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56. Plugged percutaneous biopsy of the liver in living-donor liver transplantation recipients suspected to have graft rejection.

Author

Kim, Sung Jung, Won, Je Hwan, Kim, Young Bae, Wang, Hee-Jung, Kim, Bong-Wan, Kim, Haeryoung, and Kim, Jinoo

Subjects
LIVER biopsy, TRANSPLANTATION of organs, tissues, etc., GRAFT rejection, INTERVENTIONAL radiology, THERAPEUTIC embolization, THERAPEUTICS
Abstract

Background Percutaneous biopsy is a widely-accepted technique for acquiring histologic samples of the liver. When there is concern for bleeding, plugged percutaneous biopsy (PPB) may be performed, which involves embolization of the biopsy tract. Purpose To evaluate the efficacy and safety of PPB of the liver in patients suspected to have graft rejection after living-donor liver transplantation (LDLT). Material and Methods During January 2007 and December 2013, 51 patients who underwent PPB of the liver under the suspicion of post-LDLT graft rejection were retrospectively analyzed. A total of 73 biopsies were performed. Biopsy was performed with a 17-gauge core needle and 18-gauge cutting needle. The needle tract was embolized using gelatin sponge (n = 44) or N-butyl cyanoacrylate (NBCA) (n = 29). The specimens were reviewed to determine their adequacy for histologic diagnosis. We reviewed all medical records after PPB. Results Specimens were successfully acquired in all procedures (100%). They were adequate for diagnosis in 70 cases (95.9%) and inadequate in three (1.3%). Average of 9.8 complete portal tracts was counted per specimen. One minor complication (1.4%) occurred where the patient had transient fever after the procedure. Conclusion PPB is easy and safe to perform in LDLT recipients and provides high diagnostic yield. [ABSTRACT FROM AUTHOR]

Published
2017
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89. Usefulness of B-mode and doppler sonography for the diagnosis of severe acute viral hepatitis A.

Author

Shin, Sang Wook, Kim, Tae Yeob, Jeong, Woo Kyoung, Kim, Yongsoo, Kim, Jinoo, Kim, Young Hwan, Park, Hwan Cheol, and Sohn, Joo Hyun

Abstract

ABSTRACT Background To investigate B-mode and Doppler ultrasonography (US) features correlating with laboratory findings for the diagnosis of severe acute hepatitis (SAH) in patients with hepatitis A virus infection. Methods Thirty-nine consecutive serologically proven patients were enrolled. Decreased parenchymal echotexture, periportal tracking, gallbladder wall change, and splenomegaly were assessed on B-mode images. Blood flow velocities were measured in the main portal (VPORTAL) and in the hepatic veins, and the hepatic venous pulsatility index was calculated. SAH was defined as high model for end-stage liver disease (MELD) score ≥15 with or without coagulopathy. The relationship between US features and laboratory findings was assessed, and SAH diagnosis was evaluated. Results Serum alanine transaminase and prothrombin time were significantly different depending on the presence of gallbladder wall change and splenomegaly ( p < 0.05). VPORTAL was inversely correlated with MELD score ( r = −0.485) and several laboratory markers. The hepatic venous waveform and hepatic venous pulsatility index were significantly correlated with MELD score. For the diagnosis of SAH, the area under the receiver operating characteristic curve of VPORTAL was 0.798. It reached 0.869 in the patients with typical GB change. Conclusions Both B-mode and Doppler US correlated well with several laboratory variables and may be helpful to diagnose SAH in patients with hepatitis A virus infection. © 2014 Wiley Periodicals, Inc. J Clin Ultrasound 43:384-392, 2015 [ABSTRACT FROM AUTHOR]

Published
2015
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90. Transcatheter renal artery embolization with N-butyl cyanoacrylate

Author

Kim, Jinoo, Shin, Ji Hoon, Yoon, Hyun-Ki, Ko, Gi-Young, Gwon, Dong II, Kim, Eun-Young, and Sung, Kyu-Bo

Abstract

BACKGROUND: Despite its long history, the application of N-butyl cyanoacrylate (NBCA) has been limited compared to other materials such as particulate agents and coils. This possibly owes to a widespread misconception that NBCA is difficult to handle and carries a high risk of complications due to its liquid nature and rapid polymerization time. However, recent reports have shown that, with knowledge and experience, NBCA is safe and effective to use in visceral arteries. PURPOSE: To review the outcome of transcatheter embolization of the renal artery using NBCA for varied etiologies in the kidney. MATERIAL AND METHODS: Fourteen patients with varied etiologies in the kidney underwent renal artery embolization using NBCA as the sole embolic agent (64%) or in combination with an additional embolic material (36%). A review of medical charts and images were performed to gather information regarding underlying etiologies, clinical presentation, and outcome of embolization. RESULTS: Technical success was achieved in all patients (100%) while clinical success was achieved in 12 (85.7%). One failed case was managed by repeat embolization using microcoils, while the other underwent partial nephrectomy after failed reattempt at embolization. Three patients with recurrent bleeding after previously having undergone embolization using microcoils or gelatin sponge particles were successfully managed the second time using NBCA. NBCA embolization was also effective in three patients with hemostatic abnormality. Complications attributable to NBCA embolization were renal atrophy in one patient and microcatheter tip fracture in another. CONCLUSION: The application of NBCA for transcatheter embolization of varied etiologies involving the renal artery is feasible and safe in the hands of an experienced interventional radiologist. It offers immediate and effective occlusion of the pathologic vessel and, while it can be used exclusively on its own, it can also be used to complement other embolic materials.

Published
1960
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98. Comparison of Two Paclitaxel-Coated Balloons with Different Excipients for the Treatment of Femoropopliteal Artery Disease.

Author

Choi TW, Won JH, Kim J, Joh JH, Jeong J, Park SW, Oh JS, Kim HO, Kim CW, and Jae HJ

Abstract

Purpose: To evaluate the efficacy and safety of a novel drug-coated balloon (DCB), Genoss DCB (Genoss) using shellac plus vitamin E as an excipient, compared to a reference DCB using urea., Materials and Methods: Patients with femoropopliteal arterial disease under Rutherford classes 2-5 were enrolled in this prospective, multicenter, non-inferiority clinical trial, and randomly assigned 1:1 to Genoss DCB and IN.PACT Admiral (Medtronic). The primary endpoint was late lumen loss at 6 months, which was evaluated using CT angiography by an independent investigator blinded to the treatment assignment., Results: A total of 119 patients from 10 institutions in the Republic of Korea were assigned to the Genoss DCB (N = 59) and IN.PACT Admiral (N = 60) groups. The late lumen loss was -0.08 ± 0.59 mm in the Genoss DCB group and 0.02 ± 0.72 mm in the IN.PACT Admiral group (P = 0.469). The upper limit of the one-sided 97.5% confidence interval for differences in late lumen loss was 0.17 mm, lower than the non-inferiority limit of 0.50 mm, demonstrating the non-inferiority of Genoss DCB as compared to IN.PACT Admiral. In addition, the two groups showed no significant differences in clinically driven target lesion revascularization, major amputation, and all-cause mortality., Conclusion: In this prospective, randomized trial, the safety and 6-month late lumen loss of a new DCB using shellac plus vitamin E as excipients was non-inferior compared with the reference DCB using urea as the excipient., (Copyright © 2025. Published by Elsevier Inc.)

Published
2025
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99. Hepatic Arterial Infusion Chemotherapy for Advanced Hepatocellular Carcinoma: Radiologic and Clinical Factors Predictive of Survival.

Author

Kim B, Won JH, Kim J, Kwon Y, Cho HJ, Huh J, and Kim JK

Subjects
Adult, Aged, Antineoplastic Agents therapeutic use, Cisplatin therapeutic use, Female, Fluorouracil therapeutic use, Humans, Infusions, Intra-Arterial, Kaplan-Meier Estimate, Liver diagnostic imaging, Male, Middle Aged, Retrospective Studies, Survival Analysis, Treatment Outcome, Antineoplastic Combined Chemotherapy Protocols therapeutic use, Carcinoma, Hepatocellular diagnostic imaging, Carcinoma, Hepatocellular drug therapy, Liver Neoplasms diagnostic imaging, Liver Neoplasms drug therapy, Magnetic Resonance Imaging methods, Tomography, X-Ray Computed methods
Abstract

OBJECTIVE. The goal of this study was to evaluate radiologic and clinical factors associated with overall survival of advanced hepatocellular carcinoma treated with hepatic arterial infusion chemotherapy (HAIC). MATERIALS AND METHODS. This single-center retrospective study included 180 patients with advanced hepatocellular carcinoma who underwent HAIC with a 5-fluorouracil (250-500 mg/m 2 for 5 hours) plus cisplatin (10-20 mg/m 2 for 1-2 hours) regimen via an implantable port system. Survival curves were generated by the Kaplan-Meier method and compared by log-rank tests. Factors associated with overall survival were evaluated with Cox proportional hazard models. RESULTS. The median overall survival time was 7.6 months (95% CI, 6.1-9.1), and the objective response rate was 15%. In multivariate analysis, infiltrative tumor growth (hazard ratio [HR], 1.002; p = .03) and rimlike arterial enhancement (HR, 3.040; p < .001) were pretreatment radiologic factors associated with reduced overall survival. No early response to treatment (HR, 2.064-6.491) and higher Child-Pugh class (HR, 2.010-2.815) were strong prognostic factors of poor outcome. Treatment with three or more HAIC cycles (HR, 0.371; p = .001) and high-dose HAIC (HR, 0.447; p < .001) were favorable for increased overall survival. CONCLUSION. Infiltrative tumor growth and rimlike arterial enhancement in pre-treatment imaging studies were associated with poor prognosis, and better early radiologic response and preserved liver function reserve were strong indicators of prolonged survival. Recognizing these radiologic and clinical predictors may help optimize care of patients with hepatocellular carcinoma.

Published
2021
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100. [Atherectomy in Peripheral Artery Disease: Current and Future].

Author

Kwon Y, Kim J, Won JH, Kim SH, Kim JE, and Park SJ

Abstract

Atherectomy has become a promising treatment option for peripheral artery disease caused by diabetes mellitus or end-stage renal disease. Atherectomy refers to the removal of atheromatous tissue by mechanical method, resulting in an enlarged lumen of the treated blood vessel. Based on this method, the term is limited to the percutaneous minimally invasive approach, and there are currently two types of atherectomy devices available in Korea. The increased prevalence of atherectomy has led to the concept of "vascular preparation" and a new treatment concept of "leave nothing behind." Various studies have proven the safety and effectiveness of atherectomy; however, there are some limitations. We need to remain focused on patient selection and subsequent large-scale research., Competing Interests: Conflicts of Interest: The authors have no potential conflicts of interest to disclose., (Copyrights © 2021 The Korean Society of Radiology.)

Published
2021
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