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Treatment of DeBakey Ⅲ aortic dissection with domestic branched endovascular stent-graft
JVIR
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Posters and Exhibits
S261
pediatric population 2) Understand the advantages/ disadvantages, and complications, of nephrostomy tube placement in the pediatric population using the trocar technique. Background: Percutaneous nephrostomy tube placement is a common procedure performed to decompress the renal collecting system in the setting of genitourinary tract obstruction. Procedural differences between adult and pediatric placement of nephrostomy tubes is multifactorial. Superior ultrasonic visualization of the pediatric kidney when compared to adults facilitates access into the renal collecting system, bypassing the need for fluoroscopic radiation exposure and contrast administration. Additionally, the ability to perform nephrostomy tube placement via the trocar technique decreases procedure time, cost, and manipulation of the renal pelvis. Clinical Findings/Procedure Details: This educational exhibit will provide a pictorial and descriptive review of the trocar technique for nephrostomy tube placement in the pediatric patient. Additionally, pictorial and descriptive information regarding advantages/disadvantages and complications of trocar nephrostomy tube placement will be presented. Conclusions: The trocar technique is useful for nephrostomy tube placement in the pediatric population, although rarely described in the radiology literature. Using the trocar technique, we have successfully placed multiple pediatric nephrostomy tubes without complications. This technique for percutaneous nephrotomy tube placement in the pediatric population is simple, safe, and efficacious. References 1. Sancaktutar AA, et al., Radiation-free percutaneous nephrostomy performed on neonates, infants, and preschool-age children. J Pediatr Urol 2013; 9 (4):464–471. 2. Lodh B, et al., Ultrasound Guided Direct Percutaneous Nephrostomy (PCN) Tube Placement: Stepwise Report of a New Technique with Its Safety and Efficacy Evaluation. J Clin Diagn Res 2014; 8(2):84–87.
Abstract No. 593 Treatment of DeBakey III aortic dissection with domestic branched endovascular stent-graft J. Ma1, P. Zhou2, H. Xinwei3; 1Dept. of Radiology, the First Affiliated Hospital Zhengzhou University, Zhengzhou, China; 2The firstr affiliated hospital of Zhengzhou univenrsity, Zhengzhou, China; 3Zhengzhou, China
Abstract No. 594 Combined microwave ablation and percutaneous screws fixation plus cementoplasty in the treatment of painful bone metastases C. Pusceddu, L. Melis, N. Ballicu; AOBrotzu, Cagliari, Italy Purpose: The primary goal for bone metastases treatment is usually pain relief and preservation of ambulatory functions. Our retrospective study was made to evaluate the feasibility and effectiveness of TC-guided microwave ablation (MWA) and percutaneous screw fixation plus cementoplasty (PSFPC) in patients with painful bone metastases with fractures or to prevent pathological fracture. Materials: Fourteen patients (6 men and 8 women, median age 59 years) with 18 metastatic bone lesions underwent CT-guided MWA followed by PSFPC in the same session. All patients were not more susceptible for chemotherapy or radiotherapy and were considered unfit for surgery. All the procedures were performed under local anaesthesia and conscious sedation. Vertebrae (12 cases), femurs (4 cases) and pelvis (2 cases) were the intervention sites and the primary end point was pain relief. Pain severity was estimated by using a visual analogue scale (VAS) before treatment and 6 months post-treatment. Functional outcome was assessed by improved patient walking ability. Results: All sessions were completed and all procedures were well tolerated. There were no complications related to ablation or to incorrect positioning of the screws or leakage of cement. All patients were able to walk already within 6 hours after procedure and the average length of hospital stay was 2 days. VAS score decreased from 7.4 (range, 4-9) before treatment to 1.5 (range, 0-4) 6 months after and improvement patients’ walking ability at 6 months was 100%. No new bone fracture occurred during a median follow-up of 8 months. Conclusions: MWA followed by PSFPC is a safe and effective procedure which allows us to reduce the tumoral tissue, stabilize the fracture and prevent pathological fractures with significant pain relief and good recovery of walking ability. MWA followed by PSFPC seems to be a promising alternative for patients who are not candidates for surgery.However further studies with large series are required to confirm these preliminary results.
Educational Exhibit
Abstract No. 595
Percutaneous intraosseous doxycycline injections for aneurysmal bone cysts: a minimally invasive treatment option performed by interventional radiology J. Hughes1, A. Isaacson2, J. Stavas3; 1University of Oklahoma College of Medicine, Oklahoma City, OK; 2 UNC Dept of Radiology, Chapel Hill, NC; 3University of North Carolina, Chapel Hill, NC
Posters and Exhibits
Purpose: To investigate the efficacy of domestic branched endovascular stent-graft for DeBakey III aortic dissection. Materials: 82 patients with DeBakey III aortic dissection were diagnosed by contrast-enhanced CT scanning at 2-15 days from onset. The diatance from the orifice of left subclavian artery to primary entry tear point was less than 2 cm.Domestic branched stents were placed into left subclavian artery and the arch of aorta. Results: Stent-graft was successfully performed in all patients. All ruptures were completely closed.The blood flow in the true lumen and the left subclavian artery returned to normal.There were no complications during the 1 to 2 year follow-up. Conclusions: Domestic branched endovascular stent-graft is a safe, reliable and effective choice for acute aortic dissection.
When The diatance from the orifice of left subclavian artery to primary entry tear point was less than 2 cm, using this stent can keep the left subciacian artery blooding flow unobstructed.
’
Posters and Exhibits
S261
pediatric population 2) Understand the advantages/ disadvantages, and complications, of nephrostomy tube placement in the pediatric population using the trocar technique. Background: Percutaneous nephrostomy tube placement is a common procedure performed to decompress the renal collecting system in the setting of genitourinary tract obstruction. Procedural differences between adult and pediatric placement of nephrostomy tubes is multifactorial. Superior ultrasonic visualization of the pediatric kidney when compared to adults facilitates access into the renal collecting system, bypassing the need for fluoroscopic radiation exposure and contrast administration. Additionally, the ability to perform nephrostomy tube placement via the trocar technique decreases procedure time, cost, and manipulation of the renal pelvis. Clinical Findings/Procedure Details: This educational exhibit will provide a pictorial and descriptive review of the trocar technique for nephrostomy tube placement in the pediatric patient. Additionally, pictorial and descriptive information regarding advantages/disadvantages and complications of trocar nephrostomy tube placement will be presented. Conclusions: The trocar technique is useful for nephrostomy tube placement in the pediatric population, although rarely described in the radiology literature. Using the trocar technique, we have successfully placed multiple pediatric nephrostomy tubes without complications. This technique for percutaneous nephrotomy tube placement in the pediatric population is simple, safe, and efficacious. References 1. Sancaktutar AA, et al., Radiation-free percutaneous nephrostomy performed on neonates, infants, and preschool-age children. J Pediatr Urol 2013; 9 (4):464–471. 2. Lodh B, et al., Ultrasound Guided Direct Percutaneous Nephrostomy (PCN) Tube Placement: Stepwise Report of a New Technique with Its Safety and Efficacy Evaluation. J Clin Diagn Res 2014; 8(2):84–87.
Abstract No. 593 Treatment of DeBakey III aortic dissection with domestic branched endovascular stent-graft J. Ma1, P. Zhou2, H. Xinwei3; 1Dept. of Radiology, the First Affiliated Hospital Zhengzhou University, Zhengzhou, China; 2The firstr affiliated hospital of Zhengzhou univenrsity, Zhengzhou, China; 3Zhengzhou, China
Abstract No. 594 Combined microwave ablation and percutaneous screws fixation plus cementoplasty in the treatment of painful bone metastases C. Pusceddu, L. Melis, N. Ballicu; AOBrotzu, Cagliari, Italy Purpose: The primary goal for bone metastases treatment is usually pain relief and preservation of ambulatory functions. Our retrospective study was made to evaluate the feasibility and effectiveness of TC-guided microwave ablation (MWA) and percutaneous screw fixation plus cementoplasty (PSFPC) in patients with painful bone metastases with fractures or to prevent pathological fracture. Materials: Fourteen patients (6 men and 8 women, median age 59 years) with 18 metastatic bone lesions underwent CT-guided MWA followed by PSFPC in the same session. All patients were not more susceptible for chemotherapy or radiotherapy and were considered unfit for surgery. All the procedures were performed under local anaesthesia and conscious sedation. Vertebrae (12 cases), femurs (4 cases) and pelvis (2 cases) were the intervention sites and the primary end point was pain relief. Pain severity was estimated by using a visual analogue scale (VAS) before treatment and 6 months post-treatment. Functional outcome was assessed by improved patient walking ability. Results: All sessions were completed and all procedures were well tolerated. There were no complications related to ablation or to incorrect positioning of the screws or leakage of cement. All patients were able to walk already within 6 hours after procedure and the average length of hospital stay was 2 days. VAS score decreased from 7.4 (range, 4-9) before treatment to 1.5 (range, 0-4) 6 months after and improvement patients’ walking ability at 6 months was 100%. No new bone fracture occurred during a median follow-up of 8 months. Conclusions: MWA followed by PSFPC is a safe and effective procedure which allows us to reduce the tumoral tissue, stabilize the fracture and prevent pathological fractures with significant pain relief and good recovery of walking ability. MWA followed by PSFPC seems to be a promising alternative for patients who are not candidates for surgery.However further studies with large series are required to confirm these preliminary results.
Educational Exhibit
Abstract No. 595
Percutaneous intraosseous doxycycline injections for aneurysmal bone cysts: a minimally invasive treatment option performed by interventional radiology J. Hughes1, A. Isaacson2, J. Stavas3; 1University of Oklahoma College of Medicine, Oklahoma City, OK; 2 UNC Dept of Radiology, Chapel Hill, NC; 3University of North Carolina, Chapel Hill, NC
Posters and Exhibits
Purpose: To investigate the efficacy of domestic branched endovascular stent-graft for DeBakey III aortic dissection. Materials: 82 patients with DeBakey III aortic dissection were diagnosed by contrast-enhanced CT scanning at 2-15 days from onset. The diatance from the orifice of left subclavian artery to primary entry tear point was less than 2 cm.Domestic branched stents were placed into left subclavian artery and the arch of aorta. Results: Stent-graft was successfully performed in all patients. All ruptures were completely closed.The blood flow in the true lumen and the left subclavian artery returned to normal.There were no complications during the 1 to 2 year follow-up. Conclusions: Domestic branched endovascular stent-graft is a safe, reliable and effective choice for acute aortic dissection.
When The diatance from the orifice of left subclavian artery to primary entry tear point was less than 2 cm, using this stent can keep the left subciacian artery blooding flow unobstructed.