This study aimed to examine the diagnostic accuracy and clinical efficacy of initial CT-guided percutaneous biopsy of the vertebral lesions. A total of 305 percutaneous biopsies of the vertebral lesions were performed under either CT guidance (n=127) or C-arm guidance (n=178). The diagnostic accuracy rate was evaluated by comparing the histopathological diagnosis with the ultimate diagnosis. The histopathological diagnosis was consistent with the ultimate diagnosis in 108 (85.0%, 108/127) cases of CT-guided biopsy and in 135 (75.8%, 135/178) cases of C-arm guided biopsy and there was a significant difference. The accuracy of diagnosis based on biopsies varied with different diseases, including primary benign or malignant tumors, metastatic tumors, inflammatory lesions and fractures. A second biopsy or further examinations were required for patients with negative result obtained in the initial biopsy. The complication rate was 3.1% (4/127) in CT-guided biopsy and 7.3% (13/178) in C-arm guided biopsy. In conclusion, CT-guided percutaneous biopsy is an accurate and safe technique for biopsy of the vertebral lesions.
Biopsy, Needle ; methods ; Diagnosis, Differential ; Humans ; Radiography, Interventional ; adverse effects ; methods ; Reproducibility of Results ; Retrospective Studies ; Sensitivity and Specificity ; Spinal Diseases ; diagnosis ; Tomography, X-Ray Computed ; adverse effects ; methods

Coronary stent dislodgement is a rare complication of percutaneous coronary intervention. We report a case of stent dislodgement in the ascending thoracic aorta. The stent was mechanically distorted in the left circumflex artery (LCX) while being delivered to the proximal LCX lesion. The balloon catheter was withdrawn, but the stent with the guide wire was remained in the ascending thoracic aorta. The stent was unable to be retrieved into the guide catheter, as it was distorted. A goose neck snare was used successfully to catch the stent in the ascending thoracic aorta and retrieved the stent externally via the arterial sheath.
Angioplasty, Balloon, Coronary/*adverse effects/*instrumentation ; *Aorta, Thoracic/radiography ; Cardiac Catheterization/*adverse effects/*instrumentation ; Coronary Angiography ; Device Removal/*instrumentation ; Foreign Bodies/etiology/radiography/*therapy ; Humans ; Male ; Middle Aged ; Radiography, Interventional ; *Stents ; Treatment Outcome

OBJECTIVE: To compare the efficacy and adverse effects of endovenous foam sclerotherapy (EFS) and liquid sclerotherapy (ELS) using a microcatheter for the treatment of varicose tributaries. MATERIALS AND METHODS: From December 2007 to January 2009, patients with venous reflux in the saphenous vein were enrolled. The foam or liquid sclerosant was injected through a microcatheter just before endovenous laser ablation (EVLA). Patients were evaluated for the technical success, clinical success, and procedure-related complications during the procedure and follow-up visits. RESULTS: A total of 94 limbs were included: 48 limbs (great saphenous vein [GSV], 35; small saphenous vein [SSV], 13) were managed using EFS and EVLA (foam group; FG), and 46 limbs (GSV, 37; SSV, 9) were treated by ELS and EVLA (liquid group; LG). Varicose tributaries demonstrated complete sclerosis in 92.7% with FG and in 71.8% with LG (p = 0.014). Bruising (78.7% in FG vs. 73.2% in LG, p > 0.05), pain or tenderness (75.6% in FG vs. 51.2% in LG, p = 0.0237) were noted. Hyperpigmentation (51.2% in FG vs. 46.2% in LG, p > 0.05) was found. CONCLUSION: Endovenous foam sclerotherapy using a microcatheter is more effective than ELS for eliminating remnant varicose tributaries prior to EVLA. However, EFS is more commonly associated with local complications such as pain or tenderness than ELS. Furthermore, both techniques seem to prolong the duration of hyperpigmentation along with higher costs.
Catheters/adverse effects ; Femoral Vein ; Fluoroscopy/methods ; Humans ; Laser Therapy/methods ; Radiography, Interventional/methods ; *Saphenous Vein/radiography/surgery ; Sclerosing Solutions/*administration & dosage/chemistry ; Sclerotherapy/adverse effects/instrumentation/*methods ; Treatment Outcome ; Varicose Veins/radiography/*therapy ; Venous Insufficiency/surgery

OBJECTIVE: We wanted to assess the safety and efficacy of performing radiofrequency ablation (RFA) in patients with non-colorectal liver metastases. MATERIALS AND METHODS: In this retrospective study, 25 patients with 40 hepatic metastases (M:F = 17:8; mean age, 57 years; tumor size, 0.5-5.0 cm) from a non-colorectal origin (stomach, biliary, breast, pancreas, kidney and skin) were treated with RFA. The RFA procedures were performed using either an internally cooled electrode or a clustered electrode under ultrasound or CT guidance. Contrast-enhanced CT scans were obtained immediately after RFA and follow-up CT scans were performed within three months after ablation and subsequently at least every six months. The intrahepatic disease-free interval was estimated and the overall survival from the time of the initial RFA was analyzed using the Kaplan-Meier method. RESULTS: No intraprocedural deaths occurred, but four major complications developed, including abscesses (n = 3) and pneumothorax (n = 1). Technical effectiveness was determined on the initial follow-up images. During the follow-up period (range, 5.9-68.6 months; median time, 18.8 months) for 37 tumors in 22 patients where technical effectiveness was achieved, 12 lesions (32%, 12 of 37) showed local tumor progression and new intrahepatic metastases occurred in 13 patients (59%, 13 of 22). The median intrahepatic disease-free interval was 10.1 months. The 1-year, 3-year and 5-year overall survival rates after RFA were 86%, 39% and 19%, respectively. CONCLUSION: RFA showed intermediate therapeutic effectiveness for the treatment of non-colorectal origin liver metastases.
Adult ; Aged ; Aged, 80 and over ; *Catheter Ablation/adverse effects ; Disease Progression ; Disease-Free Survival ; Female ; Humans ; Liver Neoplasms/mortality/radiography/*secondary/*surgery ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Radiography, Interventional ; Tomography, X-Ray Computed ; Ultrasonography, Interventional

A percutaneous transthoracic needle biopsy is a common procedure in the practice of pulmonology. An air embolism is a rare but potentially fatal complication of a percutaneous transthoracic needle biopsy. We report four cases of a cerebral air embolism that developed after a percutaneous transthoracic needle biopsy. Early diagnosis and the rapid application of hyperbaric oxygen therapy is the mainstay of therapy for an embolism. Prevention is the best course and it is essential that possible risk factors be avoided.
Adult ; Aged ; Biopsy, Needle/*adverse effects/methods ; Embolism, Air/*etiology/therapy ; Female ; Humans ; Hyperbaric Oxygenation ; Intracranial Embolism/*etiology/therapy ; Lung/*pathology ; Male ; Radiography, Interventional

No abstract available.
Aged ; Cardiovascular Agents/*administration & dosage ; Drug-Eluting Stents/*adverse effects ; *Femoral Artery/radiography/ultrasonography ; Foreign-Body Migration/diagnosis/*etiology ; Humans ; Male ; Percutaneous Coronary Intervention/*adverse effects/instrumentation ; Prosthesis Design ; Sirolimus/*administration & dosage ; Ultrasonography, Interventional

Acute kidney injury (AKI) is closely associated with the mortality of hospitalized patients and long-term development of chronic kidney disease, especially in children. The purpose of our study was to assess the evidence of contrast-induced AKI after cardiac catheterization in children with heart disease and evaluate the clinical usefulness of candidate biomarkers in AKI. A total of 26 children undergoing cardiac catheterization due to various heart diseases were selected and urine and blood samples were taken at 0 hr, 6 hr, 24 hr, and 48 hr after cardiac catheterization. Until 48 hr after cardiac catheterization, there was no significant increase in serum creatinine level in all patients. Unlike urine kidney injury molecule-1, IL-18 and neutrophil gelatinase-associated lipocalin, urine liver-type fatty acid-binding protein (L-FABP) level showed biphasic pattern and the significant difference in the levels of urine L-FABP between 24 and 48 hr. We suggest that urine L-FABP can be one of the useful biomarkers to detect subclinical AKI developed by the contrast before cardiac surgery.
Acute Kidney Injury/blood/*chemically induced/*urine ; Biological Markers/urine ; Cardiac Catheterization/*adverse effects ; Child ; Contrast Media/adverse effects/diagnostic use ; Fatty Acid-Binding Proteins/*urine ; Female ; Heart Defects, Congenital/complications/*radiography ; Humans ; Iohexol/adverse effects/*analogs & derivatives/diagnostic use ; Male ; Radiography, Interventional/adverse effects ; Reproducibility of Results ; Sensitivity and Specificity

BACKGROUND/AIMS: Radiofrequency ablation (RFA) is emerging as a new therapeutic method in the management of hepatocellular carcinoma (HCC). We report the results of 64 patients with a follow-up interval of 3 to 19 months. METHOD: Sixty-four patients with 82 nodules underwent ultrasound guided RFA. The mean tumor diameter was 2.5+/-1.0 cm. Laparoscopic ultrasound guided RFA was performed in 38 cases, and percutaneous ultrasound guided RFA in 26 cases. The therapeutic efficacy was evaluated by means of three-phase dynamic abdominal computed tomography (CT) performed within at least one week after ablating. The recurrence was evaluated after treatment by means of abdominal CT and alpha fetoprotein every 3 months. We calculated cumulative recurrence rates, survival rates of patients, and found out complication of RFA. RESULTS: Cumulative recurrence rates in 3, 6, 12 months after RFA was 8.8%, 15.8%, 25.9%. 12 cases were recurred during follow-up. Among them, intrahepatic recurrences were noted in 11 cases, local recurrences in 3 cases. Cumulative survival curves indicated that survival rate was 95% at the third month, 94% at the sixth month, 81% at the twelfth month. After RFA, the alpha fetoprotein level was decreased significantly after 1 month (p<0.05), and serum transaminase levels were transiently elevated (p<0.01) but returned to normal within one week. Complications of RFA were not serious, and resolved spontaneously. CONCLUSION: RFA can be considered a useful new treatment for HCC. Laparoscopic RFA is a useful procedure for the treatment of HCC regardless of its location.
Adult ; Aged ; Carcinoma, Hepatocellular/radiography/*surgery/ultrasonography ; *Catheter Ablation/adverse effects ; English Abstract ; Female ; Human ; *Laparoscopy ; Liver Neoplasms/radiography/*surgery/ultrasonography ; Male ; Middle Aged ; Neoplasm Recurrence, Local ; Tomography, X-Ray Computed ; *Ultrasonography, Interventional

OBJECTIVE: The aim of this study was to report on the long-term results of transabdominal ultrasound guided conformal brachytherapy in patients with cervical cancer with respect to patterns of failures, treatment related toxicities and survival. METHODS: Three hundred and nine patients with cervical cancer who presented to Institute between January 1999 and December 2008 were staged with magnetic resonance imaging and positron emission tomography and treated with external beam radiotherapy and high dose rate conformal image guided brachytherapy with curative intent. Follow-up data relating to sites of failure and toxicity was recorded prospectively. RESULTS: Two hundred and ninety-two patients were available for analyses. The median (interquantile range) follow-up time was 4.1 years (range, 2.4 to 6.1 years). Five-year failure free survival and overall survival (OS) were 66% and 65%, respectively. Primary, pelvic, para-aortic, and distant failure were observed in 12.5%, 16.4%, 22%, and 23% of patients, respectively. In multivariate analysis, tumor volume and nodal disease related to survival, whereas local disease control and point A dose did not. CONCLUSION: Ultrasound guided conformal brachytherapy of cervix cancer has led to optimal local control and OS. The Melbourne protocol compares favorably to the more technically elaborate and expensive GEC-ESTRO recommendations. The Melbourne protocol's technical simplicity with real-time imaging and treatment planning makes this a method of choice for treating patients with cervical cancer.
Adenocarcinoma/pathology/radiography/secondary/ultrasonography ; Adult ; Aged ; Brachytherapy/adverse effects/*methods ; Carcinoma, Squamous Cell/pathology/radiography/secondary/ultrasonography ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Lymphatic Metastasis ; Middle Aged ; Neoplasm Staging ; Prognosis ; Prospective Studies ; Radiation Dosage ; Radiotherapy, Conformal/adverse effects/*methods ; Treatment Failure ; Ultrasonography, Interventional/*methods ; Uterine Cervical Neoplasms/pathology/*radiography/ultrasonography

BACKGROUND/AIMS: Recent intravascular ultrasound (IVUS) studies of sirolimus-eluting stents (SES) and paclitaxel-eluting stents (PES) have demonstrated a significant reduction in neointimal hyperplasia (NIH) based on simple coronary lesions. In this study, we evaluated the efficacy of SES and PES using IVUS in complex coronary lesions. METHODS: Eighty-seven patients in whom 95 drug-eluting stents (66 SES and 29 PES) were implanted in complex coronary lesions were enrolled in this study. Case selection was based on the availability of IVUS and quantitative coronary angiographic (QCA) examinations at the index procedure and at follow-up. The neointimal volume index (volume/length: NIVI) and percent neointimal volume (% NIV) were calculated. The longitudinal length of stented segments without IVUS-detectable NIH was also evaluated. RESULTS: The baseline patient demographics were similar between the SES and PES groups. At follow-up, no significant differences were observed in the vessel, plaque, or stent volume indices between the two groups. However, the NIVI and % NIV were significantly lower in the SES group (p<0.01). The longitudinal length of stented segments without IVUS-detectable NIH was significantly higher in the SES group (p<0.01). The net gain was significantly larger in the SES group (2.3+/-0.7 vs. 2.0x0.6 mm, p=0.025), while the rate of major adverse cardiac events was similar between the two groups. CONCLUSIONS: Although SES showed significantly greater suppression of NIH at follow-up, both stents were highly effective at inhibiting NIH in complex coronary lesions.
Adult ; Aged ; Coronary Angiography ; Coronary Artery Disease/radiography/*therapy/ultrasonography ; *Drug-Eluting Stents/adverse effects ; Female ; Follow-Up Studies ; Humans ; Hyperplasia ; Male ; Middle Aged ; Paclitaxel/*administration & dosage ; Sirolimus/*administration & dosage ; Tunica Intima/pathology ; Ultrasonography, Interventional/*methods