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2.
Eur J Radiol ; 120: 108644, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31539793

RESUMO

PURPOSE: Transverse sinus stenosis (TSS) is the most sensitive imaging characteristic of idiopathic intracranial hypertension (IIH). This study aimed to assess the diagnostic performance of contrast-enhanced magnetic resonance high-resolution variable flip angle turbo-spin-echo (T1 SPACE) technique in TSS patients and evaluate the diagnostic accuracy of enhanced T1 SPACE, and phase-contrast magnetic resonance venography (PC MRV) with digital subtraction angiography (DSA) as standard imaging. METHOD: This prospective study enrolled 62 patients with suspected IIH and PC MRV-confirmed transverse sinus stenosis. All patients underwent lumbar puncture, PC MRV, enhanced T1 SPACE sequences and DSA examination. The accuracy, sensitivity, and specificity of enhanced T1 SPACE in detecting venous sinus stenosis were calculated and compared with those of PC MRV. Intermodality agreement (Kendall's rank correlation coefficients and weighted kappa statistic) was assessed. RESULTS: Sixty-two patients were enrolled from November 2016 to October 2018. For the measured stenosis, better correlation was observed in enhanced T1 SPACE and DSA (AUC = 0.953) than PC MRV (AUC = 0.871). Intermodality agreement of enhanced T1 SPACE (rk = 0.895 and weighted ĸ = 0.868) was better than PC MRV (rk = 0.753 and weighted ĸ = 0.653) compared with DSA. Thirty-seven intrasinus filling defects were detected by contrast-enhanced T1 SPACE, while only twenty of them were detected on source imaging of PC MRV. CONCLUSIONS: The contrast-enhanced T1 SPACE sequence was more sensitive and specific compared with PC MRV in assessing stenosis and detecting lesions in TSS patients. Accurate determination of the presence and extent of TSS using this technique might be useful in patient selection and guiding the treatment.


Assuntos
Hipertensão Intracraniana/patologia , Seios Transversos/patologia , Adulto , Idoso , Angiografia Digital/métodos , Constrição Patológica/patologia , Feminino , Humanos , Angiografia por Ressonância Magnética/métodos , Masculino , Flebografia/métodos , Estudos Prospectivos , Sensibilidade e Especificidade
3.
Cardiovasc Intervent Radiol ; 42(11): 1619-1626, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31471721

RESUMO

PURPOSE: This study evaluates the image quality of lower extremity CT venography reconstructed with orthopedic metal artifact reduction (O-MAR) in patients with unilateral or bilateral metallic prostheses in the hip or knee. METHODS: This retrospective study was approved by our institutional review board, and informed consent was waived. Twenty-nine patients of lower extremity CT with 51 metallic hip or knee prostheses were reconstructed to both standard CT images and O-MAR images. The subjective image quality and vessel conspicuity for both images were evaluated by two readers using five-point scales (0-4). Vessel conspicuity scores of 3 or 4 were considered diagnostically acceptable. Image noise was measured in the air and subcutaneous fat. RESULTS: O-MAR images showed significantly higher scores of subjective image quality (p < .001) and vessel conspicuity (p = .002) than standard CT images. Diagnostic acceptance of vessel conspicuity was not significantly different between O-MAR images and standard CT images (p = 1.000). O-MAR images showed significantly less image noise than conventional CT images (p < .001 for both air and subcutaneous fat). CONCLUSION: O-MAR may be an effective solution for the metal artifacts in lower extremity CT venography; however, the distance between prostheses and vessels affects the diagnostic acceptance in patients with metallic hip or knee prostheses. LEVEL OF EVIDENCE: Level 4, Case Series.


Assuntos
Artefatos , Extremidade Inferior/diagnóstico por imagem , Flebografia/métodos , Próteses e Implantes , Interpretação de Imagem Radiográfica Assistida por Computador/métodos , Tomografia Computadorizada por Raios X/métodos , Idoso , Idoso de 80 Anos ou mais , Algoritmos , Feminino , Humanos , Extremidade Inferior/irrigação sanguínea , Masculino , Metais , Pessoa de Meia-Idade , Estudos Retrospectivos
4.
J Med Vasc ; 44(5): 354-358, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474348

RESUMO

Bilateral absence of the superior vena cava (SVC) is an uncommon congenital vascular anomaly, mainly asymptomatic, usually undetected, and often associated with other cardiac anomalies. Though usually harmless and totally innocent, this vascular anomaly might complicate cardiovascular surgery, the insertion of a central venous catheter and the transvenous placement of a pacemaker. This SVC anomaly is still not well known, underdiagnosed and its incidence is much higher than described. A better understanding of this anomaly and its detection could play a key role in avoiding its potential complications. We are sharing a case of a female adult, with no medical history, who presented herself to the department of visceral surgery with a collateral venous circulation of the upper thorax, that was at first, mistaken for a portal hypertension syndrome, findings were pushed to finally conclude a bilateral absence of the SVC.


Assuntos
Malformações Vasculares , Veia Cava Superior/anormalidades , Adulto , Circulação Colateral , Angiografia por Tomografia Computadorizada , Erros de Diagnóstico , Feminino , Humanos , Flebografia/métodos , Valor Preditivo dos Testes , Malformações Vasculares/diagnóstico por imagem , Malformações Vasculares/fisiopatologia , Veia Cava Superior/diagnóstico por imagem , Veia Cava Superior/fisiopatologia
5.
Methodist Debakey Cardiovasc J ; 15(2): 152-155, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384380

RESUMO

Iatrogenic aortocaval fistula is an extremely rare pathologic condition that often results in clinically significant left-to-right extracardiac shunt. In slow-progressing cases, chronic right-sided heart failure can occur and, in some patients, may persist for years. We present a patient with a long-standing aortocaval fistula that was causing high-flow left-to-right shunting, tricuspid regurgitation, severe pulmonary hypertension, and right-side heart failure. After undergoing complete endoscopic isolation of the aortocaval fistula, the patient experienced dramatic clinical improvement and continued to have excellent imaging and clinical resolution after 2 years of follow-up.


Assuntos
Aorta/fisiopatologia , Fístula Arteriovenosa/terapia , Embolização Terapêutica , Procedimentos Endovasculares , Insuficiência Cardíaca/etiologia , Hipertensão Pulmonar/etiologia , Doença Iatrogênica , Veia Cava Inferior/fisiopatologia , Aorta/diagnóstico por imagem , Aortografia/métodos , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/etiologia , Fístula Arteriovenosa/fisiopatologia , Angiografia por Tomografia Computadorizada , Ecocardiografia Doppler em Cores , Embolização Terapêutica/instrumentação , Procedimentos Endovasculares/instrumentação , Insuficiência Cardíaca/diagnóstico por imagem , Insuficiência Cardíaca/fisiopatologia , Humanos , Hipertensão Pulmonar/diagnóstico por imagem , Hipertensão Pulmonar/fisiopatologia , Masculino , Pessoa de Meia-Idade , Flebografia/métodos , Desenho de Prótese , Fluxo Sanguíneo Regional , Dispositivo para Oclusão Septal , Fatores de Tempo , Resultado do Tratamento , Veia Cava Inferior/diagnóstico por imagem
6.
J Stroke Cerebrovasc Dis ; 28(11): 104324, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31422004

RESUMO

BACKGROUND: It is plausible that extent of cerebral venous sinus thrombosis (CVST) may determine clinical severity, magnetic resonance imaging (MRI) lesion, and outcome, therefore this study was undertaken. METHODS: A total of 160 CVST patients were included and their clinical details, risk factors, Glasgow Coma Scale score, and parenchymal lesion on MRI were noted. The extent of venous sinus thrombosis on magnetic resonance venography was assessed by using CVST score which was computed giving 1 point for each thrombosed sinus and 3 points to superior sagittal sinus (SSS). Death and outcome at 6 months were assessed using modified Rankin Scale (mRS) as good (≤2) and poor (mRS 3-5). RESULTS: Their median age was 29.5 years, and 76 (47%) were females. The median CVST score was 3 (range 1-9). CVST score did not correlate with clinical severity and risk factors. Insignificantly higher proportion of patients had parenchymal lesion with a CVST score of more than 2 (76.5% versus 64.2%). Superficial venous system thrombosis, however, correlated with seizure, papilloedema, and frontal lobe lesion. Frontal, temporal lesion correlated with SSS thrombosis, frontal and temporal with transverse sinus, temporal and cerebellar involvement in sigmoid, and basal ganglia and thalamus in straight sinus thrombosis. Seventeen patients (11%) died, and at 6 months, 132 (82%) had good and 11 (7%) poor recovery. Death and 6 months outcomes were not related to CVST score. CONCLUSIONS: Extent of CVST does not determine clinical severity, MRI lesion, and outcome. The location of parenchymal lesion however is related to thrombosis of draining sinus.


Assuntos
Angiografia Cerebral/métodos , Imagem de Difusão por Ressonância Magnética/métodos , Angiografia por Ressonância Magnética/métodos , Flebografia/métodos , Trombose dos Seios Intracranianos/diagnóstico por imagem , Trombose Venosa/diagnóstico por imagem , Adulto , Feminino , Escala de Coma de Glasgow , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Sistema de Registros , Fatores de Risco , Trombose do Seio Sagital/diagnóstico por imagem , Índice de Gravidade de Doença , Trombose dos Seios Intracranianos/mortalidade , Trombose dos Seios Intracranianos/terapia , Fatores de Tempo , Trombose Venosa/mortalidade , Trombose Venosa/terapia , Adulto Jovem
7.
Braz J Cardiovasc Surg ; 34(3): 368-371, 2019 06 01.
Artigo em Inglês | MEDLINE | ID: mdl-31310478

RESUMO

The Bridge Occlusion Balloon is a compliant balloon, specifically designed for temporary Superior vena cava occlusion in case of Superior Vena Cava laceration during lead extraction procedures. We here report the first case, using Bridge Occlusion Ballon for a venous angioplasty in a patient with dysfunctional pacemaker leads and symptomatic Superior Vena Cava occlusion. After successful lead extraction, venography was showing a narrow venous canal. Therefore, venous angioplasty using the Bridge balloon was performed. Especially for high-risk lead extraction cases in patients with Superior Vena Cava stenosis, the Bridge Occlusion Ballon might be used as a combination of a safety-net in case of Superior Vena Cava perforation and for Superior Vena Cava angioplasty.


Assuntos
Angioplastia com Balão a Laser/métodos , Síndrome da Veia Cava Superior/terapia , Idoso de 80 Anos ou mais , Angiografia por Tomografia Computadorizada/métodos , Humanos , Masculino , Flebografia/métodos , Fatores de Risco , Síndrome da Veia Cava Superior/diagnóstico por imagem , Resultado do Tratamento
9.
Vasc Endovascular Surg ; 53(6): 501-506, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31159685

RESUMO

Inferior vena cava (IVC) filters are important devices for patients who are at high risk for developing thrombi and pulmonary embolism but have conditions that preclude the use of pharmacologic anticoagulants. IVC filter retrieval has become an important quality initiative backed by Food and Drug Administration guidelines for prompt removal after the filter is no longer indicated. Filter retrieval is a common procedure that usually has very few complications. However, when the filter is tilted or embedded in the caval wall, advanced techniques of retrieval may be necessary. These techniques have a higher rate of success but also a higher risk of complications such as injury to the IVC. Here, we describe a case of IVC filter retrieval resulting in formation of an arteriovenous fistula between the right renal artery and IVC and subsequent successful repair of this fistula using a vascular plug.


Assuntos
Fístula Arteriovenosa/etiologia , Remoção de Dispositivo/efeitos adversos , Implantação de Prótese/instrumentação , Artéria Renal/lesões , Lesões do Sistema Vascular/etiologia , Filtros de Veia Cava , Veia Cava Inferior/lesões , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/terapia , Angiografia por Tomografia Computadorizada , Embolização Terapêutica , Feminino , Humanos , Pessoa de Meia-Idade , Flebografia/métodos , Artéria Renal/diagnóstico por imagem , Resultado do Tratamento , Lesões do Sistema Vascular/diagnóstico por imagem , Lesões do Sistema Vascular/terapia , Veia Cava Inferior/diagnóstico por imagem
11.
Vasc Health Risk Manag ; 15: 115-122, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31190849

RESUMO

Iliac vein compression (LIVC) is a prevalent finding in the general population, but a smaller number of patients are symptomatic. ILVC should be considered in symptomatic patients with unexplained unilateral lower leg swelling. Patients typically complain of one or more of the following symptoms: lower leg pain, heaviness, venous claudication, swelling, hyperpigmentation and ulceration. ILVC can be thrombotic, combined with acute or chronic DVT, or non-thrombotic. ILVC is best diagnosed with intravascular ultrasound (IVUS), but computed tomography angiography (CTA) and magnetic resonance angiography (MRA) have emerged as valid screening tests. Venography underestimates the severity of ILVC but may provide insights into the anatomy and the presence of collaterals. Based on current available evidence, endovascular therapy with stenting remains the main treatment strategy for ILVC. Dedicated nitinol venous stents are currently under review by the Food and Drug Administration for potential approval in the United States. These stents have been released outside the US. There is no consensus to the optimal anticoagulation regimen post-ILVC stenting. Oral anticoagulants, however, remain a preferred therapy in patients with history of thrombotic ILVC.


Assuntos
Anticoagulantes/administração & dosagem , Diagnóstico por Imagem/métodos , Procedimentos Endovasculares , Veia Ilíaca , Síndrome de May-Thurner , Administração Oral , Anticoagulantes/efeitos adversos , Angiografia por Tomografia Computadorizada , Procedimentos Endovasculares/efeitos adversos , Procedimentos Endovasculares/instrumentação , Humanos , Veia Ilíaca/diagnóstico por imagem , Veia Ilíaca/fisiopatologia , Veia Ilíaca/cirurgia , Angiografia por Ressonância Magnética , Síndrome de May-Thurner/diagnóstico por imagem , Síndrome de May-Thurner/epidemiologia , Síndrome de May-Thurner/fisiopatologia , Síndrome de May-Thurner/terapia , Flebografia/métodos , Valor Preditivo dos Testes , Prevalência , Stents , Resultado do Tratamento , Ultrassonografia Doppler em Cores , Ultrassonografia de Intervenção
12.
J Stroke Cerebrovasc Dis ; 28(8): e116-e118, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31171457

RESUMO

We describe a 45-year-old man who presented with nausea, vomiting, and strong occipital headache on the right side. Although no abnormalities on neurological examination or computed tomography imaging were found on admission, peripheral blood cell counts showed polycythemia (hemoglobin 20.6 g/dL) and electrocardiography demonstrated atrial fibrillation. Therefore, anticoagulant treatment with heparin was started immediately. On the following day, the occipital headache continued. Brain T2*-weighted (T2*WI) magnetic resonance imaging (MRI) and, to a lesser extent, susceptibility-weighted imaging showed dilation of numerous cortical veins, suggesting the possibility of cerebral venous thrombosis (CVT). MR venography (MRV) showed a deficit of the right transverse sinus. Contrast-enhanced MRI revealed partial defects of the right transverse sinus, and led to the definite diagnosis of CVT, and the anticoagulation therapy was continued. On day 7 the headache disappeared, and MRV on day 16 showed the recanalization of the right transverse sinus. There were no complications subsequent to the CVT. On day 25, the patient was discharged with no after-effect. We speculate that the dilation of cortical veins on T2*WI is a helpful sign in detecting acute-phase CVT.


Assuntos
Veias Cerebrais/diagnóstico por imagem , Imagem de Difusão por Ressonância Magnética , Trombose dos Seios Intracranianos/diagnóstico por imagem , Anticoagulantes/uso terapêutico , Angiografia Cerebral/métodos , Veias Cerebrais/patologia , Dilatação Patológica , Heparina/uso terapêutico , Humanos , Angiografia por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Flebografia/métodos , Valor Preditivo dos Testes , Trombose dos Seios Intracranianos/tratamento farmacológico , Trombose dos Seios Intracranianos/patologia , Resultado do Tratamento
13.
World Neurosurg ; 130: 129-132, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31229748

RESUMO

BACKGROUND: Internal jugular vein stenosis (IJVS) results in poor venous outflow and can result in intracranial hypertension. Venous stenting has become a debated topic for correction of this pathology. CASE DESCRIPTION: A 49-year-old male merchant with bilateral IJVS presented with headache, dizziness, and pulsatile tinnitus. He was found to have intracranial hypertension and left IJVS caused by styloid process compression and right IJVS caused by damage of the venous intima. His symptoms improved after undergoing styloidectomy followed by left intra-internal jugular vein (IJV) balloon. However, 1 year later, the prior symptoms reoccurred. At this time, the patient underwent right intra-IJV stenting. After treatment of the contralateral side, the symptoms resolved during the following 3 months. CONCLUSIONS: The clinical practice in this case indicated that in patients with bilateral IJVS, a 2-side intervention may be necessary when unilateral correction fails. We advise a staged approach to correction of bilateral IJVS. Styloid compression-induced IJVS should be corrected by styloidectomy in combination with balloon and/or stenting, whereas IJVS induced by venous wall issues needs only stenting.


Assuntos
Constrição Patológica/cirurgia , Cefaleia/etiologia , Hipertensão Intracraniana/cirurgia , Veias Jugulares/cirurgia , Constrição Patológica/complicações , Constrição Patológica/diagnóstico , Cefaleia/diagnóstico , Humanos , Hipertensão Intracraniana/diagnóstico , Hipertensão Intracraniana/etiologia , Veias Jugulares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Flebografia/métodos , Stents/efeitos adversos
14.
BMC Neurol ; 19(1): 133, 2019 Jun 18.
Artigo em Inglês | MEDLINE | ID: mdl-31215399

RESUMO

BACKGROUND: Heat stroke (HS) is a critical illness that can cause multiple organ dysfunction, including damage to the central nervous system (CNS), which can be life-threatening in severe cases. Brain lesions in patients with HS who present with CNS damage have been rarely reported before, and they usually vary in different cases, hence, patients with such lesions may present a clinical challenge in terms of diagnosis and management. Cerebral venous thrombosis (CVT) is a rare cause of stroke that mostly affects young individuals and children. The pathogenesis of brain damage caused by HS is complex, and CVT may be involved in the pathogenesis of HS with CNS damage. In this manuscript, we have reported a case of a patient with HS having CVT with symmetrical lesions in the bilateral putamen, posterior limb of the internal capsule, external capsule, insular lobe, and subcortical white matter in the brain. CASE PRESENTATION: We encountered a 48-year-old man who presented with HS in the summer season. During admission, he had a high body temperature and was in coma and shock. Then, he developed rhabdomyolysis syndrome, acute kidney and liver damage, electrolyte imbalance, and acid-base balance disorders, and his D-dimer level was elevated. After several days of anti-shock treatment, the patient's level of consciousness improved. However, he experienced a decline in vision. Cerebral magnetic resonance imaging (MRI) showed symmetrical lesions in the bilateral posterior limb of the internal capsule, putamen, external capsule, insula, and subcortical white matter, and cerebral magnetic resonance venography (MRV) showed the development of CVT. Therefore, anti-coagulation treatment was provided. After timely clinical intervention, the symptoms of the patient gradually improved. CONCLUSIONS: This case showed that HS can cause CVT. Therefore, cerebral MRI findings in HS must be assessed; in addition, early MRV can help in the diagnosis of the disease, which can effectively improve prognosis.


Assuntos
Golpe de Calor/complicações , Golpe de Calor/diagnóstico por imagem , Golpe de Calor/patologia , Trombose Intracraniana/diagnóstico por imagem , Trombose Intracraniana/etiologia , Trombose Intracraniana/patologia , Encéfalo/diagnóstico por imagem , Encéfalo/patologia , Humanos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Flebografia/métodos
15.
Vasc Endovascular Surg ; 53(6): 507-511, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31216954

RESUMO

Inferior vena cava (IVC) thrombosis is a specific form of thromboembolism that occurs at a rate of 1.5% in all patients hospitalized with a deep vein thrombosis. Malignant IVC thrombosis may occur due to compression from a tumor mass or metastasis or may also occur through tumor invasion of the venous vasculature. Obstruction of the IVC can lead to IVC syndrome, marked by ascites, lower extremity edema, and even congestive hepatic failure. We present a case of extensive IVC thrombosis in a 69-year-old female with metastatic adrenal cell carcinoma, presenting with severe bilateral lower extremity edema and ascites. Computed tomography showed IVC compression by the caudate lobe due to a metastatic liver mass and extensive clot burden of the IVC extending from the renal veins to the right atrium (RA). She underwent percutaneous IVC stenting with 4 stents placed in tandem from the IVC to the RA. Her hospital course was complicated by gastrointestinal bleed requiring clipping, acute liver failure, and hypophysitis due to trial therapy. Although her IVC symptoms were partially relieved with percutaneous intervention, her acute liver failure worsened and she was ultimately transitioned to hospice care.


Assuntos
Neoplasias do Córtex Suprarrenal/complicações , Carcinoma Adrenocortical/complicações , Procedimentos Endovasculares , Veia Cava Inferior/cirurgia , Trombose Venosa/cirurgia , Neoplasias do Córtex Suprarrenal/diagnóstico por imagem , Neoplasias do Córtex Suprarrenal/patologia , Carcinoma Adrenocortical/diagnóstico por imagem , Carcinoma Adrenocortical/secundário , Idoso , Angiografia por Tomografia Computadorizada , Procedimentos Endovasculares/instrumentação , Feminino , Humanos , Flebografia/métodos , Stents , Resultado do Tratamento , Ultrassonografia de Intervenção , Veia Cava Inferior/diagnóstico por imagem , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/etiologia
16.
J Stroke Cerebrovasc Dis ; 28(9): e139-e142, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31239222

RESUMO

Postoperative cerebral embolism after left upper or lower lobectomy caused by the thrombus in the pulmonary vein stump (PVS) is a rare complication. However, it is still unclear how the cerebral embolism develop after lobectomy, and how can we prevent further embolism after thrombus removal. We present a case of a 55-year-old man without cardiovascular disease history suffering cerebral embolism 2 days after left upper lobectomy. Patient underwent endovascular thrombectomy and discharged hospital 10 days later with proper recovery. No thrombus was detected in an enhanced pulmonary CT after 1 month of aspirin intake, but the length of PVS was measured.


Assuntos
Embolia Intracraniana/etiologia , Pneumonectomia/efeitos adversos , Veias Pulmonares/cirurgia , Cirurgia Torácica Vídeoassistida/efeitos adversos , Angiografia Cerebral , Angiografia por Tomografia Computadorizada , Imagem de Difusão por Ressonância Magnética , Humanos , Embolia Intracraniana/diagnóstico por imagem , Embolia Intracraniana/cirurgia , Masculino , Pessoa de Meia-Idade , Flebografia/métodos , Pneumonectomia/métodos , Veias Pulmonares/diagnóstico por imagem , Trombectomia , Fatores de Tempo , Resultado do Tratamento
18.
Vasc Endovascular Surg ; 53(6): 446-451, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31046635

RESUMO

PURPOSE: To evaluate the safety and efficacy of retrieval of inferior vena cava filters (IVCF) temporarily placed in a suprarenal position. METHODS: Retrieval of IVCF placed in a suprarenal position was performed in 13 patients (5 men and 8 women; mean age: 45.1 ± 13.8 years) between July 2006 and May 2018 using either a loop snare technique or endobronchial forceps. Electronic medical records were reviewed for patient demographics and procedural information. RESULTS: Inferior vena cava filters retrieved included Option Elite (n = 9, 69%) and Günther Tulip (n = 4, 31%). Caval thrombosis was not detected in any patients on pre- or postretrieval cavogram. Eleven suprarenal IVCF (84%) were retrieved during the first retrieval attempt after a median indwelling time of 1.8 months (range, 0.03-12.10 months). Retrieval was initially unsuccessful in 2 (16%) patients with Option Elite filters, but both were successfully removed on second attempt using endobronchial forceps. Thirteen suprarenal IVCF (100%) were ultimately retrieved. CONCLUSION: Endovascular retrieval of IVCF temporarily placed in a suprarenal position is safe and efficacious.


Assuntos
Remoção de Dispositivo/métodos , Procedimentos Endovasculares/métodos , Implantação de Prótese/instrumentação , Filtros de Veia Cava , Veia Cava Inferior , Adulto , Angiografia por Tomografia Computadorizada , Remoção de Dispositivo/efeitos adversos , Procedimentos Endovasculares/efeitos adversos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Flebografia/métodos , Implantação de Prótese/efeitos adversos , Estudos Retrospectivos , Fatores de Risco , Resultado do Tratamento , Veia Cava Inferior/diagnóstico por imagem
19.
BMJ Case Rep ; 12(4)2019 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-31036738

RESUMO

Isolated cortical venous thrombosis (ICVT) occurring in the absence of dural venous thrombosis, constitutes about 2%-5% of all cerebral venous thrombosis. Its vague, non-specific presentation makes it a difficult and challenging diagnosis that needs an extensive workup especially in young patients. Outcome and prognosis depend mainly on early diagnosis and treatment. Here we discuss the clinical presentation, diagnosis and the treatment of a young woman diagnosed with ICVT with acute ischaemic venous stroke, in the setting of eclampsia and family history of coagulation disease.


Assuntos
Trombose Intracraniana/patologia , Acidente Vascular Cerebral/diagnóstico por imagem , Trombose Venosa/patologia , Adulto , Anticoagulantes/administração & dosagem , Anticoagulantes/uso terapêutico , Feminino , Morte Fetal , Humanos , Trombose Intracraniana/complicações , Trombose Intracraniana/diagnóstico por imagem , Trombose Intracraniana/etiologia , Imagem por Ressonância Magnética/métodos , Flebografia/métodos , Gravidez , Doenças Raras , Acidente Vascular Cerebral/tratamento farmacológico , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/patologia , Resultado do Tratamento , Trombose Venosa/complicações , Trombose Venosa/diagnóstico por imagem , Trombose Venosa/etiologia
20.
Diagn Interv Radiol ; 25(3): 242-244, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31063143

RESUMO

Self-expanding nitinol stents are routinely used to treat left common iliac vein compression in patients with May-Thurner syndrome. On occasion these stents do not provide adequate radial force to achieve a sufficient iliac lumen. If symptoms persist and persistent iliac vein compression is noted then balloon-expandable stents may be used to provide buttressing support at the compression site. We present a case where the buttressing balloon-expandable stent is crushed and subsequently removed percutaneously prior to placement of a high radial force self-expanding stent at the compressive site.


Assuntos
Angioplastia com Balão/instrumentação , Veia Ilíaca/patologia , Síndrome de May-Thurner/complicações , Stents Metálicos Autoexpansíveis/normas , Adulto , Ligas , Angioplastia com Balão/efeitos adversos , Feminino , Humanos , Veia Ilíaca/diagnóstico por imagem , Síndrome de May-Thurner/patologia , Flebografia/métodos , Desenho de Prótese , Falha de Prótese , Stents/efeitos adversos , Instrumentos Cirúrgicos , Resultado do Tratamento , Grau de Desobstrução Vascular
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