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1.
Ultrasound Q ; 2023 Nov 01.
Article in English | MEDLINE | ID: mdl-37918108

ABSTRACT

OBJECTIVES: Sonoporation as a method of intracellular drug and gene delivery has not yet progressed to being used in vivo. The aim of this study was to prove the feasibility of sonoporation at a level practical for use in vivo by using a large amount of carbon dioxide micro-nano bubbles. METHODS: The carbon dioxide micro-nano bubbles and 100 mg of cisplatin were intra-arterially injected to the swine livers, and ultrasound irradiation was performed from the surface of the liver under laparotomy during the intra-arterial injection. After the intra-arterial injection, ultrasound-irradiated and nonirradiated liver tissues were immediately excised. Tissue platinum concentration was measured using inductively coupled plasma mass spectrometry. Liver tissue platinum concentrations were compared between the irradiated tissue and nonirradiated tissue using the Wilcoxon signed rank test. RESULTS: The mean (SD) liver tissue platinum concentration was 6.260*103 (2.070) ng/g in the irradiated liver tissue and 3.280*103 (0.430) ng/g in the nonirradiated liver tissue, showing significantly higher concentrations in the irradiated tissue (P = 0.004). CONCLUSIONS: In conclusion, increasing the tissue concentration of administered cisplatin in the livers of living swine through the effect of sonoporation was possible in the presence of a large amount of micro-nano bubbles.

2.
Radiol Case Rep ; 18(11): 3904-3907, 2023 Nov.
Article in English | MEDLINE | ID: mdl-37670924

ABSTRACT

The patient was a 52-year-old woman. She had a history of left breast cancer at age 32 years, with no recurrences. She was examined for a feeling of oral dryness and nocturia, and central diabetes insipidus was diagnosed. A mass was seen in the posterior pituitary on magnetic resonance imaging, and multiple pulmonary nodules were seen on computed tomography. Breast cancer metastases were diagnosed in both tissues. Since this patient had no cancer other than the breast cancer treated 20 years earlier, it was difficult to reach a diagnosis of pituitary metastasis with pituitary gland imaging alone. In estrogen receptor-positive breast cancer, there may be recurrences after a long period of time. It may be that recommending a full body examination could be useful in the differential diagnosis of metastasis even in patients who have had a long disease-free period, if they had undergone surgery for breast cancer.

3.
Interv Radiol (Higashimatsuyama) ; 7(2): 81-84, 2022 Jul 01.
Article in English | MEDLINE | ID: mdl-36196382

ABSTRACT

We treated a 64-year-old man who had an inferior mesenteric arteriovenous malformation with multiple shunts. As multiple varicosities in the draining vein became enlarged, two dilated shunts on the superior rectal and sigmoid colon arteries were coil embolized. Two days after embolization, a varicosity near the shunt (65 mm diameter) ruptured, causing intra-abdominal hemorrhage and surgical hemostasis. There were thrombi in the ruptured varicosity and its draining vein. The likely cause was a pressure increase in the incompletely thrombosed varicosity due to shunt blood flow from the remaining shunts after embolization.

4.
Interv Radiol (Higashimatsuyama) ; 7(2): 49-53, 2022 Jul 01.
Article in English | MEDLINE | ID: mdl-36196383

ABSTRACT

Computed tomography (CT) fluoroscopy-guided procedures, such as those used for percutaneous biopsy, drainage, and radiofrequency ablation, are highly safe and quite often very successful due to the precision offered by the real-time, high-resolution tomographic images. Even so, international guidelines raised concerns regarding operator exposure to high doses of radiation during these procedures. In light of these concerns, operators conducting CT fluoroscopy-guided procedures not only need to be cognizant of the exposure risk but also exhibit sufficient knowledge of radiation protection. This paper reviews the current literature on experimental and clinical studies of radiation exposure doses to operators during CT fluoroscopy-guided procedures. In addition to the literature review, this paper also introduces different approaches that can be implemented to ensure appropriate radiation protection.

5.
Interv Radiol (Higashimatsuyama) ; 7(2): 58-62, 2022 Jul 01.
Article in English | MEDLINE | ID: mdl-36196384

ABSTRACT

An 81-year-old man with previously diagnosed cancer of the pancreatic body presented with melena and anemia. Upper gastrointestinal endoscopy showed gastric varices with bleeding in the entire stomach. Contrast-enhanced computed tomography identified a splenic vein occlusion resulting from invasion by the pancreatic body cancer and dilated collateral pathways from the splenic hilum to the gastric fundus. The patient was diagnosed with gastric varices associated with left-sided portal hypertension caused by obstruction of the splenic vein and underwent percutaneous transsplenic embolization with n-butyl-2-cyanoacrylate mixed with lipiodol. Splenic subcapsular hematoma occurred and was treated conservatively. The patient died of advanced cancer 5 months after the procedure, without experiencing rebleeding. Percutaneous transsplenic embolization was effective in treating gastric variceal bleeding caused by left-sided portal hypertension.

6.
Interv Radiol (Higashimatsuyama) ; 7(1): 34-36, 2022 Mar 01.
Article in English | MEDLINE | ID: mdl-35911875

ABSTRACT

An 80-year-old woman who underwent subtotal esophagectomy with gastric tube reconstruction for esophageal cancer developed carcinoma of the left upper gingiva. The local recurrence of the gingival carcinoma resulted in trismus and prevented oral intake. Then she underwent a percutaneous transesophageal jejunostomy tube placement in the preserved cervical esophagus. Enteral feeding continued for three months with no complications until oral intake was possible. A percutaneous transesophageal jejunostomy is possible using the postoperatively preserved cervical esophagus.

7.
Anim Sci J ; 93(1): e13726, 2022.
Article in English | MEDLINE | ID: mdl-35470929

ABSTRACT

In this study, we evaluated the partial replacement of roughage with wood kraft pulp (KP) on rumen fermentation and productivity of dairy cows. Eighteen cows were divided into control and KP groups. The KP group started adaptation to KP 3 weeks before calving; after calving, they were fed a total mixed ration for 12 weeks, wherein 18% Timothy hay was replaced with KP. The dry matter intake, body weight, and milk yield and composition were similar in the control and KP groups. The average daily rumen pH was higher with KP feeding, and the average daily ruminal temperature remained lower at 16 days after calving (P < 0.05). The concentration of volatile fatty acids remained unaltered, the molar proportion of acetic acid decreased, and the molar proportion of propionic acid increased, indicating a low acetic acid:propionic acid ratio (P < 0.05). Lipopolysaccharide activity in the rumen fluid was higher in the KP group (P < 0.05); however, the rumen microbiota were unaffected. The digestibility of dry matter and neutral detergent fiber increased 12 weeks after calving, whereas excretion of urinary nitrogen decreased (P < 0.05). Partial replacement of roughage with KP did not suppress rumen fermentation and maintained postpartum productivity.


Subject(s)
Dietary Fiber , Rumen , Animals , Cattle , Diet/veterinary , Dietary Fiber/analysis , Digestion , Fatty Acids, Volatile/metabolism , Female , Fermentation , Lactation , Milk/chemistry , Propionates/metabolism , Rumen/metabolism , Wood
8.
J Vasc Access ; 23(1): 117-122, 2022 Jan.
Article in English | MEDLINE | ID: mdl-33356882

ABSTRACT

BACKGROUND AND OBJECTIVES: The blood compatibility of indwelling intravascular catheters is facilitated by the use of antithrombogenic materials. Heparin has typically been used for this purpose; however, since heparin-coated catheters are considered combination products, difficulties meeting the relevant Food and Drug Administration safety recommendations have disrupted commercialization. Other issues include coating durability and the occurrence of heparin-induced thrombocytopenia. Polymer coatings are a potential alternative; however, polymer antithrombogenicity in circulating human blood has yet to be demonstrated. The present study aimed to establish the ex vivo antithrombogenicity of a poly-2-methoxyethylacrylate (PMEA) polymer coating applied to a central venous catheter using an artificial human blood circulation system. METHODS: The present study used an artificial human blood circulation system to conduct an ex vivo evaluation of the antithrombogenicity of poly-2-methoxyethylacrylate (PMEA)-coated catheters. Human blood samples obtained from volunteer donors were loaded into a circulation system fitted with either a PMEA-coated or uncoated catheter. After 3-h, the catheter was removed and examined using scanning electron microscopy. Protein adsorption on the catheter surface was investigated by shredding the catheter that had contacted the blood inside the circulation system and immersing the pieces in 1 mL of 0.5 N NaOH for 2 days. The amount of protein in the 0.5 N NaOH was determined according to the Lowry method. RESULTS: Adherent fibrin, which forms a sheath on the catheter surface, was observed on uncoated, but not PMEA-coated catheters. Furthermore, the amount of protein adsorption was significantly less with PMEA-coated than uncoated catheters (p = 0.043). CONCLUSIONS: The present findings demonstrated the antithrombogenicity of PMEA-coated catheters in circulating human blood.


Subject(s)
Central Venous Catheters , Coated Materials, Biocompatible , Catheterization , Catheters, Indwelling , Heparin , Humans , Polymers/pharmacology
9.
Medicine (Baltimore) ; 100(51): e28340, 2021 Dec 23.
Article in English | MEDLINE | ID: mdl-34941138

ABSTRACT

RATIONALE: Patients with congenital pulmonary varix are asymptomatic and require no treatment, but the radiological characteristics of a pulmonary varix are similar to those of a pulmonary arteriovenous malformation, which requires treatment. Pulmonary angiography is useful for obtaining information about the dynamics of pulmonary blood flow to differentiate a pulmonary varix from a pulmonary arteriovenous malformation for the purpose of treatment planning. Two cases of congenital pulmonary varices that were differentiated from pulmonary arteriovenous malformations based on pulmonary angiography findings are presented. PATIENT CONCERNS AND DIAGNOSIS: The first patient was an asymptomatic 39-year-old man. Non-contrast-enhanced computed tomography performed as part of the treatment course for pneumonia showed pulmonary arteriovenous malformation in the right lung. Pulmonary angiography was performed and showed that it was a pulmonary varix. The second patient was an asymptomatic 23-year-old woman. As part of her regular health check-up, she underwent plain chest X-ray examination, which showed an abnormal shadow. Non-contrast-enhanced computed tomography was performed, and pulmonary arteriovenous malformation was suspected. However, contrast-enhanced computed tomography findings suggested that the patient had a congenital pulmonary varix rather than a pulmonary arteriovenous malformation. Pulmonary angiography was subsequently performed for diagnosis, and a pulmonary varix was confirmed. INTERVENTIONS AND OUTCOMES: No treatment was administered to either patient. The first patient was followed up for four years, and the second patient for two years. Both patients had no symptoms or complications during the follow-up period. LESSONS: Two cases of congenital pulmonary varices were reported. Information about the dynamics of pulmonary blood flow obtained by performing pulmonary angiography was effective in distinguishing between pulmonary arteriovenous malformation and congenital pulmonary varix.


Subject(s)
Angiography/methods , Arteriovenous Malformations/diagnostic imaging , Pulmonary Veins/diagnostic imaging , Varicose Veins/diagnostic imaging , Adult , Arteriovenous Fistula , Female , Humans , Lung/diagnostic imaging , Male , Pulmonary Artery/abnormalities , Pulmonary Veins/abnormalities , Young Adult
10.
Drug Discov Ther ; 15(3): 169-170, 2021.
Article in English | MEDLINE | ID: mdl-34234068

ABSTRACT

The principal concept of the percutaneous tandem drainage procedure for an intractable hepaticojejunostomy (HJ) leakage is to decrease the amount of fluid and divide the fluid-filled cavity into several small cavities, which can then be drained individually. Percutaneous abscess drainage (PAD) has a role in drainage of the fluid cavity, whereas percutaneous trans-anastomotic jejunum drainage (PTAJD) has a role in drainage to reduce the bile fluid and digestive juices. A decrease in fluid induces effective drainage of the fluid cavity by PAD. A negative pressure suction drain accelerates reduction of the fluid cavity. PAD is removed when the localized fluid cavity has collapsed. PTAJD is finally removed after a clamping test is performed. Since 2020, we performed the percutaneous tandem drainage for two patients, and an intractable HJ leakage was gently resolved within 3 months without any adverse event. The percutaneous tandem drainage technique is safe for steady drain management of an intractable HJ leakage.


Subject(s)
Drainage/methods , Hepatectomy/adverse effects , Jejunostomy/adverse effects , Postoperative Complications/therapy , Digestive System Diseases/surgery , Humans
11.
BMC Gastroenterol ; 21(1): 241, 2021 May 27.
Article in English | MEDLINE | ID: mdl-34044783

ABSTRACT

BACKGROUND: A chronic expanding hematoma (CEH) enlarges as a result of slight bleeding over several months, and the tissue shows a mixture of blood breakdown products, granulation tissue with capillary ingrowth, and inflammatory tissue. This report presents a case of a subcapsular hepatic CEH that was treated with transarterial embolization (TAE) and hepatectomy. CASE PRESENTATION: A 56-year-old man presented with vomiting and right-sided abdominal pain. Plain abdominal computed tomography (CT) showed a high-density area of fluid collection beneath the capsule of the right hepatic lobe, which was diagnosed as a hematoma. From its anatomical position on the CT images, a subcapsular hepatic hematoma was diagnosed. Though conservative therapy was provided, CT-guided percutaneous drainage and TAE were performed due to worsening symptom. Because the patient's abdominal symptoms re-appeared, extended right segmentectomy including the hematoma was performed. In the resected specimen, the hematoma was located beneath the capsule of the right hepatic lobe, and it was displacing the hepatic parenchyma. Microscopic examination showed a thick fibrous capsule around the hematoma, peripheral lymphocyte and plasmacyte invasion, and aggregations of histiocytes containing phagocytosed hemosiderin. CONCLUSIONS: Anatomically, this was a case of a subcapsular hepatic hematoma, and pathologically it was shown to be a CEH. Complete surgical resection was effective treatment for this CEH.


Subject(s)
Liver Diseases , Drainage , Hematoma/diagnostic imaging , Hematoma/etiology , Humans , Liver Diseases/diagnostic imaging , Male , Middle Aged , Tomography, X-Ray Computed
12.
Article in English | MEDLINE | ID: mdl-33108016

ABSTRACT

AIM: The pathology of post-partum hemorrhage (PPH) differs depending on its cause, background and timing of bleeding, and the effectiveness of transarterial embolization (TAE) is thought to vary based on these characteristics. The aim of this study is to evaluate the treatment outcomes of TAE for PPH. METHODS: Technical success, initial clinical success (hemostasis without repeat TAE or surgical treatment after initial TAE) and final clinical success (hemostasis with or without repeat TAE, but without surgical treatment) were assessed in 62 Japanese patients. Factors affecting final clinical success were analyzed using univariate analysis. Values of P < 0.05 were considered statistically significant. Further, the clinical course and factors associated with rebleeding, return of menstruation and fertility, and complications of TAE were assessed. RESULTS: Final clinical success rate was significantly lower in cases with obstetrical disseminated intravascular coagulation (DIC) or the International Society on Thrombosis and Hemostasis (ISTH) DIC (P = 0.01, 0.03). Rebleeding (n = 9, 14.5%) was more common in patients with retained products of conception (RPOC) (P = 0.006). On long-term follow-up in 23 patients, return of menstruation was confirmed in 17 (73.9%) of these patients. Subsequent pregnancy was confirmed in seven patients (30.4%). TAE-related complications were seen in 6 patients (9.0%). There were no maternal deaths. CONCLUSIONS: Obstetrical and ISTH DIC reduced the success rate of TAE for PPH (P = 0.01, 0.03). Rebleeding, which is observed significantly more frequently in PPH caused by RPOC (P = 0.006), can be effectively treated by repeat TAE.

13.
Micromachines (Basel) ; 11(9)2020 Sep 10.
Article in English | MEDLINE | ID: mdl-32927718

ABSTRACT

This study introduces a modeling method for a supermolecular structure of microtubules for the development of a force generation material using motor proteins. 3D imaging by confocal laser scanning microscopy (CLSM) was used to obtain 3D volume density data. The density data were then interpreted by a set of cylinders with the general-purpose 3D modeling software Blender, and a 3D network structure of microtubules was constructed. Although motor proteins were not visualized experimentally, they were introduced into the model to simulate pulling of the microtubules toward each other to yield shrinking of the network, resulting in contraction of the artificial muscle. From the successful force generation simulation of the obtained model structure of artificial muscle, the modeling method introduced here could be useful in various studies for potential improvements of this contractile molecular system.

14.
Cardiovasc Intervent Radiol ; 43(5): 775-780, 2020 May.
Article in English | MEDLINE | ID: mdl-32055927

ABSTRACT

PURPOSE: The purpose of this study was to evaluate the antithrombogenic effects of poly-2-methoxyethylacrylate (PMEA) coating applied to the internal surfaces of the port-catheter system to prevent thrombotic occlusion. MATERIALS AND METHODS: PMEA coating was applied to the inner surfaces of the entire system, including the chamber, catheter, and connecting stem. PMEA-coated and uncoated port-catheter systems were each filled with fresh human blood for 1 or 3 h and then flushed with saline. Volumes of residual thrombi in the system and protein in the catheter were then compared. RESULTS: Saline flushing of the PMEA-coated port-catheter system expelled all visually recognizable thrombi, leaving no unremovable adhesions. In contrast, the uncoated port showed thrombi adherent to the inner surfaces and incomplete expulsion with flushing. Mean (± standard deviation) residual thrombus mass was significantly lower in PMEA-coated port-catheter systems (20.5 ± 6.2 mg) than in uncoated systems (230.3 ± 92.5 mg; p < 0.01). Mean residual protein was likewise significantly lower in PMEA-coated systems (20.5 ± 6.2 mg) than in uncoated systems (230.3 ± 92.5 mg; p < 0.01). CONCLUSIONS: PMEA coating on a central venous port-catheter system decreased accumulation and facilitated flushing of thrombi from the system by flushing, as compared with the uncoated system. PMEA-coated central venous port-catheter systems appear relatively antithrombotic compared to uncoated systems.


Subject(s)
Acrylates , Catheterization, Central Venous/methods , Central Venous Catheters , Coated Materials, Biocompatible , Polymers , Thrombosis/prevention & control , Adult , Female , Humans , Male , Middle Aged
15.
Interv Radiol (Higashimatsuyama) ; 5(1): 10-13, 2020 Feb 28.
Article in English | MEDLINE | ID: mdl-36284836

ABSTRACT

This case report describes a 72-year-old man who developed an intra-abdominal abscess and major postoperative anastomotic leakage. He reported a history of pancreaticoduodenectomy, partial hepatectomy, and segmental colectomy for hepatic and colonic invasion of extrahepatic cholangiocarcinoma. Three catheters, (one in the transverse colon and two in the abscess cavity) were placed simultaneously through the drainage tract formed by the intraoperatively placed Pleats drain. The intra-abdominal abscess resolved following this intervention and has not recurred since. Postoperative drainage and starvation were continued for 52 and 84 days, respectively. This case report describes a novel technique of catheter insertion from the abscess cavity into the intestine through the site of rupture to reduce intestinal pressure and partially block the enteric fistula.

16.
Jpn J Radiol ; 38(3): 248-255, 2020 Mar.
Article in English | MEDLINE | ID: mdl-31834578

ABSTRACT

PURPOSE: This study evaluated the results of provocative angiography performed to identify the site of hemorrhage in lower gastrointestinal bleeding to enable transcatheter arterial embolization. MATERIALS AND METHODS: The subjects of this study were 11 patients with acute lower gastrointestinal bleeding who underwent provocative angiography, after contrast agent extravasation could not be identified during conventional angiography. One patient underwent provocative angiography twice, making 12 cases of provocative angiography that were analyzed in this study. Urokinase was used in all cases. Heparin was administered in 2 cases, nicardipine in 3 cases, and alprostadil and isosorbide in 1 case each. RESULTS: Contrast agent extravasation as a result of provocative angiography was observed in 6/12 cases (50%). Selective transcatheter arterial embolization was performed in all 6 cases in which extravasation was apparent, and it was technically successful in all six. Clinical success was achieved in 5 (83.3%) of the 6 cases in which technical success was achieved after provocative angiography. CONCLUSION: Provocative angiography enabled the site of lower gastrointestinal bleeding to be identified in 6 of 12 cases (50.0%) when it could not be identified by conventional angiography, and in all 6 cases hemostasis was effectively achieved by embolization.


Subject(s)
Angiography/methods , Embolization, Therapeutic/methods , Gastrointestinal Hemorrhage/diagnostic imaging , Gastrointestinal Hemorrhage/therapy , Urokinase-Type Plasminogen Activator/administration & dosage , Aged , Aged, 80 and over , Extravasation of Diagnostic and Therapeutic Materials/complications , Extravasation of Diagnostic and Therapeutic Materials/diagnostic imaging , Extravasation of Diagnostic and Therapeutic Materials/therapy , Female , Gastrointestinal Hemorrhage/complications , Gastrointestinal Tract/diagnostic imaging , Humans , Male , Middle Aged , Retrospective Studies
17.
Cardiovasc Intervent Radiol ; 42(5): 779-783, 2019 May.
Article in English | MEDLINE | ID: mdl-30617452

ABSTRACT

A patient developed abdominal distension, dyspnea, and nausea due to chylothorax and chylous ascites 1 month after bruising her back. Lymphangiography was unable to identify the site of lymph leakage, and lymphatic duct embolization was impractical. However, lymphangiography showed occlusion of the thoracic duct. Thus, balloon plasty was performed to restore the patency of the thoracic duct, and the chylothorax and chylous ascites improved. Although embolization of the thoracic or lymphatic ducts has been reported as a treatment for lymphorrhea, it is impractical if the lymphatic duct responsible for leakage cannot be identified. In such a case, balloon plasty of the occluded thoracic duct to lower the pressure in the peripheral lymphatic ducts was successfully performed.


Subject(s)
Angioplasty, Balloon/methods , Chylothorax/complications , Chylous Ascites/complications , Thoracic Duct/pathology , Chylothorax/diagnostic imaging , Chylothorax/therapy , Chylous Ascites/diagnostic imaging , Chylous Ascites/therapy , Female , Humans , Lymphography , Thoracic Duct/diagnostic imaging , Treatment Outcome
18.
Oral Radiol ; 35(3): 321-325, 2019 09.
Article in English | MEDLINE | ID: mdl-30484211

ABSTRACT

The pterygopalatine fossa is a small area between the posterior wall of the maxillary sinus and the anterior surface of the pterygoid process of the sphenoid bone. The pterygopalatine fossa can be seen clearly on panoramic imaging. We present the case of a 57-year-old man who exhibited right pterygopalatine fossa expansion on panoramic imaging. Computed tomography (CT), magnetic resonance imaging (MRI), and panoramic imaging all showed a tumor at the right pterygopalatine fossa in this patient. CT indicated that the tumor replaced right retromaxillary fat and displaced the posterior wall of the maxillary sinus. On MRI, the tumor showed intermediate signal intensity at the paranasal area on T1-weighted images, and variable intermediate and high signal intensities on fat-suppressed T2-weighted images. It was eventually diagnosed as a schwannoma. Thus, panoramic imaging can be used for disease screening at the posterior border of the maxilla. Our conclusion is based on this report of a patient with a schwannoma at the posterior wall of the maxillary sinus, which panoramic imaging revealed to have pterygopalatine fossa expansion.


Subject(s)
Neurilemmoma , Pterygopalatine Fossa , Radiography, Panoramic , Humans , Male , Maxilla , Maxillary Sinus , Middle Aged , Neurilemmoma/diagnostic imaging , Pterygopalatine Fossa/diagnostic imaging , Sphenoid Bone
19.
Jpn J Radiol ; 36(7): 450-455, 2018 Jul.
Article in English | MEDLINE | ID: mdl-29744732

ABSTRACT

PURPOSE: To evaluate the clinical results of central venous access port (CV port) placement by translumbar inferior vena cava cannulation using angio-CT unit for cancer patients with superior vena cava syndrome. MATERIALS AND METHODS: A CV port was placed by translumbar inferior vena cava cannulation using an angio-CT unit, in 14 consecutive patients. All patients had occlusion or advanced stenosis of the superior vena cava due to cancer progression. RESULTS: The technical success rate of the percutaneous translumbar CV port placement was 100%. The only complication related to port placement was bleeding in the right iliopsoas muscle seen on CT in one patient, but it stopped with conservative treatment. The mean initial device service interval was 125 days (range 6-448 days). Complications in the chronic phase occurred in two patients, one with catheter-related infection and the other with catheter breakage, for a rate of 0.44/1000 catheter days. In the patient with the broken catheter, the port chamber placement site was cut and replaced with a new catheter by guidewire exchange. CONCLUSIONS: CV port placement with translumbar inferior vena cava cannulation using an angio-CT unit for cancer patients with superior vena cava syndrome was safe and effective.


Subject(s)
Catheterization, Central Venous/methods , Catheters, Indwelling , Neoplasms/complications , Superior Vena Cava Syndrome/complications , Tomography, X-Ray Computed/methods , Vena Cava, Inferior/diagnostic imaging , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged
20.
Cardiovasc Intervent Radiol ; 41(2): 317-322, 2018 Feb.
Article in English | MEDLINE | ID: mdl-29038875

ABSTRACT

PURPOSE: To report a sclerotherapy technique for rectal varices consisting of direct puncture of the superior rectal vein with a small-bore sheathed needle via the greater sciatic foramen without insertion of a sheath or catheter. MATERIALS AND METHODS: The subjects of this retrospective study were three consecutive patients who underwent embolization of rectal varices, two for rupture of rectal varices and one for hepatic encephalopathy and hyperammonemia. A 5% solution of ethanolamine oleate with iodinated contrast agent (5% EOI) was injected through puncture of the superior rectal vein and carried in the blood flow, after which n-butyl cyanoacrylate mixed with lipiodol (NBCA-Lip) was immediately injected to stop the blood flow. RESULTS: The 5% EOI and NBCA-Lip were successfully injected in all three patients. There was no movement of NBCA-Lip on plain radiographs or computed tomography (CT) immediately after injection, and the 5% EOI remained within the rectal varices. The mean procedure time was 53 min (42-60 min). On contrast-enhanced CT 1 month after the procedure, there was no contrast enhancement of the rectal varices that had been seen on preoperative CT in any of the three patients, confirming that the rectal varices had disappeared. CONCLUSION: Sclerotherapy for rectal varices using an approach for puncture of the superior rectal vein with a small-bore sheathed needle via the greater sciatic foramen was technically feasible and clinically effective.


Subject(s)
Esophageal and Gastric Varices/therapy , Oleic Acids/therapeutic use , Rectal Diseases/therapy , Sclerosing Solutions/therapeutic use , Sclerotherapy/methods , Aged , Contrast Media , Esophageal and Gastric Varices/diagnostic imaging , Female , Humans , Needles , Punctures , Radiography , Rectal Diseases/diagnostic imaging , Rectum/blood supply , Rectum/diagnostic imaging , Retrospective Studies , Sclerotherapy/instrumentation , Tomography, X-Ray Computed , Treatment Outcome
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