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Complications of surgery for thoracic outlet syndrome
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
One of the most common issues with treatment of venous TOS is the management of residual subclavian vein obstruction following decompression.6 This is addressed in the paraclavicular and infraclavicular approaches by intraoperative venography and direct vein reconstruction at the time of operation. In protocols based on transaxillary first rib resection, venography is usually performed several weeks after surgery and any residual venous obstruction is addressed with endovascular approaches at that time. Unfortunately, up to 25% of patients will have a fixed subclavian vein occlusion that cannot be crossed with a guidewire, for whom long-term anticoagulation is recommended.
Cardiovascular system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Venography was for a long time the only useful method of assessing the deep veins of the leg, usually for suspected deep vein thrombosis (DVT), but the side-effect of causing DVT in some patients meant it had limited use and it has now been replaced by ultrasound, which produces more useful information without significant risk. Conventional venography may occasionally be used to assess the subclavian vein (for instance suspected thrombosis related to central lines) if ultrasound is technically unsuccessful.
Venous Thrombosis
Published in Hau C. Kwaan, Meyer M. Samama, Clinical Thrombosis, 2019
Gary E. Raskob, Russell D. Hull
Venography is the accepted reference standard for the diagnosis of venous thrombosis.105,106 The aim of venography is to inject radiopaque contrast medium into a dorsal foot vein so that the deep venous system of the leg is clearly outlined. In practice, ascending venography with careful attention to technique provides adequate visualization of the deep veins of the calf, and the popliteal, femoral, external iliac, and common iliac veins. In the occasional patient, direct puncture of the femoral vein is required to adequately visualize the common femoral or iliac veins.
Current clinical diagnosis and management of orbital cellulitis
Published in Expert Review of Ophthalmology, 2021
Sara A. Khan, Ahsen Hussain, Paul O. Phelps
Cavernous sinus thrombosis is an uncommon, and one of the most dangerous complication of orbital cellulitis. These patients present with more severe disease with an eventual, bilateral presentation, cranial nerve involvement, and meningeal signs [33,42,81]. In these cases, venography studies may be useful with the recommended CT and MRI imaging to evaluate extent of involvement [33,82]. These cases may require longer hospital stays (average 21 days), and majority may require intensive-care unit admission, lumbar puncture, frequent neurological assessments, and surgical source control [33,81]. In terms of therapy, long-term use of IV antibiotics (average 5.2 weeks) and anticoagulation for an average of 3 months [33]. Risk for intracranial complications is high along with risk for long-term visual deficits [33,81].
Surgical and non-surgical approaches in the management of lower limb post-thrombotic syndrome
Published in Expert Review of Cardiovascular Therapy, 2021
M Machin, S Salim, M Tan, S Onida, AH Davies, J Shalhoub
CDT is a procedure undertaken alongside fluoroscopic guidance in which an ipsilateral caudad venous puncture, such as the popliteal vein is undertaken and the deep venous system cannulated [16]. Ipsilateral puncture is preferred as the valves in the venous system can make contralateral access difficult. Baseline venography is performed. A wire is then passed crossing the occlusion. A multi-side hole infusing catheter, such as a Cragg-McNamara, is then passed into the thrombus and thrombolysis commenced. A follow-up angiogram is performed after 12–24 hours (as per individual center guidelines). UACDT provides additional high-frequency low-intensity ultrasound which is believed to shorten the overall time to clot resolution and hence a reduction in thrombolysis administration and possibly hemorrhagic complications [17].
Atypical posterior reversible encephalopathy syndrome with albuminocytological dissociation and late emerging neuroradiological findings: A case report
Published in Postgraduate Medicine, 2021
Yaprak Ozum Unsal Bilgin, Neslihan Eskut, Asli Koskderelioglu, Muhtesem Gedizlioglu
The control of BP was achieved within 24 hours. The second CSF examination was done on the 3rd day of admission. The CSF opening pressure was high (290 mmH2O). The biochemical analysis of CSF revealed leukocyte count: 20/mm3, erythrocyte count: 300/mm3 and protein: 220 mg/dl. CSF protein levels were as high as in the initial examination. Cytological examination of CSF revealed no malignant cells. Blood testing for autoimmune encephalitis panel (NMDAR, AMPA1, AMPA 2, CASPR 2, LGI1, GABARB1 antibodies), serology testing for HIV, brucella and syphilis were negative. On the 6th day, cranial MRI showed hyperintense lesions consistent with vasogenic edema in T2-weighted images and fluid-attenuated inversion recovery (FLAIR) sequences in bilateral posterior parietal and occipital lobes (Figures 4, Figures 5). Flow was detected in all venous structures of MR venography imaging. Cranial MRI was repeated on the 6th day but due to the patient’s respiratory problems, the DWI sequences couldn’t be performed again. The patient was diagnosed with PRES according to the symptoms of admission, history of uncontrolled hypertension, presence of hypertensive crisis and radiological findings.