Embolization of perigraft leaks after endovascular stent-graft treatment of distal arch anastomotic pseudoaneurysm with coil and n-butyl 2-cyanoacrylate.
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Aged↗
Biomedical subjects
K Sakuyama
Publications and source records attributed to K Sakuyama.
Measurement of thyroid iodine by CT.
For evaluation of thyroidal iodine kinetics and thyroid nodules, we carried out quantitative in vivo measurement of thyroid iodine concentration by CT. Neuron activation analysis of iodine content was conducted on 48 thyroid fragments without calcification operatively obtained from 18 patients who had undergone CT of the thyroid without contrast enhancement. The CT attenuation values were obtained from the regions of interest in the CT image that corresponded to the analyzed fragment. When iodine concentration in the thyroid tissue was greater than 0.02 mg/g, the CT values correlated linearly with the iodine concentrations in thyroid nodules, thyroids with diffuse thyroid disease, and normal thyroids. The relationship is represented by the following formula: iodine concentration (mg/g) = (CT value-65)/104. The relationship between iodine concentration and CT value in diffuse thyroid disease, thyroid nodules, and normal thyroids was not significantly different.
Humans↗
Local thrombolytic therapy for superior mesenteric artery embolism: complications and long-term clinical follow-up.
PURPOSE: To evaluate the effectiveness and complications of local intraarterial fibrinolysis in selected patients with superior mesenteric artery (SMA) embolism. MATERIALS AND METHODS: Intraarterial thrombolytic therapy was performed for acute SMA embolism in eight patients. Patients were selected for thrombolytic therapy on the basis of absence of peritoneal signs of intestinal necrosis at physical examination and absent findings of bowel infarction by CT. RESULTS: Clinical success was achieved in five patients and technical success in six. Complications included death due to massive shower emboli from the left ventricle in one patient and extravasation in one patient, who required surgery on the following day. Within one month after thrombolytic therapy, one patient each died of myocardial infarction and cerebral infarction due to emboli, and one patient underwent aorto-SMA bypass surgery due to residual stenosis. In the long-term follow-up period (2-7 years), four patients were still alive, with another embolic episode of a lower limb in one patient. One patient died of an unrelated cause without experiencing another embolic episode. CONCLUSION: Intraarterial fibrinolysis may be a therapeutic alternative in the management of SMA embolism in selected patients in whom an early diagnosis can be made. The long-term results depend on the occurrence of another embolic event.
Embolism↗
Lower leg ischemia associated with aortic dissection.
Lower leg ischemia associated with aortic dissection is a potentially life-threatening condition requiring immediate treatment. To better understand the diagnostic factors and improve the treatment strategy of this serious complication, we analyzed our experience regarding the radiographic findings, treatment, and outcome in eight patients (aged 28-72 years, six men and two women). CT revealed type A aortic dissection in seven patients and type B in one. The obstructed site was in the iliac artery in five patients and in the abdominal aorta below the renal arteries in three. Surgical procedures included five ascending aortic graft replacements, three femoro-femoral bypasses, and one each of surgical fenestration, aorto-iliac bypass, and axillo-femoral bypass with thrombectomy. Endovascular treatment was performed in two patients, iliac stent placement in one, and thrombolysis of the iliac artery in one. Five patients survived and three died due to myonephrotic metabolic syndrome in two and postoperative bleeding in one. Treatment strategy depends on several issues regarding aortic dissection including ascending aortic involvement, patent false lumen, entry site, renal artery involvement, and thrombosis in a true or false lumen. CT and angiography are the most important methods for deciding upon appropriate therapy in each individual.
Adult↗