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Concepts, considerations, and concerns on the cutting edge of radiofrequency ablation.
Brown DB
(2005) J Vasc Interv Radiol 16: 597-613
MeSH Terms: Catheter Ablation, Humans, Neoplasms, Radiography, Interventional, Tomography, X-Ray Computed
Show Abstract · Added March 5, 2014
Radiofrequency (RF) ablation is rapidly expanding from a tool to treat isolated hepatic malignancy to a therapy for patients with renal, adrenal, skeletal, breast, lung, and other soft-tissue neoplasms. The purpose of this article is to review the status of RF ablation outside the liver and lung and compare outcomes with current clinical standards when appropriate. The author also reviews how differences in local tissue environments play a role in creation of a thermal lesion and achievement of subsequent clinical success.
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5 MeSH Terms
Quality improvement guidelines for percutaneous management of acute limb ischemia.
Rajan DK, Patel NH, Valji K, Cardella JF, Bakal C, Brown D, Brountzos E, Clark TW, Grassi C, Meranze S, Miller D, Neithamer C, Rholl K, Roberts A, Schwartzberg M, Swan T, Thorpe P, Towbin R, Sacks D, CIRSE and SIR Standards of Practice Committees
(2005) J Vasc Interv Radiol 16: 585-95
MeSH Terms: Acute Disease, Arm, Combined Modality Therapy, Humans, Ischemia, Leg, Patient Selection, Peripheral Vascular Diseases, Radiography, Interventional, Thrombectomy, Thrombolytic Therapy
Added March 5, 2014
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1 Members
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11 MeSH Terms
Gadolinium, carbon dioxide, and iodinated contrast material for planning inferior vena cava filter placement: a prospective trial.
Brown DB, Pappas JA, Vedantham S, Pilgram TK, Olsen RV, Duncan JR
(2003) J Vasc Interv Radiol 14: 1017-22
MeSH Terms: Aged, Angiography, Digital Subtraction, Carbon Dioxide, Contrast Media, Female, Gadolinium, Humans, Male, Middle Aged, Observer Variation, Prospective Studies, Radiography, Interventional, Renal Veins, Vena Cava Filters, Vena Cava, Inferior
Show Abstract · Added March 5, 2014
PURPOSE - To prospectively compare the diagnostic accuracy of CO(2) and gadolinium to iodinated contrast material for inferior vena cavography before inferior vena cava (IVC) filter placement.
MATERIALS AND METHODS - Forty patients underwent injection of iodinated contrast material, CO(2), and gadolinium. Iodinated contrast material was used as the standard. Caval diameter was determined with calibrated software. Three readers blinded to contrast agent used measured the distance from the superior image border to the inferior margin of the renal veins and from the inferior image border to the iliac bifurcation. The measurements with CO(2) and gadolinium were compared to those with iodinated contrast material to obtain the interobserver and intraobserver variability. The presence or absence of caval thrombus and variant anatomy was noted. The same readers reexamined 12 studies in a separate session to determine intraobserver variability and correlation.
RESULTS - Caval diameter differed by 0.4 mm or less for all three agents. Measurements with all agents were within 2 mm of each other for all patients. Gadolinium and CO(2) were not significantly different from one another in measuring caval diameter. At the initial reading, compared with iodinated contrast material, gadolinium had greater mean interobserver error in measuring the distance to the iliac bifurcation and both renal veins (range, 1.6-1.8 mm) than CO(2) (range, 0.2-1.4 mm). This finding, although statistically significant for gadolinium (P <.05), was of doubtful clinical relevance. Interobserver correlation was significantly worse for CO(2) at the levels of the iliac bifurcation (P =.02) and right renal vein (P =.008). Interobserver correlation for gadolinium was similar to that for iodinated contrast material at all levels. At repeat reading, there was significantly inferior intraobserver correlation with use of CO(2) for both renal veins (P <.05) compared to iodinated contrast material and for the left renal vein (P <.05) compared to gadolinium. Gadolinium identified three of three renal vein anomalies identified with iodinated contrast material whereas CO(2) localized one of three.
CONCLUSION - CO(2) and gadolinium had limitations when compared with iodinated contrast material. Gadolinium provided superior consistency in identifying relevant landmarks for filter placement. CO(2) demonstrated significantly greater mean correlative error than gadolinium at initial and repeat readings.
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15 MeSH Terms
Angioscopic observations after percutaneous thrombectomy of thrombosed hemodialysis grafts.
Vesely TM, Hovsepian DM, Darcy MD, Brown DB, Pilgram TK
(2000) J Vasc Interv Radiol 11: 971-7
MeSH Terms: Angioscopy, Blood Vessel Prosthesis, Female, Graft Occlusion, Vascular, Humans, Male, Prospective Studies, Radiography, Interventional, Renal Dialysis, Statistics, Nonparametric, Thrombectomy, Thrombosis, Treatment Outcome, Videotape Recording
Show Abstract · Added March 5, 2014
PURPOSE - To use angioscopy to evaluate and compare the amount of residual thrombus and endoluminal wall damage in hemodialysis grafts after percutaneous thrombectomy procedures.
MATERIALS AND METHODS - Thirty-nine thrombectomy and angioscopy procedures were performed in 35 patients. Percutaneous thrombectomy methods included eight different mechanical thrombectomy devices and the "lyse and wait" technique. Videotaped images of 33 angioscopic examinations were independently reviewed by three radiologists. Two parameters-the amount of residual thrombus and degree of endoluminal wall damage-were scored on a scale of 1 to 5. Data were initially analyzed to validate the grading system and then further studied to compare the different thrombectomy techniques.
RESULTS - The Spearman rank order analysis validated the data pertaining to the amount of residual thrombus (r = 0.71, P < .0001), but there was poor correlation between reviewers regarding the degree of endoluminal wall damage. Combined scores from three reviewers revealed that the Cragg brush and Percutaneous Thrombectomy Device (PTD) left the smallest amounts of residual thrombus. The other methods tested, listed by increasing amount of residual thrombus, were the Endovac, Hydrolyser, Amplatz Thrombectomy Device, AngioJet, Oasis, and the lyse and wait technique. There were two complications related to angioscopy procedures.
CONCLUSION - Subjective observations reveal that wall-contact thrombectomy devices leave less residual thrombus than hydrodynamic devices, aspiration devices, or the lyse and wait technique.
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14 MeSH Terms
Diagnosis of non-Hodgkin's lymphoma using flow cytometry.
Brown DB, Simpson EL, Carr R
(1996) AJR Am J Roentgenol 166: 727-8
MeSH Terms: Aged, Biopsy, Needle, Flow Cytometry, Humans, Intestinal Neoplasms, Lymphoma, Non-Hodgkin, Male, Radiography, Interventional, Tomography, X-Ray Computed
Added March 5, 2014
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9 MeSH Terms