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  1. Article ; Online: Successful Treatment of a Left Gastric Artery Pseudoaneurysm by Image Guided Percutaneous Thrombin Injection.

    Thomson, Benedict / Patel, Virjen / Moser, Steven / Diamantopoulos, Athanasios

    Vascular and endovascular surgery

    2022  Volume 57, Issue 3, Page(s) 306–310

    Abstract: Visceral artery pseudoaneurysms are common complications of pancreatitis that carry a high mortality rate. The splenic artery is the commonest artery involved. Gastric artery pseudoaneurysms are less common with less than 50 cases reported in the ... ...

    Abstract Visceral artery pseudoaneurysms are common complications of pancreatitis that carry a high mortality rate. The splenic artery is the commonest artery involved. Gastric artery pseudoaneurysms are less common with less than 50 cases reported in the literature. A 58-year-old female was referred to the Interventional Radiology department with a left gastric artery pseudoaneurysm secondary to acute pancreatitis. Initial Digital Subtraction Angiography revealed the pseudoaneurysm arising from the left gastric artery. Several attempts to cannulate the pseudoaneurysm were unsuccessful due to arterial spasm. Consequently, the left gastric artery proximal to the pseudoaneurysm was embolised with 300 microns of polyvinyl alcohol and two coils. 24 hours post-procedure, a computed tomography (CT) scan was performed which revealed a blush of contrast enhancement within the pseudoaneurysm sac, consistent with unsuccessful embolisation. Using a combination of ultrasound and cone beam CT guidance, a 22-gauge Chiba needle was advanced percutaneously via a transhepatic approach to the patent segment of the pseudoaneurysm. 2.5 ml of human thrombin was then injected directly into the pseudoaneurysm. Image guided injection of thrombin has become a well-recognised treatment for a variety of peripheral and visceral pseudoaneurysms and is often performed following a failed attempt of routine endovascular embolisation. We report the case of a patient affected by a pseudoaneurysm of the left gastric artery, treated with a CT guided percutaneous thrombin injection directly into the pseudoaneurysm. This demonstrates that percutaneous coagulation can be an adjunct or an alternative to endovascular embolisation.
    MeSH term(s) Female ; Humans ; Middle Aged ; Thrombin ; Aneurysm, False/etiology ; Gastric Artery ; Acute Disease ; Pancreatitis/complications ; Treatment Outcome ; Ultrasonography, Interventional/adverse effects ; Femoral Artery/diagnostic imaging
    Chemical Substances Thrombin (EC 3.4.21.5)
    Language English
    Publishing date 2022-12-05
    Publishing country United States
    Document type Case Reports ; Journal Article
    ZDB-ID 2076272-0
    ISSN 1938-9116 ; 1538-5744
    ISSN (online) 1938-9116
    ISSN 1538-5744
    DOI 10.1177/15385744221144386
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Intraluminal catheter plasty. An alternative technique to remove tethered abdominal surgical drains.

    Patel, Virjen / Thomson, Benedict / Thulasidasan, Narayanan / Diamantopoulos, Athanasios

    BJR case reports

    2021  Volume 7, Issue 4, Page(s) 20210025

    Abstract: Objective: Retained surgical drains can lead to significant complications including gastrointestinal fistulae, abscess formation and intestinal obstruction. Today, there is little in the literature describing the role of Interventional Radiology (IR) in ...

    Abstract Objective: Retained surgical drains can lead to significant complications including gastrointestinal fistulae, abscess formation and intestinal obstruction. Today, there is little in the literature describing the role of Interventional Radiology (IR) in assisting the removal of surgical drains. We describe the use of the well-established intraluminal catheter plasty technique, previously used for the removal of adhered central venous catheters, in order to remove a tethered abdominal drain.
    Methods and materials: A 67-year-old female was referred to the IR department for the removal of a 24 Fr Robinson's intra-abdominal surgical drain that could not be removed by conventional methods, as there was a concern that it was kinked internally. Both fluoroscopy and cone beam CT were performed, which identified the drain to be sited within the pelvis with no kinks.A first attempt to remove the drain over a 0.035 stiff wire was unsuccessful due to resistance and patient discomfort. We suspected that this was due to adhesions surrounding the drain. Consequently, a 9 × 40 mm angioplasty balloon was used over the wire with serial dilatations along the drain to disrupt the adhesions. Several areas of waisting were identified. The drain was gently withdrawn over the wire with minimal resistance.
    Conclusion: We describe a safe and effective novel technique of intraluminal catheter plasty used to remove a tethered surgical drain following failed conventional methods.
    Language English
    Publishing date 2021-04-29
    Publishing country England
    Document type Case Reports
    ISSN 2055-7159
    ISSN (online) 2055-7159
    DOI 10.1259/bjrcr.20210025
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Salvage Therapy With Selpercatinib for

    d'Arienzo, Paolo D / Cunningham, Niamh / O'Sullivan, Hazel / Grieco, Charlotte / Patel, Virjen / Popat, Sanjay

    JTO clinical and research reports

    2023  Volume 4, Issue 12, Page(s) 100581

    Abstract: Selpercatinib and pralsetinib are RET inhibitors with substantial activity in ... ...

    Abstract Selpercatinib and pralsetinib are RET inhibitors with substantial activity in advanced
    Language English
    Publishing date 2023-09-29
    Publishing country United States
    Document type Case Reports
    ISSN 2666-3643
    ISSN (online) 2666-3643
    DOI 10.1016/j.jtocrr.2023.100581
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article: The Surgical Management of Tympanic Membrane Retraction Pockets Using Cartilage Tympanoplasty.

    Kasbekar, Anand V / Patel, Virjen / Rubasinghe, Mihiri / Srinivasan, Venkat

    Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India

    2014  Volume 66, Issue 4, Page(s) 449–454

    Abstract: Evaluate the surgical treatment of tympanic membrane (TM) retractions with modified cartilage augmentation tympanoplasty. Retrospective review of subjects with Charachon stage II and III TM retractions who underwent modified cartilage augmentation ... ...

    Abstract Evaluate the surgical treatment of tympanic membrane (TM) retractions with modified cartilage augmentation tympanoplasty. Retrospective review of subjects with Charachon stage II and III TM retractions who underwent modified cartilage augmentation tympanoplasty following excision of the retracted TM segment. Pre and postoperative symptoms and air-bone gaps were recorded. Forty two ears were included in the study. Twenty six ears were of stage II and 16 were stage III retractions. 35 (83 %) ears had ossicular erosion and cholesteatoma was found in 13 (31 %) ears, all in stage III retractions. Follow-up ranged 12-102 months. The air-bone gap (ABG) improved in 29 (76 %) and worsened in seven (19 %). Ears without cholesteatoma had a greater improvement in ABG. The results of our modified cartilage tympanoplasty technique are comparable to the published literature and should provide a safe and acceptable result. The high rate of cholesteatoma found preoperatively in stage III retractions advocates early surgical intervention.
    Language English
    Publishing date 2014-08-13
    Publishing country India
    Document type Journal Article
    ZDB-ID 1471137-0
    ISSN 0973-7707 ; 2231-3796 ; 0019-5421
    ISSN (online) 0973-7707
    ISSN 2231-3796 ; 0019-5421
    DOI 10.1007/s12070-014-0764-9
    Database MEDical Literature Analysis and Retrieval System OnLINE

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