina-8/metabolismo , Estimativa de Kaplan-Meier , Paclitaxel/administração & dosagem , Desenho de Prótese , Coelhos , Sistema Respiratório/citologia , Estenose Traqueal/etiologia , Vitamina B 12RESUMO
OBJECTIVES: To assess mid-term outcome of biodegradable biliary stents (BBSs) to treat benign biliary strictures refractory to standard bilioplasty. METHODS: Institutional review board approval was obtained and patient consent was waived. 107 patients (61 males, 46 females, mean age 59 ± 16 years), were treated. Technical success and complications were recorded. Ninety-seven patients (55 males, 42 females, aged 57 ± 17 years) were considered for follow-up analysis (mean follow-up 23 ± 12 months). Fisher's exact test and Mann-Whitney U tests were used and a Kaplan-Meier curve was calculated. RESULTS: The procedure was always feasible. In 2/107 cases (2 %), stent migration occurred (technical success 98 %). 4/107 patients (4 %) experienced mild haemobilia. No major complications occurred. In 19/97 patients (18 %), stricture recurrence occurred. In this group, higher rate of subsequent cholangitis (84.2 % vs. 12.8 %, p = 0.001) and biliary stones (26.3 % vs. 2.5 %, p = 0.003) was noted. Estimated mean time to stricture recurrence was 38 months (95 % C.I 34-42 months). Estimated stricture recurrence rate at 1, 2, and 3 years was respectively 7.2 %, 26.4 %, and 29.4 %. CONCLUSION: Percutaneous placement of a BBS is a feasible and safe strategy to treat benign biliary strictures refractory to standard bilioplasty, with promising results in the mid-term period. KEY POINTS: ⢠Percutaneous placement of a BBS is 100 % feasible. ⢠The procedure appears free from major complications, with few minor complications. ⢠BBSs offer promising results in the mid-term period. ⢠With a BBS, external catheter/drainage can be removed early. ⢠BBSs represent a new option in treating benign biliary stenosis.
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Implantes Absorvíveis , Doenças Biliares/cirurgia , Implantação de Prótese , Stents , Sistema Biliar , Constrição Patológica/cirurgia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva , Estudos Retrospectivos , Resultado do TratamentoRESUMO
PURPOSE: To assess whether the presence of an atherosclerotic lesion may alter the deposition kinetics of paclitaxel on the arterial wall after drug-eluting balloon (DEB) angioplasty, as well as paclitaxel concentrations in serum and in the recovered balloons. MATERIALS AND METHODS: Three New Zealand White rabbit models were created: an atheroma group (arterial mechanical injury and hyperlipidic diet; group A), a prelesional group (fat arterial infiltration, hyperlipidic diet; group B), and a control healthy group (group C). Forty-five animals underwent DEB angioplasty in the iliac artery. Arteries and serum samples were analyzed by liquid chromatography/tandem mass spectrometry at 1, 24, 48, 72, and 96 hours (arteries) and at 1, 6, 12, and 24 hours (serum). Recovered balloons were analyzed by UV chromatography. Histologic and statistical analyses were also performed. RESULTS: Group A showed significantly higher arterial paclitaxel concentrations in the first hour after DEB angioplasty (632.05 ng/mg ± 125.75 in group A vs 179.55 ng/mg ± 45.64 and 168.54 ng/mg ± 83.48 in groups B and C, respectively; P < .05). Paclitaxel was undetectable in serum at 24 hours in all groups, but the amount was significantly higher (P < .05) in group B at 1, 6, and 12 hours. The paclitaxel amount in navigated balloons from group A was significantly lower than in other groups (P < .05). CONCLUSIONS: Paclitaxel concentration in an atherosclerotic lesion model immediately after DEB angioplasty is nearly fourfold higher than in a healthy artery. Paclitaxel remains in the bloodstream longer when a universal state of fat arterial infiltration is achieved. These findings could have clinical implications, as studies testing commercial drug-eluting devices on healthy animals may be underestimating paclitaxel arterial uptake.
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Angioplastia com Balão/métodos , Aterosclerose/metabolismo , Aterosclerose/terapia , Stents Farmacológicos , Artéria Ilíaca/cirurgia , Paclitaxel/farmacocinética , Animais , Terapia Combinada/métodos , Artéria Ilíaca/metabolismo , Masculino , Taxa de Depuração Metabólica , Paclitaxel/administração & dosagem , Coelhos , Resultado do Tratamento , Moduladores de Tubulina/administração & dosagem , Moduladores de Tubulina/farmacocinéticaRESUMO
Abernethy malformation is a rare abnormal embryological development of splanchnic venous system characterised by the presence of a congenital extrahepatic portosystemic shunt. We present a rare case of an adult male patient that was admitted with severe lower gastrointestinal bleeding, requiring multiple blood transfusions. The patient's medical history and the laboratory tests performed led to the misdiagnosis of a congenital Abernethy malformation. We present a rare case, discussing the reasons for the misdiagnosis and we conclude that management of clinical data and imaging are highly important to discard these types of congenital malformations that can mimic a portal hypertension condition.
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Erros de Diagnóstico , Hemorragia Gastrointestinal/etiologia , Hipertensão Portal/diagnóstico , Cirrose Hepática/diagnóstico , Veia Porta/anormalidades , Derivação Portossistêmica Transjugular Intra-Hepática , Malformações Vasculares/diagnóstico , Adulto , Hemorragia Gastrointestinal/cirurgia , Humanos , Masculino , Veia Porta/cirurgia , Reto , Malformações Vasculares/complicações , Malformações Vasculares/cirurgiaRESUMO
The feline population is extensive in urban areas worldwide, comprising stray and domestic cats. Cats, acting as reservoirs, can transmit various zoonotic organisms to humans, which can cause significant public health issues. We evaluated the seroprevalence of zoonotic pathogens in stray cats in an urban area of northeast Spain (the city of Zaragoza) to assess potential risks to human health. A total of 88 sampled cats (52 females and 36 males) underwent antibody evaluation using the indirect immunofluorescence technique. Seroprevalence rates were determined for IgG antibodies to Bartonella henselae (36.3%), Toxoplasma gondii (31.8%), Rickettsia felis (14.7%), Rickettsia typhi (9%), and Leishmania infantum (10.2%). Our results confirmed the presence in stray cats of antibodies against all those pathogens, indicating that they all circulate in the feline population in Zaragoza. Male cats exhibited a higher predisposition to T. gondii, whereas females showed an increased likelihood of contracting B. henselae. This difference may be attributed to distinct behaviors according to sex. Our findings underscore the importance of maintaining and intensifying surveillance coupled with preventive measures against zoonotic pathogens in cats. They highlight the need for comprehensive control strategies designed to mitigate public health risks associated with feline populations.
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Bartonella henselae , Doenças do Gato , Toxoplasma , Toxoplasmose Animal , Zoonoses , Animais , Gatos , Espanha/epidemiologia , Estudos Soroepidemiológicos , Doenças do Gato/epidemiologia , Doenças do Gato/parasitologia , Doenças do Gato/microbiologia , Masculino , Feminino , Toxoplasma/imunologia , Toxoplasma/isolamento & purificação , Bartonella henselae/imunologia , Bartonella henselae/isolamento & purificação , Toxoplasmose Animal/epidemiologia , Zoonoses/epidemiologia , Zoonoses/parasitologia , Anticorpos Antiprotozoários/sangue , Leishmania infantum/imunologia , Leishmania infantum/isolamento & purificação , Rickettsia typhi/isolamento & purificação , Rickettsia typhi/imunologia , Anticorpos Antibacterianos/sangue , Rickettsia felis/isolamento & purificação , HumanosRESUMO
The transversus thoracis plane (TTP) block desensitizes the intercostal nerves that run through this plane, providing analgesia to the ventral thoracic wall. Two canine cadavers were used to assess the feasibility of the transverse approach for the TTP (t-TTP) under ultrasound guidance to inject a solution at the third and sixth intercostal spaces. Eight cadavers were used to compare the spread and number of intercostal nerves that were stained when a low volume (LV) 0.5 mL kg-1 or a high volume (HV) 1 mL kg-1 of a dye-lidocaine solution was injected into the same hemithorax, injecting the volume equally at these intercostal spaces using the transverse approach. Fisher's exact test and Wilcoxon signed-rank test were used to contrast the spread of the different volume solutions. The injectate spread along the TTP after all injections, dying a median number (range) of 3 (2-5) and 6 (5-6) nerves with LV and HV, respectively (p = 0.011). The two-point injection of HV, using the t-TTP approach, is a feasible technique that provides a consistent staining from T2 to T7 intercostal nerves. The injection of HV instead of LV increases the spread and enhances the number of stained intercostal nerves.
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Background: There are different indications for endovascular surgery in horses, mainly the treatment of guttural pouch mycosis. Traditionally, these procedures are carried out by open arteriotomy of the common carotid artery (CCA), although less invasive percutaneous ultrasound-guided carotid access (PUGCA) has been described in experimental horses. In human medicine, commercial closure systems are used to seal these arterial puncture sites and reduce complications. The aims of this study are to retrospectively describe our experience with PUGCA in clinical cases and to report, for the first time, the use of the commercial vascular closure device Angio-Seal after PUGCA in horses. Methods: Retrospective study of clinical case records. Collected parameters, including the feasibility of the PUGCA and variables related to the safety and efficacy of the use of the Angio-Seal. Results: Twelve PUGCA procedures in 11 horses were included. In all cases, the artery was effectively accessed, and the planned procedure could be performed. In two cases, haematoma/bleeding due to incorrect use of the Angio-Seal was recorded. This complication rate (16.66%) was lower than that obtained in other studies using PUGCA in horses, but where the puncture was sealed by manual compression only. Main limitations: A control group of clinical cases with PUGCA but without using Angio-Seal is not available. Conclusions: Clinical data confirm previous experimental results, which showed that PUGCA is safe and effective in horses. The Angio-Seal system, regardless of possible complications due to incorrect use, can be used safely and effectively in horses. Further studies comparing arterial access site management using manual compression or Angio-Seal would be necessary to state if its routine use in horses is advisable.
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Nowadays, there is a great concern about the prevalence of multidrug resistant Enterococcus spp. and Enterobacteriaceae in food-producing animals. The aim of this work was to evaluate the effect of oxytetracycline or enrofloxacin treatment on vancomycin-resistant enterococci (VRE), extended spectrum ß-lactamase (ESBL) and carbapenemase-producing Enterobacteriaceae in pigs. A total of 26 piglets were received and distributed in three groups. Group 1 was treated with enrofloxacin (N = 12), group 2 with oxytetracycline (N = 10) and group 3 did not receive any treatment (control group) (N = 4). A higher number of vancomycin-resistant E. faecium were recovered compared to E. faecalis. In the pigs treated with enrofloxacin, vancomycin resistant E. faecium was found in a higher percentage of animals than in the control group. ESBL-producing E. coli was not detected in rectal samples from control animals. However, it was detected in 17-20% of animals treated with oxytetracycline on days 6 to 17 and in 17-50% of the animals treated with enrofloxacin. Carbapenemase-producing E. coli was isolated in animals treated with oxytetracycline, but not in animals treated with enrofloxacin or in the control group. This study highlights that the use of oxytetracycline or enrofloxacin in food-producing animals could select ESBL and carbapenemase-producing E. coli. Further studies shall be needed to validate the results obtained, considering a more robust and extended experimental design.
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PURPOSE: To verify the penetration of struts and hooks of two inferior vena cava (IVC) filters (Günther tulip retrievable filter [GTF] and Celect filter) through the vena cava wall and to assess local or systemic complications resulting from this penetration. MATERIALS AND METHODS: Eight IVC filters were placed in the IVC of four ewes for 30 days (1 GTF and 1 Celect filter in each ewe). Angiographic and laparoscopic examinations of the animals were performed to demonstrate the penetration through the vena cava wall, and the filters were removed under laparoscopic control. Specimens were extracted for anatomicopathological and histologic examination. RESULTS: Two-projection cavography showed a filter leg seemingly out of the vena cava in 19 of 32 legs (59.3%). Laparoscopy showed 7 real penetrating legs (5 Celect filters and 2 GTFs) out of the 14 legs that could be identified by laparoscopy owing to technique limitations. Neither laparoscopy nor necropsy showed any sign of wall hemorrhage or other injuries. Histologic examination showed intimal remodeling and slight thickening of adventitial tissue around filter legs. CONCLUSIONS: GTFs and Celect filters can produce a real penetration 1 month after implantation. This penetration did not lead to any complications in the IVC or surrounding tissues and did not compromise the subject's health in any of the studied cases.
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Laparoscopia , Lesões do Sistema Vascular/etiologia , Filtros de Veia Cava/efeitos adversos , Veia Cava Inferior/lesões , Animais , Feminino , Modelos Animais , Flebografia , Desenho de Prótese , Ovinos , Fatores de Tempo , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/patologia , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/patologiaRESUMO
PURPOSE: To describe the use of self-expandable metallic stents to manage malignant colorectal obstructions and to compare the radiation dose between fluoroscopic guidance of stent placement and combined endoscopic and fluoroscopic guidance. MATERIALS AND METHODS: From January 1998 to December 2007, 467 oncology patients undergoing colorectal stent placement in a single center were included in the study. Informed consent was obtained in all cases. All procedures were performed with fluoroscopic or combined fluoroscopic and endoscopic guidance. Inclusion criteria were total or partial colorectal obstruction of neoplastic origin. Exclusion criteria were life expectancy shorter than 1 month, suspicion of perforation, and/or severe colonic neoplastic bleeding. Procedure time and radiation dose were recorded, and technical and clinical success were evaluated. Follow-up was performed by clinical examination and simple abdominal radiographs at 1 day and at 1, 3, 6, and 12 months. RESULTS: Of 467 procedures, technical success was achieved in 432 (92.5%). Thirty-five treatments (7.5%) were technical failures, and the patients were advised to undergo surgery. Significant differences in radiation dose and clinical success were found between the fluoroscopy and combined-technique groups (P < .001). Total decompression was achieved in 372 cases, 29 patients showed remarkable improvement, 11 showed slight improvement, and 20 showed clinical failure. Complications were recorded in 89 patients (19%); the most significant were perforation (2.3%) and stent migration (6.9%). Mean interventional time and radiation dose were 67 minutes and 3,378 dGy·cm(2), respectively. CONCLUSIONS: Treatment of colonic obstruction with stents requires a long time in the interventional room and considerable radiation dose. Nevertheless, the clinical benefits and improvement in quality of life justify the radiation risk.
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Doenças do Colo/terapia , Neoplasias Colorretais/complicações , Obstrução Intestinal/terapia , Stents , Adulto , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Doenças do Colo/diagnóstico por imagem , Doenças do Colo/etiologia , Colonoscopia , Neoplasias Colorretais/diagnóstico por imagem , Feminino , Fluoroscopia , Humanos , Obstrução Intestinal/diagnóstico por imagem , Obstrução Intestinal/etiologia , Estimativa de Kaplan-Meier , Masculino , Metais , Pessoa de Meia-Idade , Cuidados Paliativos , Desenho de Prótese , Doses de Radiação , Radiografia Intervencionista , Estudos Retrospectivos , Espanha , Stents/efeitos adversos , Fatores de Tempo , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Transversus thoracis plane (TTP) block has demonstrated to produce analgesia in humans undergoing median sternotomy. The objectives of the study were to describe an ultrasound-guided transverse approach to the transversus thoracis plane (t-TTP) and to evaluate the spread of two injectable volumes in canine cadavers. Two cadavers were used to describe relevant gross anatomy of the ventral thoracic area and sonoanatomy between the fifth and sixth costal cartilages. Then, eight cadavers were used to describe the ultrasound-guided injection into the TTP and were dissected to evaluate the injectate spread and the intercostal nerves staining with two different dye-lidocaine volumes: low volume (LV) 0.5 mL kg-1 and high volume (HV) 1 mL kg-1. To compare the spread between both volumes the Fisher's exact test and Wilcoxon signed-rank test were used. The solution spread along the TTP after all injections, staining a median number (range) of 3 (2-4) and 4 (3-5) nerves with LV and HV, respectively (p = 0.014). The injection of HV versus LV increases the number of stained nerves. Ultrasound-guided t-TTP is a feasible technique that provides staining of several intercostal nerves with a single injection site, so it could be useful to provide analgesia to the ventral chest wall.
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Many of the infectious diseases that affect livestock have bacteria as etiological agents. Thus, therapy is based on antimicrobials that leave the animal's tissues mainly via urine, reaching the environment through slurry and waste water. Once there, antimicrobial residues may lead to antibacterial resistance as well as toxicity for plants, animals, or humans. Hence, the objective was to describe the rate of antimicrobial excretion in urine in order to select the most appropriate molecule while reducing harmful effects. Thus, 62 pigs were treated with sulfamethoxypyridazine, oxytetracycline, and enrofloxacin. Urine was collected through the withdrawal period and analysed via LC-MS/MS. Oxytetracycline had the slowest rate of degradation (a half-life time of 4.18 days) and the most extended elimination period in urine (over 2 months), followed by enrofloxacin (a half-life time of 1.48 days, total urine elimination in ca. 3 weeks) and sulfamethoxypyridazine (a half-life time of 0.49 days, total urine elimination in ca. 1 week). Bacterial sensitivity and recommendations for responsible use are limiting when selecting the treatment. Nevertheless, with similar effectiveness, sulfamethoxypyridazine would be the choice, as waste treatment would only need to be implemented for 1 week after treatment. Thus, more in-depth knowledge regarding antibacterial elimination would improve resource management, while protecting animals and consumers' health.
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The introduction of antimicrobial residues in the food chain has a significant impact on human health. An innovative solution to avoid their presence in meat is the adaptation of current control methods for use with in vivo matrixes. Thus, the aim was to obtain paired blood and muscle samples from pigs treated with some of the main antimicrobials currently used in veterinary medicine (oxytetracycline, sulfamethoxypyridazine, enrofloxacin, amoxicillin), and to compare their rate of depletion in both matrixes. Antimicrobial concentrations in paired samples of blood and muscle were determined by liquid chromatography with tandem mass spectrometry (LC-MS/MS) or high performance liquid chromatography with fluorescence detection (HPLC-FLD). A comparison between values obtained in muscle and blood showed a similar distribution in both matrixes for oxytetracycline; for sulfamethoxypyridazine, a similar decrease rate but a concentration three times higher in blood compared to muscle was found; for enrofloxacin, we found significant differences in the rate of depletion, with similar antimicrobial concentrations in both matrixes with values close to the maximum residue limit (MRL) and higher amounts in muscle for values that lay considerably over the MRL. Conversely, amoxicillin depletion was so rapid that its appearance in carcasses does not seem to pose a risk. Therefore, blood would be a feasible matrix for the development of new in vivo tests.
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OBJECTIVE: Although surgical pulmonary thromboendarterectomy is the treatment of choice for pulmonary hypertension due to chronic thrombotic and/or embolic disease, minimally invasive endovascular techniques such as angioplasty or placement of a metallic stent can provide acceptable results when surgery is not indicated or has been refused by the patient. PATIENTS AND METHODS: Eight patients (5 men, 3 women; mean age, 62.6 years) were treated. The patients were in New York Heart Association (NYHA) class III or IV and had a mean pulmonary artery pressure of 40 mm Hg and more, a capillary wedge pressure of 15 mm Hg or less, or a Miller index greater than 0.5. In all cases, diagnosis was based on Doppler echocardiography, pulmonary angiography, hemodynamic evaluation, and ventilation-perfusion scintigraphy. All patients received fibrinolytic therapy and underwent angioplasty. A metallic stent was implanted in 3 patients. Follow-up echocardiographic assessment and ventilation-perfusion scans were scheduled at 1, 3, 6, and 12 months. RESULTS: The procedures were technically successful in all cases. The mean follow-up period was 18.7 months. Minor complications were extrasystoles (3 cases), slight bruising at the site of puncture (1 case), and rectal bleeding that resolved without treatment (1 case). One patient died from an unknown cause 24 hours after the procedure. In all other cases, improvements were noted in NYHA functional class, in hemodynamics demonstrated by echocardiography, and in vascular structure as shown by arteriography and scintigraphy. CONCLUSIONS: Minimally invasive endovascular interventions can help improve pulmonary arterial hypertension due to chronic thrombotic and/or embolic disease in patients for whom medical or surgical treatment is not possible.
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Angioplastia , Hipertensão Pulmonar/etiologia , Hipertensão Pulmonar/cirurgia , Embolia Pulmonar/complicações , Stents , Idoso , Diagnóstico por Imagem , Feminino , Humanos , Hipertensão Pulmonar/diagnóstico , Masculino , Pessoa de Meia-Idade , Estudos ProspectivosRESUMO
OBJECTIVE: To study the feasibility and safety of removing retrievable Günther-Tulip vena cava filters (GTFs) 90 days after their implantation in an ovine model. MATERIAL AND METHODS: Thirty GTFs were implanted in 30 ewes and retrieval was attempted at 90 days. Conventional cavography was performed in all cases before and after retrieval in order to evaluate inferior vena cava patency and record dimensions. The presence of complications related to placement and retrieval of the filter from the inferior vena cava was also recorded. The force required to remove the filters was measured using a modified commercial dynamometer adapted to the GTF retrieval set. Histologic study focused on the inferior vena cava wall. RESULTS: Implantation was performed successfully in all cases (100%). One ewe developed a small focus of thrombosis around 1 of the legs of the filter and another presented a small thrombus within the filter. Retrieval of the filter was attempted in all 30 sheep at 90 days and the result was satisfactory in all but 1 case (96.6%). None of the GTFs required a force greater than 12 N to disengage the hooks of the filter from the wall. No complications were detected on venacavography or at autopsy. Variable degrees of fibrosis were observed in the histologic study. CONCLUSIONS: Retrieval of GTFs 90 days after implantation in an ovine model was feasible, safe, and easy, and required little force (median, 4.2 N).
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Remoção de Dispositivo , Filtros de Veia Cava , Animais , Estudos de Viabilidade , Feminino , Fibrose , Implantes Experimentais , Período Pós-Operatório , Estudos Prospectivos , Radiografia , Ovinos , Estresse Mecânico , Trombose/etiologia , Fatores de Tempo , Grau de Desobstrução Vascular , Filtros de Veia Cava/efeitos adversos , Veia Cava Inferior/diagnóstico por imagem , Veia Cava Inferior/patologia , Veia Cava Inferior/cirurgiaRESUMO
The objective of this work was to present our experience in arterial embolization in the endovascular treatment of massive hemoptysis and remark on the importance of the workup before embolization. We present some clinical aspects to keep in mind before carrying out a bronchial embolization in a patient with severe hemoptysis. The main causes of hemoptysis are presented, as well as diagnosis means and the most important therapeutic procedures aimed to stabilize the patient who will undergo a bronchial arterial embolization. Likewise, we present our own experience with 401 patients with over a 15-year period of follow-up.
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Artérias Brônquicas , Embolização Terapêutica , Hemoptise/terapia , Artérias Brônquicas/diagnóstico por imagem , Hemoptise/etiologia , Humanos , Artéria Pulmonar , RadiografiaRESUMO
PURPOSE: We analyzed the scientific production of members of the Spanish Society of Vascular and Interventional Radiology (SERVEI) from 2010 to 2015. MATERIALS AND METHODS: We retrospectively analyzed the indexed scientific productivity of all SERVEI members for the last 6 years as measured by bibliometric indexes. Different databases were used (e.g., PubMed, Scopus, Web of Knowledge) to retrieve the total number of publications, number of citations, and h-index. Every article was assigned the impact factor of its publication year and its corresponding quartile according to Journal Citation Reports. The relationships between all of these parameters and the Spanish region, the gender and age of the interventional radiologists (IRs), and their connection to the university environment were also studied. RESULTS: A total of 519 scientific articles from 247 SERVEI members working in 118 Spanish hospitals were included, an average of 0.3 articles per interventionist/year. Most of the manuscripts were published in impact journals (52.2%) and placed in the lowest quartile (Q4). Navarre, Aragon, and Catalonia were the regions with the highest publication rate during the period studied (1.7, 0.92, and 0.6 publications per interventionist/year, respectively). Only 57 articles (12.6%) were published in 11 of the 125 journals under the category of Radiology, Nuclear Medicine, and Medical Imaging according to JCR. CONCLUSIONS: The scientific production of the Spanish IRs in the last 6 years is difficult to interpret. However, more than 50% of IRs published one article in the last 6 years. Finally, it would be advisable to repeat this study over a period of time in order to compare.
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Bibliometria , Publicações Periódicas como Assunto , Editoração , Radiologia Intervencionista , Sociedades Médicas , Bases de Dados Factuais , Humanos , Fator de Impacto de Revistas , Estudos Retrospectivos , EspanhaRESUMO
INTRODUCTION: The objective of this study was to assess tracheal reactivity after the deployment of different self-expandable metal stents (SEMS). MATERIAL AND METHODS: Forty female New Zealand rabbits were divided into four groups. Three groups received three different SEMS: steel (ST), nitinol (NiTi), or nitinol drug-eluting stent (DES); the fourth group was the control group (no stent). Stents were deployed percutaneously under fluoroscopic guidance. Animals were assessed by multi-slice, computed tomography (CT) scans, and tracheas were collected for anatomical pathology (AP) study. Data from CT and AP were statistically analyzed and correlated. RESULTS: The DES group had the longest stenosis (20.51±14.08mm vs. 5.84±12.43 and 6.57±6.54mm in NiTi and ST, respectively, day 30; P<.05), and higher granuloma formation on CT (50% of cases). The NiTi group showed the lowest grade of stenosis (2.86±6.91% vs. 11.28±13.98 and 15.54±25.95% in DES and ST, respectively; P<.05). The AP study revealed that the ST group developed intense proliferative reactivity compared to the other groups. In the DES group, a destructive response was observed in 70% of the animals, while the NiTi was the least reactive stent. CT was more effective in detecting wall thickening (positive correlation of 68.9%; P<.001) than granuloma (not significant). CONCLUSIONS: The ST group developed granulomas and significant stenosis. NiTi was the least reactive stent, while DES caused significant lesions that may be related to drug dosage. This type of DES stent is therefore not recommended for the treatment of tracheobronchial stenosis.