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Related Concept Videos

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

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Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
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The platelet phase, the second stage of hemostasis, commences around 15-20 seconds after an injury. It follows and overlaps with the vascular phase, during which blood vessels constrict to minimize blood loss.
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Related Experiment Video

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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
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Hepatic Tract Plug-Embolisation After Biliary Stenting. Is It Worthwhile?

Adam P Dale1, Rafeh Khan2, Anup Mathew3

  • 1Department of Medical Microbiology, Basingstoke and North Hampshire Hospital, Aldermaston Road, Basingstoke, Hampshire, RG24 9NA, UK. adamdale@doctors.org.uk.

Cardiovascular and Interventional Radiology
|March 13, 2015
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Summary
This summary is machine-generated.

A new liver tract closure technique significantly reduced bleeding complications after percutaneous transhepatic cholangiography (PTC) and stenting. This targeted embolisation method offers a safer approach for patients undergoing these high-risk procedures.

Keywords:
Bile ductEmbolizationHaemorrhageLiver tract embolisationPTCStent

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Area of Science:

  • Interventional Radiology
  • Hepatobiliary Medicine
  • Vascular Embolisation

Background:

  • Percutaneous transhepatic cholangiography (PTC) and stenting are invasive procedures with substantial risks.
  • Hemorrhagic complications, sepsis, renal failure, and high mortality rates are associated with PTC.
  • Existing PTC tract closure methods lack strong evidence, prompting investigation into novel techniques.

Purpose of the Study:

  • To evaluate the effectiveness of a novel expanding gelatin foam-targeted embolisation liver tract closure technique.
  • To assess the incidence of hemorrhagic complications following PTC and stenting before and after implementing the new closure method.

Main Methods:

  • Retrospective analysis of patients undergoing PTC between 9/11/2010 and 10/08/2012.
  • Comparison of hemorrhagic complication rates between patients before (subgroup 1) and after (subgroup 2) the introduction of the targeted closure technique.
  • Analysis of mean blood hemoglobin decrease and Kaplan-Meier survival outcomes.

Main Results:

  • Hemorrhagic complications decreased significantly from 12% in subgroup 1 (n=101) to 3% in subgroup 2 (n=92) (p=0.027).
  • Mean blood hemoglobin decrease was lower in subgroup 2 (0.68 g/dL) compared to subgroup 1 (1.40 g/dL) (p=0.069).
  • 30-day mortality rates were comparable (14% vs. 12%), with 50% of the cohort deceased by 174 days.

Conclusions:

  • The introduction of liver tract embolisation via targeted embolisation significantly reduced post-PTC hemorrhagic complications.
  • This technique shows potential to decrease morbidity and mortality associated with PTC by preventing access tract bleeding.
  • Targeted embolisation represents a promising advancement in managing complications of PTC procedures.