| Carbon dioxide wedged arterial splenoportography: a new technique--a case report and an experimental study. | |
| | |
MedLine Citation:
|
PMID: 19235576 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: Patients with splenic vein occlusion may present a diagnostic problem when the location, morphology, and cause of the obstructive lesion and the associated collateral veins cannot be clearly defined by standard diagnostic imaging modalities such as computed tomography, magnetic resonance venography, or indirect splenoportography (arterial portography). PURPOSE: To evaluate the safety and effectiveness of carbon dioxide (CO(2)) wedged arterial splenoportography for definitive investigation of splenic vein occlusion. MATERIAL AND METHODS: Following unsuccessful diagnosis with computed tomography and standard contrast arterial portography in a patient with recurrent gastric variceal bleeding, CO(2) was injected into a wedged splenic arterial catheter and successfully outlined splenic vein occlusion and gastric varices. Our experience with this patient prompted us to perform an experimental study in swine to evaluate the safety and effectiveness of CO(2) wedged arterial splenoportography for visualization of the splenic and portal veins. A microcatheter was advanced coaxially and wedged into the splenic arteries of three pigs. After checking the wedged positioning with contrast medium injection, CO(2) was injected manually and the splenic region imaged. The spleens were then removed for gross and microscopic examinations. RESULTS: In the patient, CO(2) wedged arterial splenoportography demonstrated gastric varices associated with splenic vein occlusion. In all animals, CO(2) wedged arterial splenoportography visualized the splenic and portal veins. No CO(2) extravasations occurred in the spleen. Gross and microscopic examinations revealed no evidence of splenic rupture or intrasplenic hematoma. CONCLUSION: CO(2) wedged arterial splenoportography may be a useful method for visualizing gastric varices associated with splenic vein occlusion. This new technique has the potential to replace the standard splenic arterial portography for visualization of splenic and portal veins, thus eliminating the need for injection of a large volume of iodinated contrast material. Further clinical studies are justified to evaluate this technique. |
| | |
Authors:
|
S C H Yu; K J Cho |
Related Documents
:
|
6507946 - Fibromuscular hyperplasia of the brachial artery--failure of calcium antagonist therapy. 6966926 - Splenic artery--pancreatic duct fistula. 20690516 - Splenic artery aneurysm in a cardiac transplant patient: a case report. 18777196 - Efficacy of the electrothermal bipolar vessel sealer in laparoscopic spleen-preserving ... 3448146 - Current status in treatment of the japanese with chronic arterial occlusive disease of ... 22605656 - Pulmonary outflow obstruction in the fetus with complex congenital heart disease: predi... |
Publication Detail:
|
Type: Case Reports; Journal Article |
Journal Detail:
|
Title: Acta radiologica (Stockholm, Sweden : 1987) Volume: 50 ISSN: 1600-0455 ISO Abbreviation: Acta Radiol Publication Date: 2009 Apr |
Date Detail:
|
Created Date: 2009-03-17 Completed Date: 2009-04-13 Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 8706123 Medline TA: Acta Radiol Country: Sweden |
Other Details:
|
Languages: eng Pagination: 265-9 Citation Subset: IM |
Affiliation:
|
Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Chinese University of Hong Kong, Hong Kong, China. simonyu@cuhk.edu.hk |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Angiography, Digital Subtraction
/
methods* Animals Carbon Dioxide / diagnostic use* Collateral Circulation / physiology Constriction, Pathologic / complications, radiography Contrast Media* Embolization, Therapeutic Esophageal and Gastric Varices / etiology, radiography*, therapy Gastrointestinal Hemorrhage / etiology, radiography*, therapy Humans Liver Neoplasms / radiography, secondary Male Middle Aged Neuroendocrine Tumors / radiography, secondary Pancreatic Neoplasms / radiography Portography / methods* Splenic Vein / radiography* Swine Tomography, X-Ray Computed |
| Chemical | |
Reg. No./Substance:
|
0/Contrast Media; 124-38-9/Carbon Dioxide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Prognostic factors of recurrent respiratory papillomatosis from a registry of 72 patients.
Next Document: Evaluation of possible prognostic factors of fulminant acute disseminated encephalomyelitis (ADEM) o...