Splenic Trauma Where to Occlude and with what
|
|
- Frederick Crawford
- 6 years ago
- Views:
Transcription
1 Splenic Trauma Where to Occlude and with what Trauma session, Thurday May 5, 2016 Pierre GOFFETTE St-Luc University Hospital Brussels
2 Pierre Goffette, M.D. Consultant/Advisory Board: Covidien (Neuro) and Terumo
3 EAST Practice management guidelines 2012 J Trauma 2012, 73: S NOM of BSI: Treatment modality of choice Success 86-97% (Raikhlin A et al. Can J Surg 2008) Hemodynamiccally stable/stabilized patients Irrespective to the grade of injury Angio-embolization: important adjunct to NOM of splenic #
4 Spleen # New CT-based grading system 2006 To predict the need for intervention Devascularization/laceration involving 50% or more of the splenic parenchyma CB > 1 cm in diameter active extravasation pseudoaneurysm AAST 1994 Large Hemoperitoneum (Diffuse, 3 or more areas) Sensitivity 100% Specificity 88% Accuracy 93% Marmery H, AJR 2007, 189: Thompson BE, J Trauma 2006, 60:
5 Splenic embolization in trauma 3 main indications in stable/stabilized Pts A. Active bleeding on CT B. Vascular injury (false-aneurysm, AVF) C. AAST Grade III-V injury to prevent rebleeding and secondary rupture (Grade IV-V for Miller, J Am Coll Surg 2014) Situation A-B: Focal lesion with normal parenchyma in the vincinity Situation C: Multiple/deep lesions involving multiples branches
6 Level of embolization? No Consensus Proximally in main splenic artery Distally and selectively Combination of both techniques High grade + bleedings Large hemoperitoneum + bleedings
7 Proximal SAE: Rationale Drop of intra-splenic arterial pressure (47% Bessoud) allowing spontaneous thrombosis of injured vessels Splenic perfusion preseved by collateral flow from left gastric branches gastroepiploic arcades pancreatic posterior arcades Theorical increased risk of secondary bleeding because arterial injuries left untreated Limited risk of major splenic infarction (minor in 63%) - No abscess requiring intervention
8 Proximal splenic artery occlusion Indications Diffuse bleeding High grade injuries Tortuous vessels Unstable patients Technics Optimize collateral flow: embo Distal to dorsal pancreatic art. Proximal to main Pancreatica Magna Balloon occlusion test Variability of pressure drop (collat.) (Requarth, J trauma 2010) Coils versus Plugs
9 Proximal splenic artery occlusion High flow vessel: Risk of Embo agent migration MacroCoils Nester,Tornado (Cook) Scaffold technique Ancor technique Detachable 2D/3D coils Interlock (Boston) Concerto (Covidien) Azur (Terumo) framing, hydrogel Retracta (Cook) Plug (AVP II, AVP IV) Straight segment 20-40% oversizing Additional coils, gelfoam
10 24-yr old male, road-traffic accident Grade III splenic #, large hemoperitoneum Blunt trauma in 14 Pts AVP 4 / 7mm (occl in5 min) (Wildus et al. JVIR 2008, 19: ) Proximal splenic art. embo with AVP I (8-12 mm) 5-6 F guiding catheter Occlusion in 10 min. Additional coils in 3 Pts 2 subsequent splenectomy (instability, false aneurysm)
11 NGE: 8Pts, Grade IV(4x), V(4x) 3 proximal, 5 combined embo AVP 4, 5fr catheter, upsizing 30% Time to occlusion: 4,5 min (2,1-10) Delayed arterial patency 100% 4 mo fup: spleen salvage 100% JVIR 2012, 27:
12 Adavantages of AVP for proximal SAE Precise occlusion Delivery through diagnostic catheter (AVP 4) Retrievable and repositionable Quick vascular occlusion <10 min No risk of device migration Prevent migration of additional coils if needed Minimal Artifact on CT, no recanalization Less radiation Wildus DM, JVIR 2008, 19: Zhu X, CVIR 2011, 34: Ng E, JVIR 2012, 27:
13 Distal splenic artery embolization Selective embolization (multiple sites in Gr IV/V) Sometimes tricky in cases of unstable hemodynamic condition BUT Does not reduces arterial pressure Bleeding vessels overloocked because spasm or mass effect by hematoma.delayed rebleeding More or less extended infarction in most cases Denys A, GEST May2011, Paris
14 Gr III BSI + active bleeding + false-aneurysm 3 µnester coils 3mm
15 Distal splenic artery embolization Indications Focal bleeding Low/high grade # Straight forward access Stable patients Technics Coaxial guiding/µkt As selective as possible µcoils, glue, gelfoam slurry PVA for multiple subcapsular bleedings (?)
16 Stable polytraumatized 43 year male (motocycle crash) Glue embolization Day 6 Control CT
17 Gr V BSI + Large Hemopritoneum Distal + Proximal SAE
18 Embolization technique: success rate Haan J, J Trauma 2005, 58: Nb of Pts CT grade Failure% Re-embo Infarct% Main coil Selective distal Combined Frandon J, Diag and intervent imaging 2014, 95: Nb of Pts CT grade Failure% Re-embo Infarct% Main coil na 6 Selective distal na 9 Combined na 0
19 Outcome of Proximal versus Distal Splenic Artery Embolization after splenic trauma Systematic Review and Meta-Analysis (479 Pts -15 series) 15/147 studies met criteria for meta-analysis: injury grade, indication for SAE, level of SAE, detailed complications All retrospective n= 497 pts Schnüriger B et al. J Trauma 2011, 70,1:252-60
20 Outcome of Proximal versus Distal Splenic Artery Embolization Systematic Review and Meta-Analysis (479 Pts -15 series) Schnüriger B et al. J Trauma 2011, 70,1:252-60
21 J Trauma 2011, 70,1:252-60
22 What is the best technique? Proximal (n=107) Distal (n=63) P value Major rebleeding 4.7% 6.3% NS Major infarction 0% 1.6% NS Major infection 1.9% 0% NS Minor rebleeding 2.2% 4.2% NS Minor infarction 0.8-4% 13-19% S Both techniques: equivalent major infarction and infection rates Minor infarction (no splenectomy): distal >> proximal embo clinical relevance questionnable! Schnuriger B et al. J Trauma 2011, 70,1: Denys A, GEST May 2011, Paris
23 Splenic Immune function after SAE Is it a concern? Lausanne experience (Bessoud, J Trauma 2007, 62:1481-6) Thrombocytes: 312 +/- 75 G/L AbPneu T19F/T14F 20% Low Ab values against pneumocoque Similar to overall population No need for antiaggregative treatment No need for standardized vaccination
24 SAE should reduce immunological complication of spleen # Distal embolization may maintain better function
25 Injury 2016, 47: studies (both adults and children) NO OPSS reported (vaccination??) All but 2 studies: preserved splenic function Lack of single parameter or test to demonstrate preserved splenic function
26 Take Home points Proximal or Distal or both SAE after BSI?? Only minor differences Physician expertise High-grade # & active bleeding: Combined techniques Plug are promising alternative to coil Splenic function not altered RcT still needed
Visceral aneurysms: Technical options Coils, Plugs, Stents and liquid agents. Pierre P. GOFFETTE St-Luc University Hospital Brussels - Belgium
Visceral aneurysms: Technical options Coils, Plugs, Stents and liquid agents Pierre P. GOFFETTE St-Luc University Hospital Brussels - Belgium Pierre Goffette, M.D. Consultant/Advisory Board: Covidien (Neuro)
More informationAbdominal & retroperitoneal endovascular intervention, Bo Kalin, Karolinska Hospital
Abdominal & retroperitoneal endovascular intervention, Bo Kalin, Karolinska Hospital What is endovascular therapy. Diagnosing Traumatic Arterial Injury Clinical signs CT / CT-angiography To diminish a
More informationSPLENIC ANEURYSM: SAVING OR EMBOLIZING THE VESSEL
SPLENIC ANEURYSM: SAVING OR EMBOLIZING THE VESSEL Ziv J Haskal MD FSIR FAHA FACR FCIRSE GEST Director / Co-Founder Professor of Radiology Vascular & Interventional Radiology Editor in Chief, Journal of
More informationSplenic blunt trauma - from diagnostic MDCT to embolisation: The role of the radiologists
Splenic blunt trauma - from diagnostic MDCT to embolisation: The role of the radiologists Poster No.: C-1859 Congress: ECR 2010 Type: Educational Exhibit Topic: Interventional Radiology Authors: J. Cazejust,
More informationThe New World of (Micro)Plugs. Jafar Golzarian Professor of Radiology and Surgery University of Minnesota Medical Center
The New World of (Micro)Plugs Jafar Golzarian Professor of Radiology and Surgery University of Minnesota Medical Center Jafar Golzarian, M.D. Stock: Embomedics Speakers Bureau: Boston Scientific, AngioDynamics,
More informationInterventional Radiology in Trauma. Vikash Prasad, MD, FRCPC Vascular and Interventional Radiology The Moncton Hospital
Interventional Radiology in Trauma Vikash Prasad, MD, FRCPC Vascular and Interventional Radiology The Moncton Hospital Disclosures None relevant to this presentation Shareholder Johnson and Johnson Goal
More informationEndovascular management of blunt trauma to the
Endovascular Management of Abdominal Solid Organ Trauma Indications and embolic agents for successful noninvasive treatment. BY RICARDO YAMADA, MD; MARCELO GUIMARAES, MD, FSIR; AND CLAUDIO SCHÖNHOLZ, MD
More informationThe Importance of Coil Packing
The Importance of Coil Packing Keigo Osuga, MD, PhD Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine Keigo Osuga, M.D., Ph.D. No relevant financial relationship
More informationVisceral aneurysm. Diagnosis and Interventions M.NEDEVSKA
Visceral aneurysm Diagnosis and Interventions M.NEDEVSKA History 1953 De Bakeyand Cooley Visceral aneurysm VAAs rare, reported incidence of 0.01 to 0.2% on routine autopsies. Clinically important Potentially
More informationUrinary tract embolization
Beograd, 14.10.2012 Urinary tract embolization asist. Peter Popovič, MD, MSc Head of abdominal radiology department, Institute of Radiology, UMC Ljubljana Embolization Who and when procedure: local/general
More informationFall down stairs. Left rib fractures. John A Cieslak III, MD, PhD Charan Singh, MD
Fall down stairs. Left rib fractures. John A Cieslak III, MD, PhD Charan Singh, MD ? Splenic lacerations, hemoperitoneum, and traumatic pseudoaneurysm formation. High attenuation extraluminal contrast
More informationInterventional Radiology for Solid Organ Trauma. Case Study 8/17/2017. Diagnosis? Case Study (cont d)
Interventional Radiology for Solid Organ Trauma Jamie Gallivan RN, BSN Interventional Radiology Case Study 6 y/o boy fell out of 2 nd story window onto concrete Hemodynamically stable at scene Arrival
More informationThe Continuing Role of Pushable Coils: Advances and Fiscal Responsibilities JAMES F BENENATI MD
The Continuing Role of Pushable Coils: Advances and Fiscal Responsibilities JAMES F BENENATI MD James Benenati, MD Royalty: Penumbra Stock: Covidien Consultant/Advisory Board: Penumbra, Endoshape, Scientia
More informationDirect Intrahepatic Porta-Caval Shunt Technique & Tips-Tricks. Pierre GOFFETTE, MD, St-Luc University Hospital University of Leuven Brussels
Direct Intrahepatic Porta-Caval Shunt Technique & Tips-Tricks Pierre GOFFETTE, MD, St-Luc University Hospital University of Leuven Brussels Pierre Goffette, M.D. Consultant/Advisory Board: Covidien (Neuro)
More informationSplenic Artery Embolization: Short and Long Term Outcomes
Splenic Artery Embolization: Short and Long Term Outcomes How well does it really work? Jacob Cynamon, MD Ajay Kohli, MD Division of Vascular and Interventinal Radiology Montefiore Medical Center GEST
More informationEfficacy of Emergent Splenic Artery Embolization in Conservative Treatment of High Grade Splenic Injury
Chin J Radiol 2005; 30: 1-7 1 Efficacy of Emergent Splenic Artery Embolization in Conservative Treatment of High Grade Splenic Injury YU-SAN LIAO YU-FAN CHENG TUNG-LIANG HUANG PAO-CHU YU CHUNG-CHENG HUANG
More informationSystem.
System www.penumbrainc.com POD System Case Examples 45 cm of POD Packing Coil in 1.5 to 3 mm diameter dilating vessel Bronchial Artery Embolization Dr. Amit Kakkar and Dr. Aksim Rivera, Bronx, NY Inflow:
More informationAcute, Blood, Trauma /ecr2015/C-2116
The Baltimore CT Severity Index (CTSI) versus the American Association of Surgical Trauma (AAST) for grading splenic Injury on CT: Use and implications of an imaging based grading system for splenic injury
More informationRole of the Radiologist
Diagnosis and Treatment of Blunt Cerebrovascular Injuries NORDTER Consensus Conference October 22-24, 2007 Clint W. Sliker, M.D. University of Maryland Medical Center R Adams Cowley Shock Trauma Center
More informationFaculty Disclosure. Glue, Particulates, Thrombin, Coils and the Kitchen Sink for Type II Endoleak Management. Background.
Glue, Particulates, Thrombin, Coils and the Kitchen Sink for Type II Endoleak Management Faculty Disclosure I disclose the following financial relationships: UCSF Vascular Symposium 2013 Receive grant/research
More informationRenal Artery Embolization in Post Traumatic Vascular Lesions
Med. J. Cairo Univ., VoL 81, No. 2, March: 69-73, 2013 www.medicaljournalofcairouniversity.com Renal Artery Embolization in Post Traumatic Vascular Lesions IHAB I. ALI, M.D.*; HESHAM BADAWY, M.D.**; AMR
More information(mm) tungsten alloy. Pushable Platinum 2,3, 4, 5, 6, 7, 8, 9,10,12,14. tungsten alloy. Pushable Platinum 3, 4, 5, 6, 8, 10, Embolization Coils
embolization coils (, Boston Scientific Corporation Cook Medical VortX Diamond-18 VortX-18 Fibered Platinum Straight-18 Figure 8-18 Multi-Loop-18 Complex -18 Fibered Platinum Interlock-18 Fibered IDC Occlusion
More informationCoils and plugs have emerged as the most commonly
The MVP Micro Vascular Plug: A New Paradigm in Peripheral Embolization BY RIPAL T. GANDHI, MD, FSVM; BRIAN E. SCHIRF, MD; AND JONATHAN IGLESIAS, MD Coils and plugs have emerged as the most commonly employed
More informationDiagnosis and Management of Femoral Access Site Complications IV: Novel Techniques for Endovascular Rescue
Diagnosis and Management of Femoral Access Site Complications IV: Novel Techniques for Endovascular Rescue Robert M. Bersin, M.D. Director, Endovascular Services Seattle Cardiology and the Cardiovascular
More informationSubclavian artery Stenting
Subclavian artery Stenting Etiology Atherosclerosis Takayasu s arteritis Fibromuscular dysplasia Giant Cell Arteritis Radiation-induced Vascular Injury Thoracic Outlet Syndrome Neurofibromatosis Incidence
More informationGastro-Intestinal Bleeding- Interventional Radiology turning off the tap. Simon McPherson, Vascular Interventional Radiologist, Leeds
Gastro-Intestinal Bleeding- Interventional Radiology turning off the tap Simon McPherson, Vascular Interventional Radiologist, Leeds Scale UK 100,000 /year Commonest Vascular IR on-call 75% UGIB 65% NVUGIB
More informationBRTO: Updates to Techniques
Session XIV: BRTO, PARTO and Portal Hypertension GEST2016 BRTO: Updates to Techniques Hiro Kiyosue Oita University Hospital, Japan Hiro Kiyosue, MD Royalty: Cook, Medkit Consulting Fee: Stryker Japan,
More informationCOIL SYSTEM ORDERING INFORMATION
EMBOLIZATION SYSTEM RUBY COIL SYSTEM FRAME with Ruby Standard FILL with Ruby Soft Now with 3 & 40 mm sizes! SYSTEM ANCHOR with Now designed to embolize 3 4 mm vessels! PACK with Coil Now with WAVE Shape
More informationRetrograde Embolization of a Symptomatic Hypogastric Artery Aneurysm
Retrograde Embolization of a Symptomatic Hypogastric Artery Aneurysm Andrew Unzeitig MD Piedmont Atlanta Hospital Georgia Vascular Society 2017 Annual Meeting Lake Oconee, Georgia Disclosures None Case
More informationNellix Endovascular System: Clinical Outcomes and Device Overview
Nellix Endovascular System: Clinical Outcomes and Device Overview Jeffrey P. Carpenter, MD Professor and Chief, Department of Surgery CAUTION: Investigational device. This product is under clinical investigation
More informationRuptured aberrant internal carotid artery pseudoaneurysm presenting with spontaneous massive ear bleeding following a single sneeze: a case report
Case eport JNET 7:312-316, 2013 uptured aberrant internal carotid artery pseudoaneurysm presenting with spontaneous massive ear bleeding following a single sneeze: a case report Seiichiro HIONO 1) Eiichi
More informationInterventions in Visceral Artery Bleed
Interventions in Visceral Artery Bleed Dr. Arun Gupta Consultant, Interventional Radiology Sir Ganga Ram Hospital, Delhi, India. INTRODUCTION Visceral artery aneurysms (VAAs) are rare, reported incidence
More informationImaging abdominal vascular emergencies. V.Stoynova
Imaging abdominal vascular emergencies V.Stoynova Abdominal vessels V. Stoynova 2 Acute liver bleeding trauma anticoagulant therapy liver disease : HCC, adenoma, meta, FNH, Hemangioma Diagnosis :CT angiography
More informationChungbuk Regional Cardiovascular Center, Division of Cardiology, Departments of Internal Medicine, Chungbuk National University Hospital Sangmin Kim
Endovascular Procedures for Isolated Common Iliac and Internal Iliac Aneurysm Chungbuk Regional Cardiovascular Center, Division of Cardiology, Departments of Internal Medicine, Chungbuk National University
More informationPRACTICE GUIDELINE TITLE: NON-OPERATIVE MANAGEMENT OF LIVER / SPLENIC INJURIES
PRACTICE GUIDELINE Effective Date: 6-18-04 Manual Reference: Deaconess Trauma Services TITLE: N-OPERATIVE MANAGEMENT OF LIVER / SPLENIC INJURIES PURPOSE: To define when non-operative management of liver
More informationDISCLOSURE TEST YOUR WAVEFORM IQ. Partial volume artifact. 86 yo female with right arm swelling, picc line. AVF on left? Dx?
Deborah Rubens University of Rochester Rochester, NY DISCLOSURE Neither I nor my immediate family have a financial relationship with a commercial organization that may have a direct or indirect interest
More informationTrauma MedEd. Emphasis: Solid Organ - Spleen January 2012 T RAUMA C ALENDAR OF E VENTS WESTERN TRAUMA ASSOCIATION 42 ND ANNUAL MEETING
The Trauma Professional s Blog Trauma MedEd Emphasis: Solid Organ - Spleen January 2012 Grading Spleen Injuries - Simplified Spleen injury grading is not as complicated as people think! The grading system
More informationCase Report 1. CTA head. (c) Tele3D Advantage, LLC
Case Report 1 CTA head 1 History 82 YEAR OLD woman with signs and symptoms of increased intra cranial pressure in setting of SAH. CT Brain was performed followed by CT Angiography of head. 2 CT brain Extensive
More informationAbdominal Solid Organ Injury
Abdominal Solid Organ Injury 9th Nordic Trauma Radiology Course Aarhus, Denmark May 23-26, 2016 K.SHANMUGANATHAN M.D. ABDOMINAL TRAUMA OBJECTIVES Splenic injury Late arterial / early p-v phase imaging
More informationPercutaneous Transarterial Embolization of Pseudoaneurysm Secondary to Pancreatitis: a case report
Chin J Radiol 2003; 28: 347-351 347 Percutaneous Transarterial Embolization of Pseudoaneurysm Secondary to Pancreatitis: a case report HSIN-YI LAI YUNG-FANG CHEN HSEIN-JAR CHIANG WU-CHUNG SHEN Department
More informationEndovascular Techniques for Visceral Artery Aneurysm Treatment
Wednesday, January 31, 2017 17:21-17:27 Endovascular Techniques for Visceral Artery Aneurysm Treatment S.Müller-Hülsbeck, MD, EBIR, FCIRSE, FICA, FSIR ACADEMIC HOSPITALS Flensburg of Kiel University Faculty
More informationObjective assessment of current stent grafts: which graft for which lesion. Ludovic Canaud, MD, PhD Pierre Alric, MD, PhD Montpellier, France
Objective assessment of current stent grafts: which graft for which lesion Ludovic Canaud, MD, PhD Pierre Alric, MD, PhD Montpellier, France Conflict of interest: none 1 Introduction Different diseases
More informationRole of radiology in colo-rectal bleedings. Alban DENYS MD FCIRSE EBIR CHUV LAUSANNE
Role of radiology in colo-rectal bleedings Alban DENYS MD FCIRSE EBIR CHUV LAUSANNE Epidemiology Lower GI bleeding accounts for 20-25% of all GI bleeding Annual incidence in USA :21-27/100000 Longstreth
More informationAbdominal Solid Organ Injury
Abdominal Solid Organ Injury 8 th Nordic Course Stockholm, Sweden May 19-22, 2014 K.SHANMUGANATHAN M.D. ABDOMINAL TRAUMA OBJECTIVES Splenic injury Late arterial / early p-v phase imaging Liver injury Blunt
More informationContaminated Wound: Report of a Cas
NAOSITE: Nagasaki University's Ac Title Author(s) Citation Endovascular Treatment of a Carotid Contaminated Wound: Report of a Cas Yamaguchi, Nimpei; Kaneko, Kenichi; Takahashi, Haruo Acta medica Nagasakiensia,
More informationLAPAROSCOPIC SPLENECTOMY
LAPAROSCOPIC SPLENECTOMY Strasboug, IRCAD October 2010 Catherine HUBERT Jean François GIGOT Benoît NAVEZ Division of Hepato Bilio Pancreatic Surgery Department of Abdominal Surgery and Transplantation
More informationPostpancreatectomy Hemorrhage: Imaging and Interventional Radiological Treatment
Postpancreatectomy Hemorrhage: Imaging and Interventional Radiological Treatment Poster No.: C-1422 Congress: ECR 2014 Type: Educational Exhibit Authors: T. Matsuura, K. Takase, T. Hasegawa, H. Ota, K.
More informationTasopoulou KM 1, Argyriou C 1, Mantatzis M 2, Kantartzi K 3, Passadakis P 3, Georgiadis GS 1
Tasopoulou KM 1, Argyriou C 1, Mantatzis M 2, Kantartzi K 3, Passadakis P 3, Georgiadis GS 1 1 Department of Vascular Surgery, 2 Department of Radiology/Interventional Radiology Unit and 3 Department of
More informationCT diagnosis of splenic infarction in blunt trauma: imaging features, clinical significance and complications
Clinical Radiology (2004) 59, 342 348 CT diagnosis of splenic infarction in blunt trauma: imaging features, clinical significance and complications L.A. Miller, S.E. Mirvis, K. Shanmuganathan, A.S. Ohson*
More informationMANAGEMENT OF SOLID ORGAN INJURIES: NON- OPERATIVE, INTERVENTIONAL AND OPERATIVE
MANAGEMENT OF SOLID ORGAN INJURIES: NON- OPERATIVE, INTERVENTIONAL AND OPERATIVE April 4, 2017 Ellen Omi, MD, FACS Trauma and Critical Care Site Program Director, Surgery Advocate Christ Medical Center
More informationCase 37 Clinical Presentation
Case 37 73 Clinical Presentation The patient is a 62-year-old woman with gastrointestinal (GI) bleeding. 74 RadCases Interventional Radiology Imaging Findings () Image from a selective digital subtraction
More informationDelayed Splenic Rupture After Non-Operative Management of Blunt Splenic Injury A AAST Multi-Institutional Prospective Trial Data Collection Tool
Delayed Splenic Rupture After Non-Operative Management of Blunt Splenic Injury A AAST Multi-Institutional Prospective Trial Data Collection Tool Enrolling Center: Patient Number (sequential within center):
More informationRuby Coil. Large Volume Detachable Coils
Ruby Coil Ruby Case Examples 38 mm Hepatic Artery Aneurysm Pulmonary AVM 2 Coils Dr. James Benenati Miami Cardiac and Vascular Institute, FL Y90 Embolization Type 2 Endoleak Dr. J Moskovitz Florida Hospital,
More informationBSIC, Manchester, September 15, Gerald S. Werner, MD, FESC, FACC Klinikum Darmstadt, Germany
BSIC, Manchester, September 15, 2006 Gerald S. Werner, MD, FESC, FACC Klinikum Darmstadt, Germany BSIC, Manchester, September 15, 2006 Chronic total occlusions update A European perspective Gerald S. Werner,
More informationAn Overview of Splenic Embolization
Vascular and Interventional Radiology Review Ahuja et al. Splenic Embolization Vascular and Interventional Radiology Review FOCUS ON: Chaitanya Ahuja 1 Khashayar Farsad 2 Meghna Chadha 1 Ahuja C, Farsad
More informationTreating Pulmonary Arteriovenous Malformations: What to Do and What Not to Do
Baptist Health South Florida Scholarly Commons @ Baptist Health South Florida All Publications 2016 Treating Pulmonary Arteriovenous Malformations: What to Do and What Not to Do Ripal Gandhi Baptist Hospital
More informationThe essentials for BTK procedures: wires, balloons, what else
A comprehensive approach to diabetic patient Tx The essentials for BTK procedures: wires, balloons, what else Dai-Do Do Clinical and Interventional Angiology Cardiovascular Department Disclosure Speaker
More informationBilateral use of the Gore IBE device for bilateral CIA aneurysms and a first interim analysis of the prospective Iceberg registry
Bilateral use of the Gore IBE device for bilateral CIA aneurysms and a first interim analysis of the prospective Iceberg registry Michel MPJ Reijnen, MD, PhD Department of Vascular Surgery, Rijnstate Hospital
More informationLessons for Successful Subintimal Angioplasty in SFA CTO
Lessons for Successful Subintimal Angioplasty in SFA CTO John R. Laird Professor of Medicine Medical Director of the Vascular Center UC Davis Medical Center CTOs in the Periphery Presence of Total Occlusion
More informationRAPID OCCLUSION OF THE INTERNAL CAROTID ARTERY WITH AMPLATZER VASCULAR PLUG AFTER INJURY
RAPID OCCLUSION OF THE INTERNAL CAROTID ARTERY WITH AMPLATZER VASCULAR PLUG AFTER INJURY Resident(s): Salim Abboud 1, MD; Sasan Partovi 1, MD 1, and Manjila, MD 2 Sunil Attending(s): Kristine Blackham
More informationDiagnosis & Management of Kidney Trauma. LAU - Urology Residency Program LOP Urology Residents Meeting
Diagnosis & Management of Kidney Trauma LAU - Urology Residency Program LOP Urology Residents Meeting Outline Introduction Investigation Staging Treatment Introduction The kidneys are the most common genitourinary
More informationMODERN METHODS FOR TREATING ABDOMINAL ANEURYSMS AND THORACIC AORTIC DISEASE
MODERN METHODS FOR TREATING ABDOMINAL ANEURYSMS AND THORACIC AORTIC DISEASE AAA FACTS 200,000 New Cases Each Year Ruptured AAA = 15,000 Deaths per Year in U.S. 13th Leading Cause of Death 80% Chance of
More informationMandatory knowledge about natural history of coronary grafts. P.Sergeant P. Maureira K.U.Leuven, Belgium
Mandatory knowledge about natural history of coronary grafts P.Sergeant P. Maureira K.U.Leuven, Belgium Types of grafts Arterial ITA/IMA (internal thoracic/mammary artery) Radial artery Gastro-epiploïc
More informationPeripheral Aneurysm Coiling Using Large Volume Ruby Coils Results from the ACE Study
Peripheral Aneurysm Coiling Using Large Volume Ruby Coils Results from the ACE Study Corey Teigen, MD 1 1 Sanford Medical Center, Fargo, ND Blaise Baxter, MD 2 ; J. David Moskovitz, MD 3 ; Henry Moyle,
More informationChristian Wissgott MD, PhD Assistant Director, Radiology Westküstenkliniken Heide
2-Year Results Of The Tack Optimized Balloon Angioplasty (TOBA) Trial For Fem- Pop Lesions Demonstrates Safety and Efficacy Of The Tack Endovascular System In Repairing Focal Post-PTA Dissections Christian
More informationEmbolization of Spontaneous Rupture of an Aneurysm of the Ovarian Artery Supplying the Uterus with Fibroids
Acta Radiologica ISSN: 0284-1851 (Print) 1600-0455 (Online) Journal homepage: https://www.tandfonline.com/loi/iard20 Embolization of Spontaneous Rupture of an Aneurysm of the Ovarian Artery Supplying the
More informationAs data on coil embolization
A Complete Embolization System The Ruby coil and POD devices. As data on coil embolization become more A robust, so must the tools and technology we use. Penumbra, Inc. has advanced this technology with
More informationMinimally Invasive Treatment Options for Renal Artery FMD
Minimally Invasive Treatment Options for Renal Artery FMD FMDSA Meeting 2016 Alan H. Matsumoto, M.D., FSIR, FACR, FAHA Professor and Chair Department of Radiology & Medical Imaging University of Virginia
More informationDEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service
M AY. 6. 2011 10:37 A M F D A - C D R H - O D E - P M O N O. 4147 P. 1 DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service Food and Drug Administration 10903 New Hampshire Avenue Document Control
More informationVisceral Artery Aneurysms Endovascular vs. Open?
Disclosures Visceral Artery Aneurysms Endovascular vs. Open? John S. Lane III, MD Professor and Acting Chief of Vascular Surgery UC San Diego, Department of Surgery None relevant UCSF Vascular Symposium,
More informationRadiological Investigations of Abdominal Trauma
76 77 Investigations of Abdominal Trauma Introduction: Trauma to abdominal organs is a common cause of patient morbidity and mortality among trauma patients. Causes of abdominal trauma include blunt injuries,
More informationVISCERAL ANEURYSM MANAGEMENT WHICH ENDOVASCULAR OPTION? PATRICE MWIPATAYI
VISCERAL ANEURYSM MANAGEMENT WHICH ENDOVASCULAR OPTION? PATRICE MWIPATAYI FCS (SA), MMed, FRACS Professor of Vascular surgery Royal Perth Hospital, University of Western Australia, Perth, WA Conflict of
More informationCase Conference. Discussion. Indications of Trauma Blue. Trauma Protocol In SKH. Trauma Blue VS. Trauma Red. Supervisor:VS 楊毓錚 Presenter:R1 周光緯
Case Conference Supervisor:VS 楊毓錚 Presenter:R1 周光緯 Discussion 2010.7.14 2/81 Trauma Protocol In SKH Indications of Trauma Blue Trauma Blue VS. Trauma Red 3/81 Severe trauma mechanism : 1. Trauma to multiple
More informationThe Supera stent In retrograde vascular access for SFA ostium treatment: The SUPRA-FAST Registry
The Supera stent In retrograde vascular access for SFA ostium treatment: PESTRICHELLA VINCENZO MD Chief Endovascular cathlab Mater Dei Hospital BARI- Italy Disclosure Speaker name:...pestrichella VINCENZO...
More informationPercutaneous Mechanical Thrombectomy for Acute Iliofemoral DVT with the Aspirex Catheter: The Dijon Experience
JFICV 2018, Beaune Percutaneous Mechanical Thrombectomy for Acute Iliofemoral DVT with the Aspirex Catheter: The Dijon Experience Prof. Romaric LOFFROY, MD, PhD, FCIRSE Chief, Department of Vascular and
More informationRecanalization Techniques: Sharp Needle Recanalization. Recanalization Techniques: Sharp Needle Recanalization
Recanalization of Occluded Central Veins When Conventional Methods Failed: Abigail Falk, MD, FSIR American Access Care New York, NY Conventional Methods of Recanalization Directional 0.035 and 0.018 Guidewires
More informationUPDATES IN INTRACRANIAL INTERVENTION Jordan Taylor DO Metro Health Neurology 2015
UPDATES IN INTRACRANIAL INTERVENTION Jordan Taylor DO Metro Health Neurology 2015 NEW STUDIES FOR 2015 MR CLEAN ESCAPE EXTEND-IA REVASCAT SWIFT PRIME RECOGNIZED LIMITATIONS IV Alteplase proven benefit
More informationTalent Abdominal Stent Graft
Talent Abdominal with THE Xcelerant Hydro Delivery System Expanding the Indications for EVAR Treat More Patients Short Necks The Talent Abdominal is the only FDA-approved device for proximal aortic neck
More informationInterventional options for treatment of pelvic vein congestion syndrome. Gerry O Sullivan
Interventional options for treatment of pelvic vein congestion syndrome Gerry O Sullivan gerard.osullivan2@hse.ie Not the easiest diagnosis I am quoting extensively from two European experts Miguel Angel
More informationCase Report Spleen-Preserving Surgery in Splenic Artery Aneurysm
Hindawi Case Reports in Surgery Volume 2017, Article ID 8716962, 4 pages https://doi.org/10.1155/2017/8716962 Case Report Spleen-Preserving Surgery in Splenic Artery Aneurysm Ulaş Aday,Emre Bozdağ,EbubekirGündeş,Selçuk
More informationThe gastroduodenal artery: Radiological anatomy, imaging and endovascular intervention
The gastroduodenal artery: Radiological anatomy, imaging and endovascular intervention Poster No.: C-2049 Congress: ECR 2010 Type: Educational Exhibit Topic: Interventional Radiology Authors: R. D. White,
More informationSPECIAL DIAGNOSTIC STUDIES IN BLUNT TRAUMA OLEH : Prof.DR.Dr Abdul Rasyid SpRad (K),Ph.D Dr.Evo Elidar Sp.Rad
SPECIAL DIAGNOSTIC STUDIES IN BLUNT TRAUMA OLEH : Prof.DR.Dr Abdul Rasyid SpRad (K),Ph.D Dr.Evo Elidar Sp.Rad Trauma Emergency Room layout Ideally the trauma emergency room is centrally located to provide
More informationACUTE PANCREATITIS: NEW CLASSIFICATION OF AN OLD FOE. T Barrow, A Nasrullah, S Liong, V Rudralingam, S A Sukumar
ACUTE PANCREATITIS: NEW CLASSIFICATION OF AN OLD FOE T Barrow, A Nasrullah, S Liong, V Rudralingam, S A Sukumar LEARNING OBJECTIVES q Through a series of cases illustrate the updated Atlanta symposium
More informationFalse Lumen Occlusion Techniques in CAD:
University Heart Center Hamburg GERMAN AORTIC CENTER False Lumen Occlusion Techniques in CAD: What is ist role? How is it done? Tilo Kölbel Fiona Rohlffs, Nikos Tsilimparis, Sebastian Debus German Aortic
More informationCT IMAGING OF BLUNT SPLENIC INJURY: A PICTORIAL ESSAY
CT IMAGING OF BLUNT SPLENIC INJURY: A PICTORIAL ESSAY Radhiana H, Azian AA, Ahmad Razali MR, Amran AR, Azlin S, S Kamariah CM Department of Radiology International Islamic University Malaysia Kuantan,
More informationPre-surgical embolization of vertebral lesions Our experience
Prof. Marco Leonardi Servizio e Cattedra di Neuroradiologia Università di Bologna Ospedale Bellaria www.neuroradiologia.unibo.it Pre-surgical embolization of vertebral lesions Our experience Dr Luigi Simonetti
More informationCHIEF COMPLAINT & HPI
THE GREAT HOUDINI Resident: Marc Lim, MD Attending: Shekher Maddineni, MD Program/Department: Westchester Medical Center/New York Medical College/Department of Radiology CHIEF COMPLAINT & HPI Chief Complaint
More informationWhat s on the Horizon in Dialysis Access? Libby Watch, MD, FACS Miami Cardiac & Vascular Institute
What s on the Horizon in Dialysis Access? Libby Watch, MD, FACS Miami Cardiac & Vascular Institute Disclosures No relevant disclosures Employee Advanced Access Care Dialysis Work 5 operating surgeons 3
More informationMultidetector CTA for Diagnosing Blunt Cerebrovascular Injuries
Multidetector CTA for Diagnosing Blunt Cerebrovascular Injuries 4 th Nordic Trauma Course 2006 Stuart E. Mirvis, M.D., FACR Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland
More informationEthylene-vinyl alcohol polymer transarterial embolization in emergency peripheral active bleeding
Ethylene-vinyl alcohol polymer transarterial embolization in emergency peripheral active bleeding Ierardi AM, Duka E, Micieli C, Carrafiello G Interventional Radiology Unit University of Insubria, Varese
More informationTranscatheter closure of right coronary artery fistula to the right ventricle
Case Report Transcatheter closure of right coronary artery fistula to the right ventricle Abstract Coronary artery fistula (CAF) is an uncommon anomaly usually congenital but can be acquired. Although,
More informationLAPAROSCOPIC SPLENECTOMY
LAPAROSCOPIC SPLENECTOMY Catherine HUBERT Jean François GIGOT Benoît NAVEZ Strasboug, IRCAD October 2011 Division of Hepato Bilio Pancreatic Surgery Department of Abdominal Surgery and Transplantation
More informationRotarex mechanical thrombectomythe first line option for thrombotic occlusions?
Rotarex mechanical thrombectomythe first line option for thrombotic occlusions? Dierk Scheinert, MD Division of Interventional Angiology University Hospital Leipzig, Germany Disclosure Advisory Board /Consultant:
More informationVertebral Artery Pseudoaneurysm
Vertebral Artery Pseudoaneurysm T. W. Khanzada,K. R. Makhdoomi ( Department of Vascular Surgery, Liaquat National Postgraduate Medical Centre, Karachi. ) Vertebral artery (VA) pseudoaneurysms are exceedingly
More informationaccount for 10% to 15% of all traffic fatalities majority fatal at the scene 50% who survive the initial injury die in the first 24 hours 90% die
account for 10% to 15% of all traffic fatalities majority fatal at the scene 50% who survive the initial injury die in the first 24 hours 90% die within the first month if aorta not repaired 30-90% overall
More informationResidual Dissection and False Lumen Aneurysm After TEVAR
WHAT WOULD YOU DO? Residual Dissection and False Lumen Aneurysm After MODERATOR: MARK FARBER, MD PANEL: YAZAN DUWAYRI, MD; MATTHEW J. EAGLETON, MD; WILLIAM D. JORDAN Jr, MD; TILO KÖLBEL, MD, PhD; AND ERIC
More informationBRTO /PARTO Indications and outcomes
BRTO /PARTO Indications and outcomes Saher Sabri, MD Associate Professor of Radiology and Surgery Division of Interventional Radiology University of Virginia Health System Saher Sabri, M.D. Speakers Bureau:
More informationThree year experience with multilayer stent in the treatment of thoracoabdominal aneurysms no evidence for aneurysm stabilization
Three year experience with multilayer stent in the treatment of thoracoabdominal aneurysms no evidence for aneurysm stabilization Thomas Larzon, MD, PhD Head of Vascular Surgery Dept of Cardiothoracic
More informationTraumatic Posterior Tibial Pseudoaneursym: A rare late complication repaired conventionally
Volume 2 Issue 3 Article 3 2016 Traumatic Posterior Tibial Pseudoaneursym: A rare late complication repaired conventionally Farzad Amiri, MD; Zachary Sanford; and Constantinous Constantinou, MD Follow
More information