المؤلفون: Anupam Lal, Rajesh Vijayvergiya, Manphool Singhal

المصدر: Indian Journal of Radiology and Imaging, Vol 33, Iss 04, Pp 543-547 (2023)

مصطلحات موضوعية: uterine artery embolization, transfemoral approach, 5F-Picard catheter, 0.035 curved-tipped hydrophilic guidewire, reverse loop, Medical physics. Medical radiology. Nuclear medicine, R895-920

الوصف: Uterine artery embolization (UAE) is a technique for management of various obstetrical and gynecological problems. Transfemoral approach (TFA) is preferred which can be unilateral or bilateral; however, unilateral puncture is preferred due to lesser chances of puncture-related complications as compared to bilateral puncture. UAE through unilateral TFA is possible with use of reverse loop catheters (Roberts uterine catheter [RUC] or Gandras catheter) to access ipsilateral uterine artery. Other way of cannulating the ipsilateral uterine artery is by maneuvering catheters to form Waltman's loop/Simmon's reverse loop. With advent of RUC, unilateral TFA became standard of care. In the recent past, RUC was retracted from Indian market and its nonavailability had mandated use of either bilateral TFA or use of catheters and techniques used in the past for unilateral TFA. Herein, we describe a technique of doing UAE by unilateral TFA using simple gentle curve catheter (Picard) by making a reverse curve loop.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/0971-3026Test; https://doaj.org/toc/1998-3808Test

الوصول الحر: https://doaj.org/article/3952b845126f497b8ab7880c01b8aedaTest

المؤلفون: Vivek Yadav, Manphool Singhal, Muniraju Maralakunte, Navneet Sharma, Arun Sharma, Anupam Lal

المصدر: Indian Journal of Radiology and Imaging, Vol 33, Iss 04, Pp 456-462 (2023)

مصطلحات موضوعية: acute pulmonary embolism, CT pulmonary angiography, dual-energy CT, iodine maps, subsegmental pulmonary thromboembolism, Medical physics. Medical radiology. Nuclear medicine, R895-920

الوصف: Objective In this study, we compare the diagnostic accuracy of dual-energy (DE) computed tomography pulmonary angiography (CTPA) derived contrast enhancement (DECTPA, CTPA images with iodine maps) with standard dual-energy pulmonary angiography (SCTPA) for diagnosis of subsegmental pulmonary embolism in the cases with clinical suspicion of acute pulmonary embolism (APE).

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/0971-3026Test; https://doaj.org/toc/1998-3808Test

الوصول الحر: https://doaj.org/article/abec9e52495d4c1b9947df1150942812Test

المؤلفون: Karamvir Chandel, Anupam Lal, Rohit K. Srinivas, Debajyoti Chatterjee, Vikas Gupta

المصدر: Journal of Gastrointestinal and Abdominal Radiology, Vol 05, Iss 03, Pp 191-195 (2022)

مصطلحات موضوعية: gallbladder, neuroendocrine tumor, radiology, Internal medicine, RC31-1245, Diseases of the digestive system. Gastroenterology, RC799-869

الوصف: Neuroendocrine tumors (NET) of the biliary system, specifically the gallbladder (GB), are extremely rare, accounting for only 0.2% of all NETs. The majority of GBNETs are discovered by chance during a histological examination of GB samples at autopsy, after cholecystectomy, or after surgery for other suspected biliary pathology. GBNETs are thought to develop from preexisting endocrine cells in the GB's neck or from induced endocrine cells caused by intestinal metaplasia of the body and fundus. We present a case of squamous cell carcinoma of the GB with neuroendocrine differentiation due to its rarity.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2581-9178Test

الوصول الحر: https://doaj.org/article/74481ddf2dfa436d9d2f5339f9258d85Test

المؤلفون: Chinna Babu Dracham, Narendra Kumar, Santosh Kumar, Arun Elangovan, Budhi Singh Yadav, Ravimohan S. Mavuduru, Anupam Lal, Pramod K. Gupta, Rakesh Kapoor

المصدر: Asian Journal of Urology, Vol 9, Iss 3, Pp 318-328 (2022)

مصطلحات موضوعية: Bladder preservation, Neoadjuvant chemotherapy, Radiotherapy, Muscle-invasive bladder cancer, Diseases of the genitourinary system. Urology, RC870-923

الوصف: Objective: Conservative approaches in muscle-invasive bladder cancer (MIBC) have been evolved to avoid aggressive surgery, but are limited to elderly, frail, and patients medically unfit for surgery. Our study aimed to assess the response rate of neoadjuvant chemotherapy (NACT) before radiotherapy (RT) in MIBC patients. Methods: Forty patients with urothelial carcinoma of stage T2–T4a, N0, M0 were enrolled between November 2013 and November 2015, and treated with three cycles of NACT with gemcitabine-cisplatin. Post-NACT response was assessed using Response Evaluation Criteria in Solid Tumors (RECIST) criteria. Patients who achieved complete response (CR) and partial response (PR) >50% were treated with radical RT, and those who had PR 50% or CR, and were treated with RT. Five (12.5%) patients who had PR

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2214388221000692Test; https://doaj.org/toc/2214-3882Test

الوصول الحر: https://doaj.org/article/63c2922dda23420199652c88db831e1cTest

المؤلفون: Devprakash Choudhary, MS, MBBS, Rajesh Vijayvergiya, MD, MBBS, Ashish Sharma, MS, MBBS, Anupam Lal, MD, MBBS, Palanivel Rajan, MD, MBBS, Ganesh Kasinadhuni, MD, MBBS, Sarbpreet Singh, MS, MBBS, Deepesh B. Kenwar, MS, MBBS

المصدر: Transplantation Direct, Vol 8, Iss 9, p e1363 (2022)

مصطلحات موضوعية: Surgery, RD1-811

وصف الملف: electronic resource

العلاقة: http://journals.lww.com/transplantationdirect/fulltext/10.1097/TXD.0000000000001363Test; https://doaj.org/toc/2373-8731Test

الوصول الحر: https://doaj.org/article/690d87e4ca9b4027aec9d1f8663608c0Test

المؤلفون: Kailash C Kurdia, Santhosh Irrinki, Bharath Siddharth, Vikas Gupta, Anupam Lal, Thakur D Yadav

المصدر: JGH Open, Vol 5, Iss 7, Pp 820-824 (2021)

مصطلحات موضوعية: benign biliary stricture, cholecystectomy, magnetic resonance cholangiopancreatography, percutaneous transhepatic cholangiography, Roux‐en‐Y hepatico‐jejunostomy, Diseases of the digestive system. Gastroenterology, RC799-869

الوصف: Abstract Background and Aim Accurate anatomical delineation is the key before definitive repair for benign biliary stricture (BBS). The role of percutaneous transhepatic cholangiography (PTC) as a road map is less studied in the era of magnetic resonance cholangiopancreatography (MRCP). Methods A prospective observational study, performed between July 2012 and December 2013. All patients of post‐cholecystectomy BBS were evaluated with MRCP and PTC prior to definitive repair. Findings of MRCP and PTC were compared with intraoperative details. Results Thirty patients with BBS were included in the study. MRCP was performed in all but PTC was amenable in 28 of 30 (93.3%) patients. PTC was comparable to MRCP in diagnosing stricture type (96.4% vs 89.3%), intrahepatic stones (75% vs 75%), and biliary anomalies (95.6% vs 100%). Additionally, PTC revealed internal biliary fistula in 4 (85.7% vs 61.4%; P value 0.04). PTC‐related minor complications were noted in 2 (7.1%) patients. Conclusion PTC is comparable to MRCP in diagnosing the stricture type, intrahepatic biliary stones, and biliary anomalies. Though comparable to MRCP, the authors could not reveal any additional information that could change the course of management in BBS.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2397-9070Test

الوصول الحر: https://doaj.org/article/cee7f23d59824ffa9231fd316d5942fbTest

المؤلفون: Ujjwal Gorsi, Raghuraman Soundararajan, Tejeshwar Singh Jugpal, Anupam Lal, Sreedhara B Shetty, Naveen Kalra, Mandeep Kang, Manavjit Singh Sandhu

المصدر: Journal of Clinical Interventional Radiology ISVIR, Vol 4, Iss 02, Pp 083-087 (2020)

مصطلحات موضوعية: renal pseudoaneurysm, angioembolization, coils, thrombin, cyanoacrylate glue, Medical physics. Medical radiology. Nuclear medicine, R895-920

الوصف: Objectives Renal pseudoaneurysms are multifactorial in origin, and angioembolization remains the mainstay of treatment. Few case reports have also described percutaneous embolization using glue or thrombin. Our study aimed to evaluate the predictors of active bleed by analyzing their etiology, morphology, imaging features, and treatment adopted. To the best of our knowledge, this is the largest such study done in India. Methods This was a retrospective study of patients treated for renal pseudoaneurysms between 2014 and 2019. We reviewed their clinical data, treatment modalities used, and clinical outcomes. We also assessed computed tomography angiography (CTA) and conventional angiography images. Results A total of 79 patients (54 males and 25 females) were included in the study. The mean age was 39.5 years (range 15–83 years). The most common cause was renal biopsy, followed by surgery. Of these, three patients (3.9%) had more than one lesion and 57% of pseudoaneurysms were seen in lower polar arteries. Active contrast extravasation was seen in 15.2% (n = 12) of the patients and 21.5% (n = 17) showed lobulations in CT and digital substraction angiography. The mean size of the pseudoaneurysms was 1.17 cm (SD 0.7); 22.8% of pseudoaneurysms were wide necked. The embolization was approached by endovascular (89.9%), percutaneous (10.1%), or both (1.3%) routes. Embolization was performed using microcoils (78.5%), gel foam (12.7%), N-butyl cyanoacrylate glue (8.9%), polyvinyl alcohol (8.9%), and thrombin (5.1%) either as a single agent or in combination. The technical success was achieved in all cases after the first procedure. Pseudoaneurysms with a wide neck (p = 0.03) and lobulations (p = 0.002) were associated with active contrast extravasation. Episodes of rebleeding were seen at a younger age (p-value = 0.02). Conclusion Minimally invasive methods remain the cornerstone in the management of renal pseudoaneurysms with high success rates. The morphology of pseudoaneurysms can help predict the risk of active bleeding and decide the type of intervention. Direct percutaneous injection into the aneurysm sac is an alternate technique and should be considered when an endovascular approach is challenging.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2456-4869Test

الوصول الحر: https://doaj.org/article/9f3261fe190d4585abc291b33f69900bTest

المؤلفون: Rajesh Vijayvergiya, Navjyot Kaur, Ganesh Kasinadhuni, Ashish Sharma, Anupam Lal, Ashwani Sood

المصدر: Jornal Vascular Brasileiro, Vol 20 (2021)

مصطلحات موضوعية: double kidney transplant, drug-eluting stent, end-stage renal disease, expanded criteria donor, percutaneous transluminal renal angioplasty, transplant renal artery stenosis, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Abstract Renal transplant remains the preferred therapy for end-stage renal disease (ESRD). Given the shortage of suitable donor kidneys, use of an expanded criteria donor (ECD) allows marginal kidneys to be transplanted; albeit at risk of increased graft failure due to lower nephron mass. To reduce the risk of graft failure, double kidney transplant (DKT) is advocated, with favorable outcomes. Transplant renal artery stenosis (TRAS) is one of the most common vascular complications following renal transplant. Unlike single kidney transplants, where TRAS usually presents with fluid overload, uncontrolled hypertension, and worsening kidney functions; it may be clinically silent in DKT patients since they have two functional transplanted kidneys. We hereby report a case of TRAS in a DKT patient who had 2 years of favorable clinical outcomes following successful endovascular stenting. He however recently died of COVID-19 associated pneumonitis.

وصف الملف: electronic resource

العلاقة: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492021000100634&tlng=enTest; https://doaj.org/toc/1677-7301Test

الوصول الحر: https://doaj.org/article/ad49664e659446eba50e47f1147d45cfTest

المؤلفون: Bipadabhanjan Mallick, Shallu Tomer, Sunil K Arora, Anupam Lal, Narendra Dhaka, Jayanta Samanta, Saroj K Sinha, Vikas Gupta, Thakur Deen Yadav, Rakesh Kochhar

المصدر: JGH Open, Vol 3, Iss 4, Pp 295-301 (2019)

مصطلحات موضوعية: acute pancreatitis, C‐reactive protein, interleukin‐10, interleukin‐6, inflammatory markers, interleukins, Diseases of the digestive system. Gastroenterology, RC799-869

الوصف: Background Percutaneous catheter drainage (PCD) is used as the first step in the management of symptomatic fluid collections in patients with acute pancreatitis (AP). There are limited data on the effect of PCD on inflammatory markers. Aim To study the effects of PCD on serum levels of C‐reactive protein (CRP), IL‐6, and IL‐10 and its correlation with the outcome. Methods Consecutive patients of AP with symptomatic fluid collections undergoing PCD were evaluated for serum levels of CRP, IL‐6, and IL‐10 before PCD and at 3 and 7 days after PCD. Resolution of organ failure (OF), sepsis, and pressure symptoms was considered to demonstrate the success of PCD. Changes in levels following PCD were correlated with outcome. Results Indications of PCD in 59 patients (age 38.9 ± 13.17 years, 49 male) were suspected/documented infected pancreatic necrosis (n = 45), persistent OF (n = 40), and pressure symptoms (n = 7). A total of 49 (83.1%) patients improved with PCD, five patients required surgery, and six died. A significant difference was noted between baseline levels of CRP (P = 0.026) and IL‐6 (P = 0.013) among patients who improved compared to those who worsened following PCD. Significant decrease (P

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2397-9070Test

الوصول الحر: https://doaj.org/article/ff73c867dc1549b6a7171b180926735fTest

المؤلفون: Rajesh Vijayvergiya, Atit Gawalkar, Ganesh Kasinadhuni, Ashish Sharma, Sarbpreet Singh, Anupam Lal

المصدر: Jornal Vascular Brasileiro, Vol 20 (2021)

مصطلحات موضوعية: endovascular stent, iliac artery dissection, renal artery angioplasty, renal transplantation, transplant renal artery stenosis, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701

الوصف: Abstract Various vascular complications following renal transplantation include renal artery and vein thrombosis, renal artery stenosis, pseudoaneurysm, and iliac artery dissection. Transplant renal artery stenosis (TRAS) is the most common, while iliac artery dissection is the rarest of these various vascular complications. We describe an elderly male, who had both external iliac artery dissection and TRAS at 2 months following renal transplantation. He underwent successful percutaneous endovascular intervention of both complications. The post-intervention course was uneventful, with improvement in graft renal functions and left lower limb perfusion.

وصف الملف: electronic resource

العلاقة: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-54492021000100630&tlng=enTest; https://doaj.org/toc/1677-7301Test

الوصول الحر: https://doaj.org/article/e4c9f496dc5242d49a7fe56f9614f0afTest