T he main central venous routes used in chronic hemodialysis patients with insufficient arteriovenous (AV) fistulas and graft failure are the jugular, subclavian, and femoral veins. Repeated interventions and chronic thrombosis, stenosis, and occlusions secondary to long-term catheterizations can make the use of these veins impossible over years (1,2). Alternative routes are lifesaving in these cases, and the principle routes are the translumbar inferior vena cava (IVC) and transhepatic veins (2-5).The use of the translumbar route is more widespread, its efficiency and safety are well known, and the experience in using this method has already been reported in the literature (5-8). Hepatic vein and IVC catheterization through the transhepatic route is a comparatively more up-to-date method than the one through the translumbar route, and there is only limited experience in using this method. Its success and complication rates were first described by Po et al. (9) in 1994 in one case, and this method was further scrutinized in three retrospective studies comprising 12, 16, and 22 adult patients in the following years (2-4).The aim of this retrospective study was to investigate the safety and functionality of transhepatic hemodialysis catheters in a series of 38 patients. Methods PatientsThe study was approved by the local ethics committee. Thirty-eight transhepatic tunneled hemodialysis catheter implanted patients (mean age 58±11 years; range, 23-80 years; I N T E R V E N T I O N A L R A D I O LO G Y O R I G I N A L A R T I C L E PURPOSEWe aimed to investigate the safety and functionality of tunneled transhepatic hemodialysis catheters in chronic hemodialysis patients. METHODSThirty-eight patients (20 women aged 56±10 years and 18 men aged 61±11 years) with transhepatic tunneled hemodialysis catheters were evaluated. The date of the first transhepatic catheterization, indications, procedure details, functional time periods of catheters, reasons for the removal or revision of catheters, catheter-related complications, and current conditions of patients were retrospectively analyzed. RESULTSA total of 69 catheters were properly placed in all patients (100% technical success) under imaging guidance during the 91-month follow-up period. The functionality of 35 catheters could not be evaluated: five catheters were removed because of noncomplication related reasons (surgical fistulas were opened in two cases [2/35, 5.7%], transplantation was performed in three cases [3/35, 8.6%]), 18 patients died while their catheters were functional (18/35, 51.4%), and 12 catheters were still functional at the time of the study (12/35, 34.3%). The functionality of catheters was evaluated the remaining 34 catheters that necessitated revision because of complications. Furthermore, only half of the catheters were functional on day 136 when evaluated using Kaplan-Meier analysis. The four main complications were thrombosis (16/34, 47%; complication rate of 0.37 days in 100 catheters), infection (8/34, 23.5%; 0.18 days in 100 catheters), m...
Background: Pre-operative radiological identification of facial nerve anomalies can help prevent intra-operative facial nerve injury during cochlear implantation. This study aimed to evaluate the incidence and configuration of facial nerve anomalies and their concurrence with inner-ear anomalies in cochlear implant candidates.Methods: Inner-ear and concomitant facial nerve anomalies were evaluated by magnetic resonance imaging and temporal high-resolution computed tomography in 48 children with congenital sensorineural hearing loss who were cochlear implant candidates.Results: Inner-ear anomalies were present in 11 out of 48 patients (23 per cent) and concomitant facial nerve anomalies were present on 7 sides in 4 patients (7 per cent of the total). Facial nerve anomalies were accompanied by cochlear or vestibular malformation.Conclusion: Potential facial nerve abnormalities should always be considered in patients with inner-ear anomalies. Pre-operative facial nerve imaging can increase the surgeon's confidence to plan and perform cochlear implantation. Magnetic resonance imaging should be used to detect inner-ear anomalies; if these are identified, temporal high-resolution computed tomography should be used to evaluate the facial nerve.
SPC related complications do not differ in regard to ipsilateral or contralateral side selection on mastectomized patients with breast cancer and lymph node dissection. SPCs can be implanted on ipsilateral or contralateral sides of the operation in these patients.
The main reason for waist and back pain in patients with gigantomasty is increased thoracic kyphosis and lumber lordosis. These symptoms and abnormal spinal angulations regress after reduction mammoplasty operations. However, the effect of chronic mechanical stress caused by gigantomasty on the spinal degenerative process is not clear yet. In this study with computed tomography it is shown that degenerative spondylosis is more widespread and severe in patients with large breasts.
Imaging plays an important role in determining indications of cochlear implantation and choosing candidates for the procedure in children. Temporal high-resolution computed tomography (HRCT) and magnetic resonance imaging (MRI) can display precisely the complex anatomic structure of inner ear. Although HRCT permits detailed imaging of bony structures, MRI gives valuable information about membranous labyrinth, internal acoustic canal, and vestibulocochlear nerve. Magnetic resonance imaging examination of the brain should be performed at the same time to evaluate any coexistent brain parenchymal abnormality. These imaging modalities are complementary methods in evaluating congenital inner ear anomalies. The aim of this pictorial essay is to reviewing temporal HRCT and MRI findings of congenital inner ear anomalies.
ÖZET:Acil arteriyel kanamaların selektif embolizasyonunda farklı ajanların kullanılması Amaç: Dijital subtraksiyon anjiyografide (DSA) üst gastrointestinal sistem (GİS), alt GİS, pulmoner ve travma nedenli arteriyel kanama odağı tespit edilen ve farklı embolizasyon ajanlarla endovasküler embolizasyon tedavileri yapılan hastaları değerlendirmeyi amaçladık. Gereç ve Yöntem: Temmuz 2012-Nisan 2016 tarihleri arasında acil şartlarda girişimsel radyoloji departmanımıza embolizasyon amaçlı yönlendirilen hastaların retrospektif incelemesi yapıldı. Bu amaçla üst GİS, alt GİS, pulmoner ve travma nedenli kanama odağı olarak DSA'da kontrast madde ekstravazasyonu ve/veya psödoanevrizma tespit edilen hastalar kabul edildi. İşlem sonundaki tedavinin başarısı DSA'da kontrast madde ekstravazasyonunun ve/veya psödoanevrizmanın olmaması ile değerlendirildi. Bulgular: On bir üst GİS, 5 alt GİS, 6 pulmoner ve 7 travma kaynaklı toplam 29 arteriyel kanama odağı başarılı şekilde embolize edildi. Embolizasyon amaçlı üst GİS kanaması ile gelen 11 hastanın hepsinde koil; alt GİS kanaması ile gelen 3 hastada koil, 1 hastada koil+glue, 1 hastada akrilik mikropartikül; pulmoner kanaması ile gelen 3 hastada koil, 1 hastada polivinilalkol (PVA), 1 hastada koil+PVA, 1 hastada akrilik mikropartikül; travma nedenli kanama ile gelen 5 hastada koil, 2 hastada glue uygulandı. Tüm hastalarımızda işlem sonundaki DSA'larında kontrast madde ekstravazasyonu ve/veya psödoanevrizma izlenmedi. Sonuç: Farklı embolizasyon seçiminin artmasıyla ve mikrokateter teknolojisinin gelişmesiyle birlikte deneyimli girişimsel radyologlar tarafından yapılan arteriyel embolizasyonlarda teknik başarı oranı artmaktadır. Anahtar kelimeler: Arteriyel kanama, dijital subtraksiyon anjiyografi, embolizasyon ajan, endovasküler embolizasyon, girişimsel radyolog ABSTRACT:
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