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The role of imaging methods and interventional radiology in liver transplantation programme: transarterial chemoembolization of hepatocellular carcinoma and therapy of vascular and biliary complications after orthotopic liver transplantation.
Laštovičková, Jarmila ; Peregrin, Jan (advisor) ; Köcher, Martin (referee) ; Hořejš, Josef (referee)
121 9. Summárý Purpose: This study was designed to evaluate the role of interventional radiology in liver transplantation programme. The aim is to present our experience, technical outcomes and long-term clinical results with chemoembolization of hepatocellular carcinoma in patients before liver transplantation and with percutaneous treatment of vascular and biliary complication after orthotopic liver transplantation. Methods: Twenty five patients (17 men, 8 women, mean age 57.76 years) with HCC were scheduled for TACE prior to liver transplantation from 2008 to 2012. Twenty three procedures were performed, 7 c-TACE in 2008 and 16 DEB TACE in next years. Thirty patients (13 men, 17 women, mean age 46.4 years) with biliary strictures after liver transplantation without endoscopic access possibility were treated with balloon dilatation and biliary duct drainage from 1996 and 2010. Twenty patients (13 men, 7 women, mean age 45.25 years) were treated with PTA/stent due to hepatic artery stenosis after liver transplantation between 1996 and 2011. Stents were placed to the hepatic/celiac artery in 16 PTAs, balloon dilatation alone was performed in 7 stenosis due to tortuosity of the vessel. Results: Liver transplantation was performed to 20 patients after TACE. Only one patient (4.5 %) was excluded from waiting...
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Dissection of Cervical Segment Internal Carotid Artery
Šercl, Miroslav ; Raupach, Jan (advisor) ; Köcher, Martin (referee) ; Beneš, Vladimír (referee)
Aims: The main aim of this study is to analyse the effectiveness, safety and causal relationships of treatment of patients with carotid artery dissection arising spontaneously, due to trauma or from an iatrogenic cause. Methods: In all patients, we analyzed baseline clinical symptomatology and NIHSS, findings on initial CTA (ev. DSA), selected therapy in the acute phase, follow-up brain imaging, medication at discharge, and clinical findings at 3 months with assessment of NIHSS and mRS with carotid artery imaging by ultrasound or CTA. The first group consisted of 38 patients with spontaneous ICA dissection. Currently asymptomatic patients after a resolved TIA or patients with NIHSS ≤ 3 were treated conservatively with antiplatelet or anticoagulation therapy. Patients with significant neurological deficit (NIHSS ≥ 4) were treated with intravenous thrombolysis, or stent implantation in the neck dissection area, mechanical thrombectomy of the distal emboli, or a combination of all methods. The second group included 16 patients with traumatic ICA dissection diagnosed on whole- body CT scan as part of the post-trauma evaluation. Patients with brain injury or major bleeding lesions were kept without antithrombotic therapy until their condition stabilized with early switch to anticoagulation therapy with...
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Multidetector row computed tonography in trauma - influence of the localization, size and density of active extravasation on subseduent clinical management
Cihlář, Filip ; Krajina, Antonín (advisor) ; Chmelová, Jana (referee) ; Köcher, Martin (referee)
Detection rate of active bleeding and number of nonoperative treatment is increasing in trauma evaluated by whole-body multi-detector row computed tomography (MDCT) imaging. The aim of the study is to evaluate a MDCT detection of the active bleeding in trauma patients. We reviewed MDCT images for the presence of active hemorrhage in our data files. The site and number of the bleeding sites was noted. The size, area, density and relative density of the hemorrhage was noted, together with the nature and size of the surrounding hemorrhage hematoma. We also evaluated clinical factors as age, sex, the Injury Severity Score (ISS), Glasgow Coma Scale (GCS), systolic blood pressure on admission (SBP), heart rate (HR), hemodynamic status of the patient (HDO) and fluid resuscitation. Results were compared with clinical follow up or intraoperative findings (nonoperative management vs. intervention, dead or alive pts. in 30 day). The authors evaluated consecutive trauma patients examined between 2004-2008 and 2010-2013 who underwent whole-body or abdominal MDCT, and were examined 967 patients. Active bleeding was detected in 128 (13,2 %) of 967 patients. A total of 183 sources of active extravasation were identified. Eighty-six (47 %) of 183 bleeding sites underwent immediate intervention - surgical or...
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The role of imaging methods and interventional radiology in liver transplantation programme: transarterial chemoembolization of hepatocellular carcinoma and therapy of vascular and biliary complications after orthotopic liver transplantation.
Laštovičková, Jarmila ; Peregrin, Jan (advisor) ; Köcher, Martin (referee) ; Hořejš, Josef (referee)
121 9. Summárý Purpose: This study was designed to evaluate the role of interventional radiology in liver transplantation programme. The aim is to present our experience, technical outcomes and long-term clinical results with chemoembolization of hepatocellular carcinoma in patients before liver transplantation and with percutaneous treatment of vascular and biliary complication after orthotopic liver transplantation. Methods: Twenty five patients (17 men, 8 women, mean age 57.76 years) with HCC were scheduled for TACE prior to liver transplantation from 2008 to 2012. Twenty three procedures were performed, 7 c-TACE in 2008 and 16 DEB TACE in next years. Thirty patients (13 men, 17 women, mean age 46.4 years) with biliary strictures after liver transplantation without endoscopic access possibility were treated with balloon dilatation and biliary duct drainage from 1996 and 2010. Twenty patients (13 men, 7 women, mean age 45.25 years) were treated with PTA/stent due to hepatic artery stenosis after liver transplantation between 1996 and 2011. Stents were placed to the hepatic/celiac artery in 16 PTAs, balloon dilatation alone was performed in 7 stenosis due to tortuosity of the vessel. Results: Liver transplantation was performed to 20 patients after TACE. Only one patient (4.5 %) was excluded from waiting...
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