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Doppler US (doppler + us)
Selected AbstractsComparison study of Doppler ultrasound surveillance of expanded polytetrafluoroethylene-covered stent versus bare stent in transjugular intrahepatic portosystemic shuntJOURNAL OF CLINICAL ULTRASOUND, Issue 7 2010Qian Huang MD Abstract Objective. This prospectively randomized controlled study aimed to assess with Doppler ultrasound (US) the shunt function of expanded polytetrafluoroethylene (ePTFE)-covered transjugular intrahepatic portosystemic shunt (TIPS) stent versus bare stent and to evaluate the usefulness of routine TIPS follow-up of ePTFE-covered stents. Methods. Sixty consecutive patients were randomized for bare or covered transjugular TIPS stenting in our institution between April 2007 and April 2009. Data of follow-up Doppler US, angiography, and portosystemic pressure gradient measurements were collected and analyzed. Results. The follow-up period was 8.34 ± 4.42 months in the bare-stent group and 6.16 ± 3.89 months in the covered-stent group. Baseline clinical characteristics were similar in both groups. Two hundred three US studies were performed in 60 patients, with a mean of 3.4 per patient, and demonstrated abnormalities in 28 patients (21 bare stents, 7 ePTFE-covered stents), 19 of them (13 in bare-stent group, 6 in covered-stent group) showing no clinical evidence of recurrence. Ten of 13 patients in the bare-stent group underwent balloon angioplasty or additional stent placement, whereas only one of six patients in the covered-stent group needed reintervention for intimal hyperplasia. The average peak velocity in the midshunt of ePTFE-covered stent was 139 ± 26 cm/s after TIPS creation and 125 ± 20 cm/s during follow-up, which was significantly higher than the bare-stent group (p < 0.05). The main portal vein and hepatic artery showed higher flow velocities in the ePTFE-covered stent group than in the bare-stent group. ePTFE-covered stents maintained lower portosystemic pressure gradient than bare stents (9.5 ± 2.9 versus 13.2 ± 1.5 mmHg, p < 0.05). Conclusions. ePTFE-covered stents resulted in higher patency rates and better hemodynamics than bare stents. Routine US surveillance may not be necessary in patients with ePTFE-covered TIPS stent. © 2010 Wiley Periodicals, Inc. J Clin Ultrasound 38:353-360, 2010 [source] Serial compression B-scan and Doppler sonography for the screening of deep venous thrombosis in patients with spinal cord injuriesJOURNAL OF CLINICAL ULTRASOUND, Issue 1 2010Alfried Germing MD Abstract Purpose To evaluate the usefulness of serial compression B-scan and Doppler sonography (US) in screening for deep venous thrombosis (DVT) of the lower extremities in patients with spinal cord injuries. Method Patients with paraplegia and tetraplegia due to spinal cord injuries were screened by a serial compression B-scan and Doppler US protocol for DVT of the bilateral lower extremities within the first 36 hours after admission, at day 7 and at day 21. In patients with DVT, a follow-up US examination was performed 3 weeks after diagnosis to assess thrombi distribution. Results Between January 2007 and March 2008, a total of 115 patients (75 males, 40 females), aged 19 to 85 years, were included. The first US examination documented a DVT in 44 cases (38.3%). After an initial negative scan, sonography after 7 days and 21 days showed DVT in 6 patients and 2 patients, respectively. Cumulative rate of DVT after the first 3 weeks was 45.2% (n=52). Follow-up US after 3 weeks in patients with DVT documented a complete recanalization in 19 patients (36.5%), no change in 12 patients (23.1%), and residual thrombi with partial recanalization in 21 patients (40.4%). Conclusion Our study supports the use of serial compression B-scan and Doppler US as a screening tool for DVT of the lower extremities in patients with spinal cord injuries early after injury. © 2009 Wiley Periodicals, Inc. J Clin Ultrasound, 2010 [source] Evaluating the effectiveness of a deep-vein thrombosis prophylaxis protocol in orthopaedics and traumatologyJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 4 2009Koray Unay MD Abstract Rationale, aims and objectives, To evaluate the effectiveness of the deep-vein thrombosis (DVT) prophylaxis protocol for adult patients in a general orthopaedics and traumatology clinic. Method, We followed the DVT prophylaxis protocol in 1326 (776 female, 550 male) of 2114 adult patients admitted to the Department of Orthopaedics and Traumatology in Goztepe Research and Training Hospital. They were followed for symptomatic DVT and possible complications of low-molecular-weight heparin (LMWH) therapy. A Doppler ultrasonography (US) was performed when DVT was suspected. The medical information treatment protocols of DVT patients were recorded. Results, Doppler US was performed in 58 patients with suspected DVT. Six of these patients were diagnosed with DVT. The side effects of LMWH were upper gastrointestinal bleeding (0.5%), widespread ecchymosis of the extremities (1.9%) and heparin-induced thrombocytopenia (0.16%). Conclusion, Symptomatic DVT occurrences were similar to those in medical literature; however, there were fewer side effects of LMWH than reported in literature. [source] Arterial anastomosis in a pediatric patient receiving a right extended split liver transplant: A case reportPEDIATRIC TRANSPLANTATION, Issue 4 2009Roberto Verzaro Abstract:, We report a case of a pediatric patient who received a right-extended liver transplant. The size of the recipient hepatic artery did not match with the donor right hepatic arterial stump. Moreover, recipient arterial anatomy made the direct anastomosis difficult or at increased risk for complications. The recipient's splenic artery was then mobilized, divided and anastomosed to the donor's right hepatic artery. The spleen was preserved and revascularization through collaterals is demonstrated by Angio CT Scan. Doppler US of the transplanted liver demonstrated good flow through the liver and the patient was discharged with perfect liver function. Splenic artery is perfectly suited for hepatic artery anastomosis. The use of splenic artery is favored in particular situations as in the case of a pediatric recipient receiving a right-extended liver graft with small caliber artery. [source] Metanephric adenoma of the kidney: clinical and radiological study of nine casesBJU INTERNATIONAL, Issue 11 2009Cyrille Bastide OBJECTIVE To analyse the clinical and radiological features of metanephric adenoma (MA, a rare benign renal tumour) in nine patients, and to review previous reports. PATIENTS AND METHODS From 1992 to 2007, we identified nine patients (eight women and one man) with MA at our institution. Four patients had a radical nephrectomy and five a partial nephrectomy. Preoperative imaging was reviewed by a senior radiologist. Renal colour Doppler ultrasonography (US), abdominal computed tomography and abdominal magnetic resonance imaging were used in seven, eight and four patients, respectively. RESULTS The mean (range) age of the patients was 46.8 (19,79) years. Six tumours were discovered incidentally. Three patients were symptomatic (two with haematuria and one with polycythaemia). There was no vascular flow on colour Doppler US within the tumours. There were peripheral and/or central calcifications in six of the tumours. All the tumours were well-circumscribed with minimal enhancement after injection with non-ionic intravenous contrast or gadolinium. CONCLUSIONS Renal MA is a benign tumour occurring mainly in young and middle-aged women. Polycythaemia is associated in ,10%. Generally, MA is solid, well-circumscribed and hypovascular, often with calcifications. Based on a combination of clinical and imaging features, it might be possible to suspect the diagnosis of MA and propose a preoperative diagnostic biopsy, a partial nephrectomy or active surveillance. [source] | ||||||||||