1. Endovascular Treatment for Ruptured Cerebral Aneurysm
Department of Neurosurgery, National Hospital Organization, Mito Medical Center
Yasunobu Nakai, Makoto Sonobe
The endovascular treatment of intracranial aneurysms has evolved over the last decade from an alternative to surgical clipping to a very well accepted universally expanding form of therapy. A recent randomized clinical trial (International subarachnoid aneurysm trial : ISAT) has legitimized the advantages of endovascular treatment over surgery. In the present article, we described the endovascular treatment for ruptured cerebral aneurysm, historical review, indications, technical considerations, and perioperative management.
- Coil embolization
- Ruptured cerebral aneurysm
- Subarachnoid hemorrhage
2. The Role of Interventional Radiology in Acute Gastrointestinal Bleeding
Department of Radiology, Osaka City University Graduate School of Medicine
Blood loss due to acute gastrointestinal bleeding is a frequent cause of admission to critical care units. Rapid diagnosis and effective treatment are the determinant prognostic factors. The initial therapeutic approach in the acute settings consists of combined medical and endoscopic treatment. In the recent years, the development of interventional radiology techniques has offered to clinicians an alternative, effective and less invasive therapeutic approach for the treatment of acute blood loss. In this article, we will show the outstanding role of interventional radiology in the treatment of acute gastrointestinal bleeding and variceal bleeding.
- Gastrointestinal bleeding
- Portal hypertension
3. Emergency Interventional Radiology in the Management of Intraperitoneal Hemorrhage
Department of Radiology1） and Emergency medicine2）, Kitasato University School of Medicine
Hiroshi Nishimaki1,2), Fumie Kashimi2), Reiko Woodhams1)
Tomomichi Kan’ou2), Saori Kawamura1), Keiji Matsunaga1), Kazui Soma2)
Intraperitoneal hemorrhage may be a life-threatening occurrence. Multislice computed tomography (MSCT) is the most commonly used modality in the initial work up of these patients. Recently, an increasing number of patients have been treated using transcatheter arterial embolization (TAE).
This review will describe the indications, pitfalls, and methods of TAE and other interventional radiology procedures in the management of hemoperitoneum caused by blunt abdominal trauma (hepatic, splenic, renal), postoperative, hepatocellular carcinoma, abdominal visceral aneurysm and coagulopathy.
- Postoperative hemorrhage
- Spontaneous extraperitoneal hemorrhage
- Segmental arterial mediolysis
4. Bleeding from Other Sites : Bleeding from the Chest and an Urogenital Apparatus
Department of Radiology, Koshigaya Hospital, Dokkyo University School of Medicine
Mamoru Iimuro, Miwako Nozaki
Department of Diagnostic Imaging and Interventional Radiology, Tokyo Women’s Medical University Yachiyo Medical Center
Some disorders resulting in hemorrhage requiring emergent hemostasis are curable. In the chest, such disorders include angioma and external injury, and in the urinary region, they include perirenal hematoma, hematuria, postpartum hemorrhage, emorrhage after undergoing gynaecological surgery and hemorrhage from uterine myomas. This study deals with the indication of intravascular therapy and the selection of catheter and embolizing material for such disorders.
- Interventional radiology
- Transcatheter arterial embolization
- Emergency interventional radiology
5. Emergency Interventional Radiology for Acute Thrombosis of Superior Mesenteric Artery and Infrapopliteal Artery
Department of Radiology, The Jikei University School of Medicine
Masanori Nagase, Shunichi Sadaoka, Kunihiko Fukuda
Interventional radiology (IVR) techniques for the treatment of acute superior mesenteric artery (SMA) thrombosis and infrapopliteal artery (IPA) thrombosis are thrombectomy and thrombolysis under selective catheterization.
Acute SMA occlusion is one of the important causes of acute abdomen. Diagnosis of this condition is sometimes delayed due to its non-specific symptoms. This delay usually results in the need for surgical treatment. However, recent clinical use of MDCT has facilitated detection of SMA thrombosis at its early stage and its treatment by IVR.
In cases with acute iliac and femoral artery thrombosis, the success rate of IVR treatment is high. On the other hand, that for acute IPA occlusion is not still satisfactory. Therefore, treatment choice for acute IPA thrombosis exists between either surgery alone or combinations of IVR and surgical procedure.
- Acute thrombosis
- Superior mesenteric artery
- Infrapopliteal artery