148 results on '"Curtis W. Bakal"'
Search Results
2. Vascular and Interventional Radiology: Principles and Practice
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Curtis W. Bakal, James E. Silberzweig, Jacob Cynamon, Seymour Sprayregen, Curtis W. Bakal, James E. Silberzweig, Jacob Cynamon and Curtis W. Bakal, James E. Silberzweig, Jacob Cynamon, Seymour Sprayregen, Curtis W. Bakal, James E. Silberzweig, Jacob Cynamon
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- 2011
3. Usage of an Electronic Database and Checklist System for Improvement in Magnetic Resonance Imaging Acquisition
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Jaclyn Therrien, Laura Semine, Lorraine Kelly, Patricia Doyle, Curtis W. Bakal, Robert Marquis, and Juan E. Small
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medicine.medical_specialty ,Data collection ,Databases, Factual ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,Efficiency, Organizational ,Magnetic Resonance Imaging ,Quality Improvement ,Checklist ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Error reporting ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Electronic database ,Diagnostic Errors ,business ,Mri scan ,Reporting system - Abstract
Purpose To determine whether implementation of an easily accessible electronic database promotes significant reporting of magnetic resonance imaging (MRI) acquisition errors. Additionally, we wanted to see if analysis of the error reports could be used to create a comprehensive checklist to avoid the most common errors. Methods A new, simple, and efficient electronic database reporting system was written in-house and implemented at our institution. Over the course of 4 months, the use of this database enabled collection and analysis of sufficient data for trend analysis. A simple 4-point checklist for MRI technologist use was developed based on the most commonly reported errors. Reported MRI acquisition error rates were collected and analyzed thereafter. Results By the first full month of implementation, MRI scan error reporting increased from a previous negligible baseline rate to 3.03%. The comprehensive checklist was based on the 4 most common issues reported. Verification of checklist use showed that adherence to this requirement averaged greater than 94%. Immediately following roll out of the checklist, the percentage of errors reported fell to 1.7% with a continued decline in error reports thereafter. An approximately 60% reduction in errors in the last month of the study was evident as compared to the first month of data collection. Conclusions The use of an efficient error reporting system and implementation of a checklist based on the most common MRI acquisition errors results in a substantial decrease in the baseline MRI acquisition error rates.
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- 2018
4. Society of Interventional Radiology: Resource and Environment Recommended Standards for IR
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Adam B. Winick, Curtis W. Bakal, Thomas J. Ward, Sean A. Kennedy, Ziv J Haskal, Curtis A. Lewis, Alan H. Matsumoto, Gerald A. Niedzwiecki, Mark O. Baerlocher, and Boris Nikolic
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medicine.medical_specialty ,Resource (biology) ,medicine.diagnostic_test ,business.industry ,MEDLINE ,Interventional radiology ,Radiology, Interventional ,Radiography, Interventional ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,0302 clinical medicine ,Radiology Information Systems ,Equipment and Supplies ,Facility Design and Construction ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Medical physics ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business ,Societies, Medical ,Quality of Health Care - Published
- 2016
5. Society of Interventional Radiology Position Statement: Staffing Guidelines for the Interventional Radiology Suite
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Gerald A. Niedzwiecki, Curtis W. Bakal, Thomas J. Ward, Adam B. Winick, Alan H. Matsumoto, Sean A. Kennedy, Ziv J Haskal, Curtis A. Lewis, Boris Nikolic, and Mark O. Baerlocher
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medicine.medical_specialty ,Operating Rooms ,Quality management ,Health Personnel ,Staffing ,MEDLINE ,Personnel Staffing and Scheduling ,030204 cardiovascular system & hematology ,Radiography, Interventional ,Health Services Accessibility ,030218 nuclear medicine & medical imaging ,03 medical and health sciences ,Patient safety ,0302 clinical medicine ,After-Hours Care ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Adverse effect ,Quality Indicators, Health Care ,medicine.diagnostic_test ,business.industry ,Interventional radiology ,medicine.disease ,Quality Improvement ,Emergency medicine ,Workforce ,Medical emergency ,Clinical Competence ,Patient Safety ,Full-time equivalent ,Cardiology and Cardiovascular Medicine ,business - Abstract
INTRODUCTION Although the risk of adverse events from image-guided and interventional radiologic procedures is low, adverse events do occur, and there is evidence that inadequate resources and staffing can be associated with poorer outcomes (1–4). There is a paucity of guidelines on the necessary components of a successful IR program (5). The intent of the present document is to provide reference guidelines for the requirements for safe operation of IR suites in terms of appropriate staffing from patient intake to discharge (including pre-, peri-, and postprocedure requirements). In centers with a greater proportion of higher-complexity cases and/or patients at higher risk (eg, American Society of Anesthesiologists [ASA] status 3/4), there may be a need for additional staffing resources.
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- 2016
6. ACC/AHA Guidelines for the Management of Patients with Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)
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Alan T. Hirsch, Ziv J. Haskal, Norman R. Hertzer, Curtis W. Bakal, Mark A. Creager, Jonathan L. Halperin, Loren F. Hiratzka, William R.C. Murphy, Jeffrey W. Olin, Jules B. Puschett, Kenneth A. Rosenfield, David Sacks, James C. Stanley, Lloyd M. Taylor, Christopher J. White, John White, Rodney A. White, Elliott M. Antman, Sidney C. Smith, Cynthia D. Adams, Jeffrey L. Anderson, David P. Faxon, Valentin Fuster, Raymond J. Gibbons, Sharon A. Hunt, Alice K. Jacobs, Rick Nishimura, Joseph P. Ornato, Richard L. Page, and Barbara Riegel
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medicine.medical_specialty ,medicine.diagnostic_test ,Arterial disease ,business.industry ,Task force ,Interventional radiology ,Vascular surgery ,Cardiovascular angiography ,Peripheral ,Internal medicine ,Cardiology ,medicine ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business ,Vascular Medicine - Abstract
A Collaborative Report from the American Associations for Vascular Surgery/Society for Vascular Surgery,* Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients with Peripheral Arterial Disease)—Summary of Recommendations
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- 2006
7. Reporting Standards for Central Venous Access
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Curtis W. Bakal, James E. Silberzweig, David B. Sacks, and Azita S. Khorsandi
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business.industry ,Medicine ,Table (database) ,Radiology, Nuclear Medicine and imaging ,Medical emergency ,Technology assessment ,Cardiology and Cardiovascular Medicine ,Catheter placement ,business ,medicine.disease ,Device failure ,Medical care ,Venous access - Abstract
CENTRAL venous access has become an integral component of modern medical care. Central venous access is defined as catheter placement with the tip positioned at the caval atrial region (1). The purpose of this document is to provide guidelines for reporting the methods and results of central venous access device (CVAD) studies (Table 1). Standardized reporting allows for comparison of the strengths and limitations of different devices, device insertion techniques, postprocedure care routines, and procedures to salvage device failure (2). The following CVAD reporting guidelines present the elements that should be documented in a study.
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- 2003
8. Advances in Imaging Technology and the Growth of Vascular and Interventional Radiology: A Brief History
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Curtis W. Bakal
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medicine.medical_specialty ,Modalities ,medicine.diagnostic_test ,business.industry ,Radiography ,Angiography ,Arteriogram ,Interventional radiology ,History, 20th Century ,Radiology, Interventional ,Cannula ,Iodinated contrast ,Fluoroscopy ,Imaging technology ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Radiology ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business ,Ultrasonography - Abstract
THE development of vascular and interventional radiology (IR) as a discipline or a set of patient-care techniques can be described from many viewpoints. One could study its pioneering and innovative physicians or assess how advances in catheters and other device-based technologies have influenced the course of vascular and IR. This article will focus on how imaging technology has shaped the discipline. The advent and subsequent evolution of the modern fluoroscopically based angiographic interventional suite enabled the development of early diagnostic angiography and subsequent interventions. Cross-sectional imaging techniques such as computerized axial tomography and real-time ultrasound (US) also enabled the development of specific interventions. These modalities have also had a profound influence on case selection and case mix and have helped catalyze the evolution of vascular and IR into an interventional specialty. The first iodine-based contrast arteriogram in a patient was reported in 1929 by Dos Santos (1), approximately 34 years after the discovery of the x ray (2) and almost simultaneously with the description of the first iodinated contrast medium (3). Without the benefit of fluoroscopy, a nonselective aortogram could be obtained only by a blind translumbar puncture advancing a stiff metallic cannula with use of surface anatomic landmarks. Filming consisted of a timed single radiographic exposure. Evolution of the translumbar technique was relatively glacial for three decades, probably for two reasons. First, there was no real push to develop it because there were few operative techniques for atherosclerotic occlusive disease or aneurysmal disease, and therefore there were few real indications for the procedure. Second, there was no practical imaging technique that allowed easy and effective visualization of catheter manipulation in real time.
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- 2003
9. Randomized Phase II Trial of Embolization Therapy Versus Chemoembolization Therapy in Previously Treated Patients with Colorectal Carcinoma Metastatic to the Liver
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Alla M. Rozenblit, Ron Kaleya, Marci Jagust, Curtis W. Bakal, Abdissa Negassa, Scott Wadler, Jacov Cynamon, and Huda S. Salman
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Adult ,Male ,medicine.medical_specialty ,Colorectal cancer ,medicine.medical_treatment ,Rectum ,Adenocarcinoma ,Antineoplastic Combined Chemotherapy Protocols ,medicine ,Humans ,Hepatic artery embolization ,Prospective Studies ,Embolization ,Chemoembolization, Therapeutic ,Aged ,Aged, 80 and over ,business.industry ,Liver Neoplasms ,Gastroenterology ,Cancer ,Middle Aged ,medicine.disease ,Embolization, Therapeutic ,Surgery ,Survival Rate ,medicine.anatomical_structure ,Oncology ,Toxicity ,Female ,Polyvinyls ,Fluorouracil ,Interferons ,Colorectal Neoplasms ,business ,Artery - Abstract
Locoregional therapies are useful in treating patients with colorectal cancer metastatic to the liver. A prospective randomized phase II trial of hepatic artery embolization versus hepatic artery chemoembolization was conducted to evaluate the response rates and toxicities of these therapies in the second-line setting. Patients were required to have biopsy-proven adenocarcinoma of the colon or rectum metastatic to the liver, with the liver as the sole or predominant site of metastatic disease. All patients had measurable disease and had failed at least one prior systemic chemotherapy treatment for metastatic disease. Patients were randomized to receive either embolization therapy with polyvinyl alcohol foam (Ivalon®) administered as a single agent or chemoembolization using polyvinyl alcohol foam mixed with 750 mg/m2 of 5-fluorouracil and 9 million units of interferon. Drugs and embolic material were administered via the hepatic artery as a slurry with polyvinyl alcohol foam. Fifty eligible patients were enrolled. There were 24 patients in the chemoembolization arm and 26 in the embolization arm. Sixty-four percent of patients in both treatment arms had the liver as the sole metastatic site. The most common National Cancer Institute common toxicity criteria grade 3/4 toxicities were diarrhea (17%) and hepatic toxicity (8%). There was 1 (4%) treatment-related mortality due to a hepatic abscess. Four patients (15.4%) treated with embolization had a partial response (PR), and 5 patients (20.8%) treated with chemoembolization had a PR. The median survival for all patients was 11 months (95% confidence interval [CI], 8–15 months). Survival in patients with extrahepatic disease was 8 months (95% CI, 6- 10 months). Survival in patients with liver-only metastases was 15 months (95% CI, 10–17 months). Embolization of the liver as second-line therapy in patients with liver-predominant metastases is safe and effective. Median survivals are comparable to other second-line therapies.
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- 2002
10. SCVIR Annual Meeting Film Panels
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Robert K. Kerlan, Jeanne M. LaBerge, Curtis W. Bakal, Matthew A. Mauro, Anne C. Roberts, and Robert L. Vogelzang
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medicine.medical_specialty ,business.industry ,medicine ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Cardiology and Cardiovascular Medicine ,business - Published
- 2002
11. Part I: Putting QI to Work: CQI Thresholds and Credentials
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Curtis W. Bakal
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Medical education ,Work (electrical) ,business.industry ,Medicine ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business - Published
- 2000
12. Thrombolytic Therapy with Use of Alteplase (rt-PA) in Peripheral Arterial Occlusive Disease: Review of the Clinical Literature
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Charles P. Semba, Timothy P. Murphy, Curtis W. Bakal, Karim A. Calis, Terence A.S. Matalon, and null the Advisory Panel
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Urokinase ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Heparin ,Thrombolysis ,Disease ,Tissue plasminogen activator ,law.invention ,Peripheral ,Surgery ,Randomized controlled trial ,law ,Anesthesia ,medicine ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,Complication ,business ,medicine.drug - Abstract
PURPOSE The clinical literature describing the use of alteplase in the treatment of peripheral arterial occlusive (PAO) disease is reviewed. MATERIALS AND METHODS The literature database was acquired by a MEDLINE search using the Boolean keyword string: tissue plasminogen activator and/or rt-PA and peripheral not animal. A review was performed to identify the dose range of alteplase, technique of infusion, use of anticoagulation, clinical success rates, and risk of complications. RESULTS Forty-six clinical studies were identified. There are few prospective, randomized clinical trials and a lack of standardized protocols and endpoints. Use of catheter-directed infusions of recombinant tissue plasminogen activator (rt-PA) may be beneficial versus surgery in the initial management of acute limb ischemia ( 14 days), irreversible acute limb ischemia, or advanced diabetic arteriopathy, catheter-directed infusion of rt-PA or other plasminogen activators may be unsuitable. The risk of adverse bleeding appears related to the overall dose and duration of infusion. These risks appear similar to those of urokinase. The role of heparin in increasing adverse bleeding during rt-PA therapy is unclear. CONCLUSIONS There is no generally accepted dose or technique for administering catheter-directed thrombolysis using alteplase; however, several studies have demonstrated its clinical safety and efficacy. Formal studies will be required to determine the optimal dose, technique of infusion, the role of anticoagulation, and complication rates when alteplase is used for PAO disease.
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- 2000
13. Quality Improvement Guidelines for Percutaneous Management of the Thrombosed or Dysfunctional Dialysis Access
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Steven B. Oglevie, Andrew G. Davis, Mark I. Silverstein, Alain T. Drooz, Richard B. Towbin, John E. Aruny, Curtis W. Bakal, Anne C. Roberts, Reed A. Omary, A. Van Moore, Steven G. Meranze, Timothy C. McCowan, Calvin D. Neithamer, Kenneth S. Rholl, David B. Sacks, Curtis A. Lewis, Orestes Sanchez, Richard Gray, James W. Husted, Patricia E. Cole, Nilesh Patel, Michael Todd Jones, John F. Cardella, Harjit Singh, Scott O. Trerotola, Clement J. Grassi, and Timothy L. Swan
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Dialysis access ,medicine.medical_specialty ,Graft occlusion ,business.industry ,Treatment outcome ,Medicine ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business ,Humanities ,Surgery - Abstract
John E. Aruny, MD, Curtis A. Lewis, MD, John F. Cardella, MD, Patricia E. Cole, PhD, MD, Andrew Davis, MD, Alain T. Drooz, MD, Clement J. Grassi, MD, Richard J. Gray, MD, James W. Husted, MD, Michael Todd Jones, MD, Timothy C. McCowan, MD, Steven G. Meranze, MD, A. Van Moore, MD, Calvin D. Neithamer, MD, Steven B. Oglevie, MD, Reed A. Omary, MD, Nilesh H. Patel, MD, Kenneth S. Rholl, MD, Anne C. Roberts, MD, David Sacks, MD, Orestes Sanchez, MD, Mark I. Silverstein, MD, Harjit Singh, MD, Timothy L. Swan, MD, Richard B. Towbin, MD, Scott O. Trerotola, MD, Curtis W. Bakal, MD, MPH, for the Society of Interventional Radiology Standards of Practice Committee
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- 1999
14. Quality Improvement Guidelines for Percutaneous Transcatheter Embolization
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Louis G. Martin, Steven J. Citron, Calvin D. Neithamer, Anne C. Roberts, Timothy E. Allen, N J Freeman, Curtis W. Bakal, Anthony C. Venbrux, A. Van Moore, Curtis A. Lewis, Patrick C. Malloy, James W. Husted, Orestes Sanchez, David B. Sacks, Alain T. Drooz, and Patricia E. Cole
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medicine.medical_specialty ,Percutaneous ,medicine.diagnostic_test ,business.industry ,Transcatheter embolization ,General surgery ,Medicine ,Radiology, Nuclear Medicine and imaging ,Interventional radiology ,Guideline ,Cardiology and Cardiovascular Medicine ,business ,Surgery - Abstract
Alain T. Drooz, MD, Curtis A. Lewis, MD, Timothy E. Allen, MD, Steven J. Citron, MD, Patricia E. Cole, PhD, MD, Neil J. Freeman, MD, James W. Husted, MD, Patrick C. Malloy, MD, Louis G. Martin, MD, A. Van Moore, MD, Calvin D. Neithamer, MD, Anne C. Roberts, MD, David Sacks, MD, Orestes Sanchez, MD, Anthony C. Venbrux, MD, Curtis W. Bakal, MD, MPH, for the Society of Interventional Radiology Standards of Practice Committee
- Published
- 1997
15. Guidelines Regarding HIV and Other Bloodborne Pathogens in Vascular/Interventional Radiology
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Keith M. Horton, Curtis W. Bakal, G. David Dixon, Eric W. Olcott, David B. Sacks, David J. Eschelman, Michael D. Katz, and Margaret E. Hansen
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Bloodborne pathogens ,medicine.diagnostic_test ,business.industry ,Transmission (medicine) ,Vascular interventional radiology ,Human immunodeficiency virus (HIV) ,Interventional radiology ,medicine.disease ,medicine.disease_cause ,Immunology ,medicine ,Radiology, Nuclear Medicine and imaging ,Medical emergency ,Exposure control ,Cardiology and Cardiovascular Medicine ,business - Abstract
CONCERN about human immunodeficiency virus (HIV) and other bloodborne pathogens is rising throughout society as infection becomes more prevalent. Many members of the Society of Interventional Radiology (SIR) have expressed the need for an official statement from the Society that addresses practice issues unique to interventional radiology. As a result, the SIR Subcommittee on HIV and Bloodborne Pathogens was formed to review current knowledge about risk of bloodborne pathogen transmission during interventional radiology procedures, to summarize exposure control regulations and recommendations as they pertain to the practice of interventional radiology and review ways that risk can be reduced, and to formulate a policy for the Society to assist its members in dealing with this complicated subject. LEVEL OF RISK IN INTERVENTIONAL RADIOLOGY
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- 1997
16. Quality Improvement Guidelines for Percutaneous Transhepatic Cholangiography and Biliary Drainage
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David B. Sacks, James W. Husted, Dana R. Burke, Curtis A. Lewis, Timothy C. McCowan, Steven B. Oglevie, Richard B. Towbin, Alain T. Drooz, Ziv J. Haskal, A. Van Moore, Curtis W. Bakal, James B. Spies, John F. Cardella, and Steven J. Citron
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medicine.medical_specialty ,Biliary drainage ,Quality management ,Percutaneous ,medicine.diagnostic_test ,business.industry ,medicine.medical_treatment ,General surgery ,Guideline ,Percutaneous transhepatic cholangiography ,Cholangiography ,Medicine ,Radiology, Nuclear Medicine and imaging ,In patient ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Complication - Abstract
PERCUTANEOUS transhepatic cholangiography is a safe and effective technique for evaluating biliary abnormalities. It reliably demonstrates the level of abnormalities and sometimes can help diagnose their etiologies. Percutaneous transhepatic biliary drainage is an effective method for the primary or palliative treatment of many biliary abnormalities demonstrated with cholangiography. Participation by the radiologist in patient follow-up is an integral part of percutaneous transhepatic biliary drainage and will increase the effectiveness of the procedure. Close follow-up, with monitoring and management of the patients’ drainage-related problems, is appropriate for the interventional radiologist. These guidelines are written to be used in quality improvement programs to assess percutaneous biliary procedures. The most important processes of care are (a) patient selection, (b) performing the procedure, and (c) monitoring the patient. The outcome measures or indicators for these processes are indications, success rates, and complication rates. Outcome measures are assigned threshold levels.
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- 1997
17. Radiologic evaluation of penile arterial anatomy in arteriogenic impotence
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S.I. Wahl, M.B. Rubin, and Curtis W. Bakal
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Male ,medicine.medical_specialty ,Duplex ultrasonography ,Urology ,Hemodynamics ,Impotence, Vasculogenic ,Internal medicine ,Radiologic Evaluation ,medicine ,Humans ,Radionuclide Imaging ,Ultrasonography ,medicine.diagnostic_test ,business.industry ,Gold standard ,Magnetic resonance imaging ,Arteries ,Blood flow ,medicine.disease ,Magnetic Resonance Imaging ,Work-up ,Surgery ,Radiography ,medicine.anatomical_structure ,Erectile dysfunction ,Regional Blood Flow ,Cardiology ,Radiology ,business ,Penis - Abstract
Functional and anatomic evaluation of penile arterial blood flow is essential in the work up of erectile dysfunction. Duplex ultrasonography is an ideal screening modality with cavernosal mean peak systolic blood flow velocity being the most sensitive predictor of arterial disease. Arterial variability of the penis may affect sonographic evaluation leading to frequent misinterpretation and therefore pudendal arteriography remains the current gold standard for penile arterial evaluation. Appreciation of the type and frequency of anatomic variants and potential collateral routes is important in interpreting penile arteriograms and in evaluating the hemodynamic significance of suspected arterial disease.
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- 1997
18. Quality Improvement Guidelines for Central Venous Access
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Anne C. Roberts, Curtis W. Bakal, Louis G. Martin, Patricia E. Cole, Kenneth S. Rholl, Anthony C. Venbrux, Steven J. Citron, Calvin D. Neithamer, Orestes Sanchez, Elizabeth A. Drucker, Alain T. Drooz, Steven B. Oglevie, John F. Cardella, Dana R. Burke, A. Van Moore, Curtis A. Lewis, Timothy E. Allen, David Sacks, and Ziv J. Haskal
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Catheterization, Central Venous ,medicine.medical_specialty ,Quality management ,Quality Assurance, Health Care ,medicine.diagnostic_test ,business.industry ,Library science ,Interventional radiology ,Radiography, Interventional ,United States ,Venous access ,Family medicine ,Practice Guidelines as Topic ,medicine ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Radiology ,Cardiology and Cardiovascular Medicine ,business - Abstract
Curtis A. Lewis, MD, Timothy E. Allen, MD, Dana R. Burke, MD, John F. Cardella, MD, Steven J. Citron, MD, Patricia E. Cole, MD, PhD, Alain T. Drooz, MD, Elizabeth A. Drucker, MD, JD, Ziv J. Haskal, MD, Louis G. Martin, MD, A. Van Moore, MD, Calvin D. Neithamer, MD, Steven B. Oglevie, MD, Kenneth S. Rholl, MD, Anne C. Roberts, MD, David Sacks, MD, Orestes Sanchez, MD, Anthony Venbrux, MD, Curtis W. Bakal, MD, MPH, for the Society of Interventional Radiology Standards of Practice Committee
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- 1997
19. Quality Improvement Guidelines for Image-guided Percutaneous Biopsy in Adults: Society of Cardiovascular & Interventional Radiology Standards of Practice Committee
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John F. Cardella, Curtis W. Bakal, Dana R. Burke, Alain T. Drooz, Ziv J. Haskal, Raymond E. Bertino, Steven G. Meranze, Patrick C. Malloy, Curtis A. Lewis, David Sacks, Steven B. Oglevie, and Richard B. Towbin
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Adult ,Quality Control ,medicine.medical_specialty ,Quality management ,medicine.diagnostic_test ,business.industry ,Biopsy, Needle ,Interventional radiology ,Radiology, Interventional ,Percutaneous biopsy ,Humans ,Medicine ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Cardiology and Cardiovascular Medicine ,business ,Societies, Medical - Published
- 1996
20. Effect of Polytetrafluoroethylene Covering of Palmaz Stents on the Development of Intimal Hyperplasia in Human Iliac Arteries
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Frank J. Veith, William D. Suggs, Samuel Waahl, Takao Ohki, Ross T. Lyon, Jacob Cynamon, Luis A. Sanchez, Richard E. Parsons, Curtis W. Bakal, John G. Yuan, and Michael L. Marin
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Male ,medicine.medical_specialty ,Intimal hyperplasia ,Surface Properties ,medicine.medical_treatment ,Arterial Occlusive Diseases ,Iliac Artery ,Muscle, Smooth, Vascular ,chemistry.chemical_compound ,Restenosis ,Ischemia ,Recurrence ,medicine.artery ,medicine ,Humans ,Vascular Patency ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Polytetrafluoroethylene ,Aged ,Aged, 80 and over ,Neointimal hyperplasia ,Leg ,Wound Healing ,Hyperplasia ,business.industry ,Stent ,Equipment Design ,Middle Aged ,equipment and supplies ,medicine.disease ,Common iliac artery ,Surgery ,surgical procedures, operative ,chemistry ,Female ,Stents ,Radiology ,Tunica Intima ,Cardiology and Cardiovascular Medicine ,business ,Porosity ,Radiographic Magnification ,Follow-Up Studies - Abstract
Purpose The occurrence of neointimal hyperplasia within a stent may result in restenosis with recurrent symptoms of end-organ ischemia. This study evaluated the potential of a nonporous covering of a stent to function as a barrier to the formation of intrastent neointimal hyperplasia. Materials and Methods Twelve endovascular stent grafts were used to treat 12 high-risk patients with limb-threatening ischemia secondary to long-segment iliac artery occlusion. A 6-mm, thin-walled polytetrafluoroethylene graft was inserted and anchored to the common iliac artery with use of Palmaz stents. Each stent was covered by graft material over one-half of its length. Control angiograms obtained immediately after graft insertion were compared with follow-up angiograms obtained between 4 and 6 months after the initial procedure. On each angiogram, the region of the stent was magnified by 20x to permit computerized luminal diameter measurements. Results The mean luminal diameter within the stent was significantly greater on the covered (7.7mm ± 0.33 standard deviation) compared with the uncovered (6.7mm ± 0.85 standard deviation) portions ( P Conclusions Partially covered stents are a unique model for assessing the effects of an extrinsic stent covering on arterial healing and myointimal hyperplasia. These data suggest that a relatively nonporous covering of polytetrafluoroethylene may inhibit stent-related restenosis in iliac arteries.
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- 1996
21. Percutaneous Management of Infrapopliteal Artery Occlusive Disease and Failing Distal Bypass Grafts
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Curtis W. Bakal
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medicine.medical_specialty ,Percutaneous ,business.industry ,Internal medicine ,Occlusive disease ,Cardiology ,Distal bypass ,Medicine ,Radiology, Nuclear Medicine and imaging ,Infrapopliteal artery ,Cardiology and Cardiovascular Medicine ,business - Published
- 1996
22. Endovascular stented graft repair of a pseudoaneurysm of the subclavian artery caused by percutaneous internal jugular vein cannulation: case report
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Frank J. Veith, Stephen M. Pastores, Vladimir Kvetan, Curtis W. Bakal, and Michael L. Marin
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medicine.medical_specialty ,Percutaneous ,medicine.diagnostic_test ,business.industry ,Treatment options ,Physical examination ,General Medicine ,Critical Care Nursing ,medicine.disease ,Surgery ,Duplex scanning ,Pseudoaneurysm ,surgical procedures, operative ,medicine.artery ,cardiovascular system ,medicine ,cardiovascular diseases ,Complication ,business ,Internal jugular vein ,Subclavian artery - Abstract
In high-risk patients endovascular repair of a pseudoaneurysm with a stented graft is a safe and reasonable treatment option that can preclude significant morbidity and shorten hospital stay. We report a case of pseudoaneurysm of the subclavian artery after internal jugular vein cannulation that was treated successfully with an endovascularly inserted, stented graft. The case report highlights the importance of recognizing this unusual but serious complication of percutaneous internal jugular vein catheterization through careful clinical examination, prompt duplex scanning, and arteriography.
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- 1995
23. Initial Experience with Transluminally Placed Endovascular Grafts for the Treatment of Complex Vascular Lesions
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Michael L. Marin, Frank J. Veith, Jacob Cynamon, Luis A. Sanchez, Ross T. Lyon, Barry A. Levine, Curtis W. Bakal, William D. Suggs, Kurt R. Wengerter, Steven P. Rivers, Richard E. Parsons, John G. Yuan, Reese A. Wain, Takao Ohki, Alla Rozenblit, and Juan C. Parodi
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,Arterial disease ,Radiography ,Arterial Occlusive Diseases ,Single Center ,Aortic aneurysm ,Postoperative Complications ,Blood vessel prosthesis ,Humans ,Medicine ,Vascular Patency ,Aged ,Aged, 80 and over ,business.industry ,Mortality rate ,Arteries ,Middle Aged ,medicine.disease ,Aneurysm ,Blood Vessel Prosthesis ,Surgery ,Female ,Stents ,Radiology ,business ,Vascular Surgical Procedures ,Aortic Aneurysm, Abdominal ,Follow-Up Studies ,Research Article ,Abdominal surgery - Abstract
OBJECTIVES: Complex arterial occlusive, traumatic, and aneurysmal lesions may be difficult or impossible to treat successfully by standard surgical techniques when severe medical or surgical comorbidities exist. The authors describe a single center's experience over a 2 1/2-year period with 96 endovascular graft procedures performed to treat 100 arterial lesions in 92 patients. PATIENTS AND METHODS: Thirty-three patients had 36 large aortic and/or peripheral artery aneurysms, 48 had 53 multilevel limb-threatening aortoiliac and/or femoropopliteal occlusive lesions, and 11 had traumatic arterial injuries (false aneurysms and arteriovenous fistulas). Endovascular grafts were placed through remote arteriotomies under local (16[17%]), epidural (42[43%]), or general (38[40%]) anesthesia. RESULTS: Technical and clinical successes were achieved in 91% of the patients with aneurysms, 91% with occlusive lesions, and 100% with traumatic arterial lesions. These patients and grafts have been followed from 1 to 30 months (mean, 13 months). The primary and secondary patency rates at 18 months for aortoiliac occlusions were 77% and 95%, respectively. The 18-month limb salvage rate was 98%. Immediately after aortic aneurysm exclusion, a total of 6 (33%) perigraft channels were detected; 3 of these closed within 8 weeks. Endovascular stented graft procedures were associated with a 10% major and a 14% minor complication rate. The overall 30-day mortality rate for this entire series was 6%. CONCLUSIONS: This initial experience with endovascular graft repair of complex arterial lesions justifies further use and careful evaluation of this technique for major arterial reconstruction.
- Published
- 1995
24. Endovascular Repair of an Internal Iliac Artery Aneurysm with Use of a Stented Graft and Embolization Coils
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Frank J. Veith, Curtis W. Bakal, Samuel I. Wahl, Alla M. Rozenblit, James E. Silberzweig, Michael L. Marin, and Jacob Cynamon
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Radiography, Interventional ,Aneurysm ,Blood vessel prosthesis ,medicine.artery ,Occlusion ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Embolization ,Iliac Aneurysm ,Pelvis ,business.industry ,Angiography ,External iliac artery ,Middle Aged ,medicine.disease ,Embolization, Therapeutic ,Internal iliac artery ,Blood Vessel Prosthesis ,Surgery ,medicine.anatomical_structure ,cardiovascular system ,Stents ,Tomography, X-Ray Computed ,Cardiology and Cardiovascular Medicine ,business - Abstract
O SCVIR, 1995 T H E high mortality associated with ruptured internal iliac artery aneurysms dictates early prophylactic repair. The traditional therapeutic options include surgical excision, ligation, or obliterative endoaneurysmorrhaphy (1-5). Although the origin of the aneurysm may be easily oversewn, the anterior and posterior divisions of the internal iliac artery usually arise deep in the pelvis and may be difficult or impossible to ligate or oversew from within. Without occlusion of these vessels, the aneurysm can remain patent by filling from contralateral pelvic collaterals and the potential for aneurysm rupture remains. Percutaneous repair of an internal iliac artery aneurysm has been performed, but i t has required complete iliac occlusion and extraanatomic bypass, as described by Hollis et a1 (6). This report describes a transfemoral endovascular approach that is effective in excluding internal iliac artery aneurysms and maintaining circulation through the ipsilateral external iliac artery.
- Published
- 1995
25. Percutaneous Retrieval of Two Wallstent Endoprostheses from the Heart through a Single Jugular Sheath
- Author
-
Jacob Cynamon, Michael L. Lipton, Curtis W. Bakal, and Seymour Sprayregen
- Subjects
Male ,Catheterization, Central Venous ,medicine.medical_specialty ,Percutaneous ,Hepatic Veins ,Radiography, Interventional ,Foreign-Body Migration ,Jugular vein ,Humans ,Portasystemic Shunt, Surgical ,Medicine ,Radiology, Nuclear Medicine and imaging ,cardiovascular diseases ,Internal jugular vein ,Aged ,Tricuspid valve ,business.industry ,Heart ,Surgery ,medicine.anatomical_structure ,cardiovascular system ,Right atrium ,Stents ,Radiology ,Jugular Veins ,Cardiology and Cardiovascular Medicine ,business ,Angioplasty, Balloon ,Follow-Up Studies - Abstract
O SCVIR, 1995 The rapidly expanding use of endovascular devices has necessitated new techniques to remove misplaced or migrated devices. Percutaneous removal of a single Wallstent with use of a combined femoral and jugular vein approach has been described previously (1). The present case demonstrates successful percutaneous retrieval of two Wallstents, one from the right atrium and one from the tricuspid valve, via a single preexisting sheath in the internal jugular vein (IJV).
- Published
- 1995
26. Human transluminally placed endovascular stented grafts: Preliminary histopathologic analysis of healing grafts in aortoiliac and femoral artery occlusive disease
- Author
-
Juan C. Parodi, Kurt R. Wengerter, Richard E. Parsons, Michael L. Schwartz, Curtis W. Bakal, William D. Suggs, Frank J. Veith, Jacob Cynamon, Luis A. Sanchez, Ross T. Lyon, and Michael L. Marin
- Subjects
Reoperation ,medicine.medical_specialty ,Pathology ,medicine.medical_treatment ,Aortic Diseases ,Macrophage-1 Antigen ,Arterial Occlusive Diseases ,Femoral artery ,Anastomosis ,Iliac Artery ,Muscle, Smooth, Vascular ,Blood vessel prosthesis ,Proliferating Cell Nuclear Antigen ,medicine.artery ,von Willebrand Factor ,medicine ,Humans ,Polytetrafluoroethylene ,Wound Healing ,Staining and Labeling ,business.industry ,Vascular disease ,Foreign-Body Reaction ,Anastomosis, Surgical ,Graft Occlusion, Vascular ,Stent ,Thrombosis ,medicine.disease ,Actins ,Blood Vessel Prosthesis ,Surgery ,Femoral Artery ,Stenosis ,surgical procedures, operative ,medicine.anatomical_structure ,Stents ,Endothelium, Vascular ,Tunica Intima ,Cardiology and Cardiovascular Medicine ,business ,Follow-Up Studies ,Artery - Abstract
Purpose: The purpose of this study was to perform a preliminary histopathologic analysis of explanted human endovascular stented grafts from patients treated for occlusive disease. Methods: Over a 16-month period, 26 endovascular stented grafts were placed in 21 patients with limb-threatening ischemia caused by aortoiliac or femoral artery occlusive disease. All grafts were inserted through open arteriotomies remote from the region of primary disease. During the follow-up period, two patients died of preexisting heart disease 2 weeks and 7 months after grafting, and a portion of their endovascular grafts with the surrounding artery was explanted. Specimens from five other endovascular grafts were obtained during surgical revision for graft stenosis after 3 and 6 weeks and for outflow artery stenosis after 3, 5, and 6 months. All specimens were formalin fixed and studied with hematoxylin and eosin and trichrome staining and immunohistochemically for factor VIII–related antigen, alpha actin smooth muscle, macrophage antigen (MAC-387) and PC-10 (a mouse monoclonal antibody which specifically recognizes proliferating cell nuclear antigen in paraffin sections). Results: Three weeks after placement of the stented grafts, organizing thrombus was present on both surfaces of the expanded polytetrafluoroethylene (PTFE) grafts. At 6 weeks, evidence of a neointima with overlying endothelium was seen in the perianastomotic region, and 3 months after grafting it was seen 1 to 3 cm from the anastomosis. The specimen explanted at 5 months demonstrated factor VIII–positive cells 8 cm from the anastomosis. The histopathologic condition of the external capsule appeared to vary, depending on the presence or absence of an external wrap on the PTFE graft and on which layer in the arterial wall the graft was inserted. A foreign body reaction characterized by multinucleated giant cells was seen adjacent to wrapped grafts or around those placed in an intraadventitial plane. Grafts inserted within the media were surrounded by orderly, arranged, smooth muscle cells and few mononuclear cells. Extensive smooth muscle cell proliferation (PC-10 activity) was not seen within native artery atherosclerotic plaques peripherally displaced and external to prosthetic endovascular grafts. Conclusions: These preliminary observations on the healing of PTFE endovascular stented grafts in human beings demonstrate limited plaque hyperplasia and the presence of endothelial cells on the luminal surface remote from the graft-artery anastomosis. It is unclear whether this is a unique manifestation of healing in prosthetic grafts inserted within the walls of arteries. (J VASC SURG 1995;21:595-604.)
- Published
- 1995
27. Utility of embolization or chemoembolization as second-line treatment in patients with advanced or recurrent colorectal carcinoma
- Author
-
Jacob Cynamon, Peter H. Wiernik, Donald J. Martinelli, Hilda Haynes, Alla M. Rozenblit, Scott Wadler, Ronald Kaleya, and Curtis W. Bakal
- Subjects
Cancer Research ,medicine.medical_specialty ,Chemotherapy ,Colorectal cancer ,business.industry ,medicine.medical_treatment ,medicine.disease ,Surgery ,Recurrent Colorectal Carcinoma ,Metastasis ,Oncology ,Fluorouracil ,medicine ,Radiology ,Embolization ,Abscess ,business ,medicine.drug ,Liver abscess - Abstract
Background Second-line therapy of patients with colorectal cancer metastatic to the liver is unsatisfactory. One alternative to systemic treatment is therapy directed locoregionally. Methods Twenty-four patients with unresectable colorectal cancer with bulky liver metastases who had failed prior systemic therapy were randomized to treatment with either embolization or chemoembolization. For the embolization group, particulate transcatheter polyvinyl alcohol (PVA) (150-250-microns particles) mixed with full-strength iodinated radiographic contrast was administered under direct fluoroscopic control. In patients randomized to chemoembolization, 5-fluorouracil (750 mg/m2) and recombinant alpha-2a-interferon (Roche Laboratories, Nutley, NJ) (9-MU) were thoroughly mixed into the PVA contrast suspension. Study end points were response to therapy and survival. Results Of 24 patients, 13 were randomized to chemoembolization and 11 to embolization therapy. All were assessable for toxicity, response, and complications. Among the first 13 patients treated initially, a suppurative abscess developed in one patient, who died. Eleven subsequent patients were pretreated with oral and intravenous antibiotics without further infectious complications. Five patients had hemorrhagic complications, two of which were serious. The treatment was otherwise well tolerated, with most patients experiencing transient pain, fevers, and elevations in leukocyte counts and liver enzymes, which resolved spontaneously. Computed tomography scans of the liver were used to assess patient response to therapy. There were 6 responders (25%) among the 24 patients treated. No differences in response to treatment or survival between the embolization and chemoembolization groups were noted. With a median follow-up of more than 12 months, the median survival was 9.3 months from the time of embolization therapy. Conclusions Embolization and chemoembolization therapy appear to have antitumor activity as second-line therapy in patients with colorectal carcinoma with bulky liver metastases. Although generally well tolerated, complications of this therapy may be severe. The addition of further patients to this trial will allow a rigorous comparison of embolization alone versus embolization with chemotherapy.
- Published
- 1994
28. Transfemoral endovascular stented graft treatment of aorto-iliac and femoropopliteal occlusive disease for limb salvage
- Author
-
Thomas F. Panetta, William D. Suggs, Kurt R. Wengerter, Frank J. Veith, Jacob Cynamon, Michael L. Marin, Curtis W. Bakal, Luis A. Sanchez, Juan C. Parodi, and Michael L. Schwartz
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Limb salvage ,Aortic Diseases ,Ischemia ,Arterial Occlusive Diseases ,Catheterization ,Gangrene ,Postoperative Complications ,medicine.artery ,Occlusion ,Humans ,Medicine ,Popliteal Artery ,cardiovascular diseases ,Polytetrafluoroethylene ,Vascular Patency ,Leg ,Aorta ,business.industry ,Stent ,General Medicine ,equipment and supplies ,medicine.disease ,Intravascular stent ,Combined Modality Therapy ,Blood Vessel Prosthesis ,Surgery ,Femoropopliteal Occlusive Disease ,Femoral Artery ,Radiography ,surgical procedures, operative ,medicine.anatomical_structure ,Stents ,Radiology ,business ,Artery - Abstract
background : Endovascular stented grafts employ a new technique that blends intravascular stent and prosthetic graft technologies. These devices may be used to treat arterial aneurysms, occlusive disease, and vascular injuries. This report describes the application of stented grafts to the treatment of limb-threatening ischemia secondary to occlusive disease of the aorta, iliac, and femoral arteries. methods : Three patients with limb-threatening ischemia and severe comorbid medical illnesses were treated with transvascular stented grafts that were composed of 6-mm thin-walled polytetrafluoroethylene grafts and Palmaz balloon expandable stents. The grafts were inserted through a cutdown in an artery remote from the site of occlusion and introduced into the vascular system within 14-Fr introducer sheaths. results : Technical success was documented in all three patients with restoration of arterial continuity following stent graft deployment. Patency and limb salvage has been achieved to 1 year. One patient required further dilatation of the proximal stent at 6 weeks. Complications were limited to an iliofemoral deep vein thrombosis in one patient. conclusions : Endovascular stented grafts can be inserted to treat limb-threatening ischemia. Although these initial results are encouraging, greater experience in more patients observed for longer periods of time is necessary before this technique can be advocated for widespread use.
- Published
- 1994
29. Quality Improvement Guidelines for the Reporting and Archiving of Interventional Radiology Procedures
- Author
-
John F. Cardella, Michael A. Bettmann, Curtis W. Bakal, Kenneth S. Rholl, Steven G. Meranze, Curtis A. Lewis, Mark S. Schwartzberg, Reed A. Omary, and David Sacks
- Subjects
medicine.medical_specialty ,Quality management ,Quality Assurance, Health Care ,medicine.diagnostic_test ,business.industry ,Medical record ,MEDLINE ,Interventional radiology ,Documentation ,Radiology, Interventional ,Subject matter ,Broad spectrum ,Radiology Information Systems ,Practice Guidelines as Topic ,Health care ,Medical Records, Problem-Oriented ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Quality assurance - Abstract
The membership of the Society of Interventional Radiology (SIR) (formerly SCVIR) Standards of Practice Committee represents experts in a broad spectrum of interventional procedures from both the private and academic sectors of medicine. Generally, Standards of Practice Committee members dedicate the vast majority of their professional time to performing interventional procedures; as such, they represent a valid, broad expert constituency of the subject matter under consideration for standards production.
- Published
- 2002
30. 2011 ACCF/AHA focused update of the guideline for the management of patients with peripheral artery disease (updating the 2005 guideline): a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines: developed in collaboration with the Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society for Vascular Medicine, and Society for Vascular Surgery
- Author
-
Rodney A. White, Jafar Golzarian, Gregory L. Moneta, James C. Stanley, Frederick G. Kushner, Alan T. Hirsch, Thom W. Rooke, Curtis W. Bakal, Loren F. Hiratzka, Heather L. Gornik, Mark A. Creager, Lloyd M. Taylor, Sanjay Misra, Norman R. Hertzer, Nancy M. Albert, R. Eugene Zierler, Jeffrey L. Anderson, Christopher J. White, E. Magnus Ohman, Alice K. Jacobs, David B. Sacks, Steven M. Ettinger, William R.C. Murphy, Judith S. Hochman, Michael R. Jaff, Clyde W. Yancy, Ziv J. Haskal, Laura K. Findeiss, Anton N. Sidawy, Jules B. Puschett, Jonathan L. Halperin, Jeffrey W. Olin, Robert A. Guyton, William G. Stevenson, Joshua A. Beckman, Kenneth Rosenfield, and John V. White
- Subjects
medicine.medical_specialty ,Arterial disease ,MEDLINE ,Radiography, Interventional ,Cardiovascular angiography ,Article ,Peripheral Arterial Disease ,Risk Factors ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Societies, Medical ,Evidence-Based Medicine ,business.industry ,Task force ,Patient Selection ,Endovascular Procedures ,Cardiovascular Agents ,General Medicine ,Evidence-based medicine ,Guideline ,American Heart Association ,Vascular surgery ,United States ,Aortic Aneurysm ,Treatment Outcome ,Lower Extremity ,Family medicine ,Cardiovascular agent ,Physical therapy ,Smoking Cessation ,Cardiology and Cardiovascular Medicine ,business ,Risk Reduction Behavior ,Vascular Surgical Procedures - Abstract
published online Sep 29, 2011; J. Am. Coll. Cardiol. J. White, John V. White, and R. Eugene Zierler Michael R. Jaff, Gregory L. Moneta, Jeffrey W. Olin, James C. Stanley, Christopher Laura K. Findeiss, Jafar Golzarian, Heather L. Gornik, Jonathan L. Halperin, W. Rooke, Alan T. Hirsch, Sanjay Misra, Anton N. Sidawy, Joshua A. Beckman, Radiology, Society for Vascular Medicine, and Society for Vascular Surgery, Thom Society for Cardiovascular Angiography and Interventions, Society of Interventional Association Task Force on Practice Guidelines Report of the American College of Cardiology Foundation/American Heart Patients With Peripheral Artery Disease (Updating the 2005 Guideline): A 2011 ACCF/AHA Focused Update of the Guideline for the Management of This information is current as of October 12, 2011 http://content.onlinejacc.org/cgi/content/full/j.jacc.2011.08.023v1 located on the World Wide Web at: The online version of this article, along with updated information and services, is
- Published
- 2011
31. Human Radiation Injury
- Author
-
Curtis W. Bakal
- Subjects
medicine.medical_specialty ,business.industry ,medicine ,General Medicine ,Radiology ,business ,Radiation injury - Published
- 2011
32. Value of Preoperative Renal Artery Embolization in Reducing Blood Transfusion Requirements during Nephrectomy for Renal Cell Carcinoma
- Author
-
Philip S. Lakritz, Curtis W. Bakal, Seymour Sprayregen, and Jacob Cynamon
- Subjects
Adult ,Male ,medicine.medical_specialty ,Blood transfusion ,medicine.medical_treatment ,Nephrectomy ,Preoperative care ,Renal Artery ,Renal cell carcinoma ,medicine.artery ,Preoperative Care ,medicine ,Carcinoma ,Humans ,Blood Transfusion ,Radiology, Nuclear Medicine and imaging ,Embolization ,Renal artery embolization ,Renal artery ,Carcinoma, Renal Cell ,Aged ,Aged, 80 and over ,business.industry ,Middle Aged ,medicine.disease ,Embolization, Therapeutic ,Kidney Neoplasms ,Surgery ,Female ,Cardiology and Cardiovascular Medicine ,business - Abstract
The authors evaluated the effectiveness of preoperative ethanol renal artery embolization in reducing transfusion requirements during nephrectomy for renal cell carcinoma.Of 93 consecutive patients who underwent nephrectomy for renal cell carcinoma from 1980 to 1990, 24 patients underwent embolization within 24 hours of nephrectomy. Finding in this group were compared with those in 69 control patients who underwent surgery without preoperative embolization.Embolized tumors were larger than nonembolized ones (mean volume, 595 vs 257 mL) (P.05). Patients with large hypervascular tumors (volume over 250 mL) who underwent complete embolization received significantly smaller mean blood transfusion volumes than control patients (250 vs 800 mL; P = .01). The transfusion volume associated with incomplete embolization was higher than that associated with no embolization.Complete alcohol embolization significantly reduces the volume of blood transfused during nephrectomy for large hypervascular renal cell carcinomas, and incomplete embolization is associated with larger transfusions. Preoperative embolization must be complete and should be performed more widely.
- Published
- 1993
33. Compression of Vein Graft by Hematoma During Fibrinolytic Therapy Simulating Intrinsic Venous Stricture—A Case Report
- Author
-
Curtis W. Bakal, Seymour Sprayregen, and Jacob Cynamon
- Subjects
Male ,medicine.medical_specialty ,medicine.medical_treatment ,Lumen (anatomy) ,Vein graft ,030204 cardiovascular system & hematology ,03 medical and health sciences ,0302 clinical medicine ,Hematoma ,Ischemia ,Fibrinolysis ,medicine ,Humans ,Saphenous Vein ,Streptokinase ,Thrombolytic Therapy ,030212 general & internal medicine ,Aged ,Aged, 80 and over ,Leg ,Chemotherapy ,Vascular disease ,business.industry ,Graft Occlusion, Vascular ,medicine.disease ,Extravasation ,Surgery ,surgical procedures, operative ,cardiovascular system ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Complication ,Extravasation of Diagnostic and Therapeutic Materials - Abstract
Narrowing of a vein graft at an area of perigraft extravasation was encountered during fibrinolytic therapy for graft thrombosis. With cessation of fibrinolytic therapy, extravasation ceased and the vein lumen widened. Extrinsic compression and/or spasm due to a hematoma should be included as causes of vein graft narrowing in patients undergoing fibrinolytic therapy.
- Published
- 1993
34. How to Put a QI and Credentials Program to Work, Part 1: CQI Thresholds and Credentials
- Author
-
Curtis W. Bakal
- Subjects
Medical education ,Work (electrical) ,business.industry ,Medicine ,Radiology, Nuclear Medicine and imaging ,Cardiology and Cardiovascular Medicine ,business - Published
- 2001
35. Contributors
- Author
-
Hani Abujudeh, Andreas Adam, Hassan M. Ahmad, Sun Ho Ahn, Kamran Ahrar, Morvarid Alaghmand, Agaicha Alfidja, Ahmad I. Alomari, Gennaro Ambrosanio, Soon Ghee Ang, John Frederick Angle, Gary M. Ansel, Bassel Atassi, Julien Auriol, Juan Carlos Baez, Curtis W. Bakal, Jörn Oliver Balzer, Joel E. Barbato, Brad P. Barnett, Gamal Baroud, Carlo Bartolozzi, Jason R. Bauer, Richard Arthur Baum, Kevin Walter Bell, Jacqueline A. Bello, Jennifer L. Berkeley, Michael A. Bettmann, Mario Bezzi, José I. Bilbao, Deniz Bilecen, Christoph A. Binkert, Haraldur Bjarnason, James H. Black, Francine Blei, Brian M. Block, Marc Bohner, Amman Bolia, Irene Boos, Charles F. Botti, Louis Boyer, Elena Bozzi, Peter Reynolds Bream, Rachel F. Brem, Mark F. Brodie, Allan L. Brook, Benjamin S. Brooke, Duncan Mark Brooks, Daniel B. Brown, Karen T. Brown, James P. Burnes, Patricia E. Burrows, Justin John Campbell, Colin P. Cantwell, Thierry Carreres, John A. Carrino, Lucie Cassagnes, Pascal Chabrot, Abbas Afif Chamsuddin, Richard Chang, Lakhmir S. Chawla, Hank (Han) K. Chen, Yung-Hsin Chen, Rush Hamilton Chewning, Kenneth H. Cho, Albert K. Chun, Timothy W.I. Clark, Felipe B. Collares, Luca Cova, Laura Crocetti, Charles D. Crum, T. Andrew Currier, Ferenc Czeyda-Pommersheim, Michael D. Dake, Michael David Darcy, L. Mark Dean, Thierry De Baère, Sudhen B. Desai, Alvaro A. Diano, Robert G. Dixon, Pablo D. Dominguez, Robert F. Dondelinger, Gregory J. Dubel, Clifford J. Eskey, Jan A. Eubig, Salomão Faintuch, Ronald N. Fairman, Chieh-Min Fan, Fabrizio Fanelli, Mark A. Farber, Laura M. Fayad, Peter F. Ford, Brian Funaki, Andreas Gabelmann, Dmitri A. Gagarin, Philippe Gailloud, Suvranu Ganguli, Lorenzo García-García, Vanessa L. Gates, Tony Geoghegan, Debra A. Gervais, Jean-Francois H. Geschwind, Matthew B. Gillbert, Mark F. Given, Y. Pierre Gobin, S. Nahum Goldberg, Theodore S. Grawbow, Roy K. Greenberg, Brian Grieme, Klaus D. Hagspiel, Keith W. Hamilton, Klaus A. Hausegger, Markus H. Heim, Robert C. Heng, Joshua A. Hirsch, J. Todd Hobelmann, Andrew H. Holden, Ed Horn, Oluwatoyin R. Idowu, Tiziana Ierace, Elizabeth Ann Ignacio, Zubin Irani, Roberto Izzo, James E. Jackson, Augustinus L. Jacob, Priya Jaga, Francis Joffre, Matthew S. Johnson, Chauncey T. Jones, Sanjeeva P. Kalva, Anthony W. Kam, Sridhar Kamath, Krishna Kandarpa, Jeffrey M. Katz, John A. Kaufman, Alexis D. Kelekis, Frederick S. Keller, Robert K. Kerlan, David Kessel, Verena Khan, Kanika Khanna, Neil M. Khilnani, Hyun S. Kim, Hiro Kiyosue, Sebastian Kos, Gaurav Kumar, Maxim Kupershmidt, Vineel Kurli, Jeanne M. LaBerge, Pierre-Yves Laffy, Carlos Lanciego, Elvira V. Lang, Arcangelo L. Lavanga, Leo Patrick Lawler, Judy M. Lee, Michael J. Lee, Thomas Lemettre, Riccardo Lencioni, Yean L. Lim, Robert J. Lewandowski, John J. Lewin, Curtis Allen Lewis, Changqing Li, Eleni Liapi, Rafael H. Llinas, Reinhard Loose, Stuart M. Lyon, Patrick C. Malloy, Michael J. Manzano, Marie Agnes Marachet, Jean-Baptiste Martin, Antonio Martínez-Cuesta, M. Victoria Marx, John M. Mathis, Alan H. Matsumoto, Matthew A. Mauro, Gordon McLennan, Simon J. McPherson, Hugh McSwain, Steven Greene Meranze, Todd S. Miller, Robert J. Min, Sally E. Mitchell, Stephan Moll, Jeffrey I. Mondschein, Laurel E. Moore, Jose Pablo Morales, Robert A. Morgan, Hiromu Mori, Paul R. Morrison, Stefan Müller-Hülsbeck, Kieran P.J. Murphy, Timothy P. Murphy, Mario Muto, Aravinda Nanjundappa, Juan C. Narvaez, Rodrigo Gomes Do Nascimento, Albert A. Nemcek, Ali Noor, Luigi Novelli, Gianluigi Orgera, Philippe Otal, Randall P. Owen, Aalpen A. Patel, Sandra Pauls, Monica Smith Pearl, Giuseppe Pelle, Olivier Pellerin, Daniel Picus, Jeffrey S. Pollak, Rupert Horst Portugaller, Batya R. Radzik, Suman W. Rathbun, Anne Ravel, Charles E. Ray, Mahmood K. Razavi, Howard A. Riina, Anne Roberts, Alain Roche, Eric E. Roselli, Robert J. Rosen, Plinio Rossi, Hervé Rousseau, Stefan G. Ruehm, Diego San Millán Ruíz, John H. Rundback, Wael E.A. Saad, Tarun Sabharwal, Gloria Maria Martinez Salazar, John Vito Salerno, Riad Salem, Marc R. Sapoval, Shawn N. Sarin, Sanjiv Sharma, Ashot Shekoyan, Ji Hoon Shin, Naomi N. Silva, Stuart G. Silverman, Charan Kamal Singh, Constantinos T. Sofocleous, Luigi Solbiati, Stephen B. Solomon, Ho-Young Song, Kean H. Soon, Thomas A. Sos, Michael C. Soulen, James B. Spies, M.J. Bernadette Stallmeyer, Joseph M. Stavas, LeAnn Simmons Stokes, Ernst-Peter Strecker, Michael B. Streiff, Deepak Sudheendra, Walter A. Tan, Elizabeth R. Tang, Mahsa R. Tehrani, Mathew M. Thompson, Kenneth R. Thompson, Gina D. Tran, Scott O. Trerotola, David Trost, Nirman Tulsyan, Kemal Tuncali, Ulku Cenk Turba, Renan Uflacker, Eric van Sonnenberg, Prasanna Vasudevan, Anthony C. Venbrux, Tom Vesely, Bogdan Vierasu, Rachel L. Vile, Isabel Vivas, Dierk Vorwerk, David L. Waldman, Michael J. Wallace, Anthony F. Watkinson, Peter N. Waybill, Joshua L. Weintraub, Robert I. White, Mark H. Wholey, Bradford D. Winters, Robert Wityk, Edward Y. Woo, Bradford J. Wood, Gerald M. Wyse, Albert J. Yoo, Chang Jin Yoon, Rex C. Yung, Soraya Zaid, Steven M. Zangan, Grace M. Zawistowski, Fabio Zeccolini, Eberhard Zeitler, Dianbo Zhang, Gregg H. Zoarski, and Christoph L. Zollikofer
- Published
- 2010
36. Radiology in Intestinal Ischemia: Plain Film, Contrast, and Other Imaging Studies
- Author
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Curtis W. Bakal, Seymour Sprayregen, and Ellen L. Wolf
- Subjects
medicine.medical_specialty ,Pathology ,Radiography ,medicine.medical_treatment ,Plain film ,Enema ,chemistry.chemical_compound ,Mesenteric Veins ,Ischemia ,medicine ,Animals ,Humans ,Colitis ,Ultrasonography ,Barium enema ,medicine.diagnostic_test ,business.industry ,Ultrasound ,medicine.disease ,digestive system diseases ,Mesenteric Arteries ,Intestines ,Barium sulfate ,chemistry ,Angiography ,Surgery ,Radiology ,Barium Sulfate ,Tomography, X-Ray Computed ,business - Abstract
Because plain films are usually normal or nonspecific in both colonic and acute mesenteric ischemia, they are not diagnostically helpful. The barium enema is the most useful radiographic examination in the diagnosis of colonic ischemia, and a double-contrast study will show abnormalities in almost all cases. Findings specific for colonic ischemia characteristically change with time. Thumbprinting is the most diagnostic finding; it is seen early in the course of the disease and usually resolves or is replaced within 1 or 2 weeks by an acute ulcerating colitis pattern. The latter may heal over months or go on to stricture formation or a persistent colitis. Nonspecific abnormalities can also be identified on CT and ultrasound, but the incidence of the findings with colonic ischemia is not known. Plain film findings occur late in the course of acute mesenteric ischemia and thus cannot be relied on for the diagnosis, although they may be useful in excluding other conditions. When acute mesenteric ischemia is suspected, angiography should be performed, but CT, ultrasound, and, perhaps, MR imaging may contribute to the diagnosis.
- Published
- 1992
37. Quality Improvement for Diagnostic Neuroangiography and Other Procedures
- Author
-
Curtis W. Bakal
- Subjects
medicine.medical_specialty ,Quality management ,business.industry ,Specialty ,Guideline ,medicine.disease ,Credentialing ,Family medicine ,Health care ,medicine ,Radiology, Nuclear Medicine and imaging ,Professional association ,Medical emergency ,Cardiology and Cardiovascular Medicine ,business ,Quality assurance ,Accreditation - Abstract
THE Quality Improvement Guidelines for Adult Diagnostic Neuroangiography published in this issue of JVIR (1) is a clinical practice guideline produced by an interdisciplinary consensus group process to cover a crucial aspect of the care of patients with potentially devastating neurovascular disease. The document should be of intense interest to all those who desire to ensure quality of care for patients undergoing carotid angiography. As the pace of development and application of carotid stent placement and intracranial thrombolysis quickens, it is important to remember that one major potential rate-limiting factor in ensuring efficacy and safety of these procedures is the training, skill, and experience of practitioners performing the diagnostic and interventional components of the procedures. Outcomesbased practice guidelines such as this one must be used to monitor results and set a benchmark for expected performance. Clinical practice guidelines are defined as systematically developed statements, which assist medical decision making. Besides quality improvement guidelines such as this one, other practice guidelines include credentialing statements and clinical pathways. Guidelines are used primarily to reduce variation in clinical practice between individual physicians or groups of physicians, thus raising the standard of care. Guidelines also assist physicians and other healthcare providers in managing the huge amount of information that is found at scientific meetings, in journal articles, and in personal clinical experiences. Clinical practice guidelines serve both an educational and a surveillance function in an effort to define and achieve an optimum level of patient care. Good practice guidelines should rest on methodical analysis of the scientific evidence, be reproducible and reliable, have clinical applicability for defined patient populations, and be updated periodically to reflect current knowledge and state of practice. We believe that this neuroangiography practice guideline meets these criteria. The quality improvement guidelines on neuroangiography comprise the first intersociety, multidisciplinary document developed by the ASNR, ASITN, and the SIR. Members of these societies together have had the overwhelming clinical experience with carotid arteriography in the United States. Radiologists (including vascular and interventional radiologists, neuroradiologists, and interventional neuroradiologists) performed 91% of the 91,558 cervicocerebral angiograms recorded in the Medicare procedural database in one recent year, while physicians in the next named specialty category (cardiology) performed only 4.2% (2). Therefore, these radiology groups possess the clinical experience and expertise to generate a realistic standard of care. The membership of the intersociety working committee represents both academic and community practices and was drawn from a wide geographic area. Quality improvement documents such as this one, as well as others in the SIR QI program (3–7), utilize an evidence-based literature search and a formalized consensus process (modified Delphi technique), which provide valid and reproducible threshold indicators. Thresholds defined by the document are appropriateness (indications), effectiveness (technical success), and safety (complication rate) (8,9). Preliminary data from the SIR HI-IQ electronic database have been used to provide actual clinical practice data on short-term outcomes and will be used in the future to validate and update quality improvement guidelines. There are multiple sources for practice guidelines, including hospital protocols and bylaws, payers, national, local and state health care agencies, professional societies, and the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). In recent years, JCAHO compliance and consequent accreditation has been of paramount concern to healthcare organizations. The JCAHO requires that there is a mechanism that ensures that the same level of quality of patient care be provided by all individuals with delineated clinical privileges, both within medical staff departments and across all departments at an institution (10). Thus, outcome measures as delineated This article first appeared in J Vasc Interv Radiol 2000; 11:1–3.
- Published
- 2000
38. Quality improvement guidelines for percutaneous drainage/aspiration of abscess and fluid collections
- Author
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Michael J, Wallace, Kenneth W, Chin, Thomas B, Fletcher, Curtis W, Bakal, John F, Cardella, Clement J, Grassi, John D, Grizzard, Alan D, Kaye, David C, Kushner, Paul A, Larson, Lawrence A, Liebscher, Patrick R, Luers, Matthew A, Mauro, and Sanjoy, Kundu
- Subjects
medicine.medical_specialty ,Quality management ,Percutaneous ,Quality Assurance, Health Care ,business.industry ,General surgery ,MEDLINE ,Ascites ,Suction ,medicine.disease ,Abscess ,United States ,Surgery ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Drainage ,Cardiology and Cardiovascular Medicine ,business ,Quality assurance - Published
- 2009
39. Temporary Segmental Renal Artery Occlusion Using Reverse Phase Polymer for Bloodless Robotic Partial Nephrectomy
- Author
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John Merhige, Jean-Marie Vogel, Alireza Moinzadeh, Peter N. Madras, Sebastian Flacke, John A. Libertino, Katy Lyall, and Curtis W. Bakal
- Subjects
medicine.medical_specialty ,Time Factors ,Swine ,Urology ,medicine.medical_treatment ,Blood Loss, Surgical ,Poloxamer ,Vascular occlusion ,Nephrectomy ,Article ,Renal Artery ,medicine.artery ,Occlusion ,Medicine ,Animals ,Artery occlusion ,Embolization ,Renal artery ,business.industry ,Robotics ,Embolization, Therapeutic ,Hemostasis, Surgical ,Surgery ,Hemostasis ,Feasibility Studies ,Laparoscopy ,medicine.symptom ,business ,Perfusion - Abstract
Renal vascular clamping with ensuing warm ischemia is typically needed during robotic or laparoscopic partial nephrectomy. We developed a technique for angiographic delivery of the novel intra-arterial reverse thermoplastic polymer LeGoo-XL that allows temporary selective vascular occlusion with normal perfusion of the remaining kidney.Eight pigs underwent a total of 16 selective angiographic occlusions of the lower pole segmental artery using gel polymer. The technical feasibility of 2 hemostatic techniques, perfusion hemostasis and local plug formation, was assessed in 4 pigs each. Selective ischemia time was recorded and the vascular occlusion site was noted radiographically and laparoscopically. The feasibility of reversing the polymer from solid back to liquid state to allow reperfusion was determined. Pathological analysis of the kidney was completed in these acute model pigs. In the last 2 cases lower pole robotic partial nephrectomy was done using the da Vinci surgical system.Selective lower pole ischemia was achieved in all 8 cases. Perfusion hemostasis yielded an inconsistent duration of occlusion (zero to greater than 60 minutes). Vascular occlusion time using local plug formation was more reliable (17 to 30 minutes) with consistent ability to reverse the plug to liquid state by cold saline flush. Two lower pole robotic partial nephrectomies were completed with minimal blood loss.We developed a reliable technique of angiographic delivery of gel polymer for temporary vascular occlusion of selective renal artery branches using local plug formation. Ongoing studies are under way to assess technique consistency and the long-term effects of the polymer.
- Published
- 2009
40. A ten-year experience with one hundred fifty failing or threatened vein and polytetrafluoroethylene arterial bypass grafts
- Author
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Frank J. Veith, Thomas F. Panetta, George L. Berdejo, Michael L. Marin, Luis A. Sanchez, Ross T. Lyon, Kurt R. Wengerter, Seymour Sprayregen, Sushil K. Gupta, Curtis W. Bakal, Jacob Cynamon, and Jamie Goldsmith
- Subjects
Reoperation ,medicine.medical_specialty ,Time Factors ,Percutaneous ,medicine.medical_treatment ,Arterial Occlusive Diseases ,Femoral artery ,Revascularization ,Veins ,Recurrence ,Blood vessel prosthesis ,medicine.artery ,Angioplasty ,medicine ,Humans ,Vascular Patency ,Popliteal Artery ,Vein ,Polytetrafluoroethylene ,Aorta ,Retrospective Studies ,Leg ,business.industry ,Graft Occlusion, Vascular ,Popliteal artery ,Blood Vessel Prosthesis ,Prosthesis Failure ,Surgery ,Femoral Artery ,medicine.anatomical_structure ,Radiology ,Cardiology and Cardiovascular Medicine ,business ,Angioplasty, Balloon - Abstract
Between Jan. 1, 1980, and Dec. 31, 1989, 2187 infrainguinal revascularization procedures were performed. In 130 of these cases with patent bypasses, hemodynamic deterioration was suspected, and urgent arteriography was performed. Twenty additional patients with aortofemoral, femorofemoral, or axillofemoral bypasses demonstrated hemodynamic deterioration. In 93% of failing grafts the condition was suspected because of recurrent symptoms or changes in the pulse examination. Two hundred eighty-five high-grade stenotic or occlusive lesions were identified in inflow arteries, outflow arteries, within the graft, or at proximal or distal anastomoses associated with these 150 grafts. One hundred sixty-one (57%) of these lesions were in patients with failing vein grafts; 115 (40%) were in patients with failing polytetrafluoroethylene (PTFE) grafts; and 9 (3%) were associated with failing composite vein/PTFE grafts. Stenotic lesions less than 5 cm in length were initially treated with percutaneous transluminal balloon angioplasty (PTA). Occlusive lesions, stenoses greater than 5 cm in length, and PTA failures were treated surgically. The overall 6-year cumulative secondary patency rate for failing grafts was 65%, and the limb salvage rate was 75%. The extended patency rate after the first intervention in the failing state was 56% at 5 years. The 5-year secondary patency rate for grafts initially treated with PTA (58%) was not significantly different (p = 0.25) from that for grafts treated initially with surgery (71%). Percutaneous transluminal angioplasty was effective for inflow stenoses of the iliac, femoral, and popliteal arteries and for some outflow lesions.(ABSTRACT TRUNCATED AT 250 WORDS)
- Published
- 1991
41. Early experience with the smart laser in the treatment of atherosclerotic occlusions
- Author
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John Keeley, Frank J. Veith, Kurt R. Wengerter, Mark A. Greenberg, Sushil K. Gupta, Curtis W. Bakal, Allan M. Dietzek, Jacob Cynamon, and Mark A. Mennigus
- Subjects
medicine.medical_specialty ,Time Factors ,Arteriosclerosis ,medicine.medical_treatment ,Balloon ,Angioplasty, Laser ,law.invention ,Lesion ,Arteriovenous Shunt, Surgical ,law ,Angioplasty ,medicine ,Humans ,Popliteal Artery ,Aged ,Laser procedure ,Interventional treatment ,business.industry ,Intermittent Claudication ,Middle Aged ,Laser ,Surgery ,Femoral Artery ,medicine.anatomical_structure ,Bypass operation ,Radiology ,medicine.symptom ,Cardiology and Cardiovascular Medicine ,business ,Angioplasty, Balloon ,Follow-Up Studies ,Artery - Abstract
A dual-laser system (helium-cadmium and pulsed dye) capable of continuous computer analysis of spectroscopic characteristics of tissue fluorescence, which can distinguish atherosclerotic plaque from components of normal arterial wall, was used to deliver laser energy to ablate plaque. During a 1-year period this system was used to facilitate balloon angioplasty of short (3 to 17 cm) total occlusions of the superficial femoral or popliteal arteries only when standard angioplasty techniques were ineffective. During the year of the study, in one institution 415 patients were subjected to arteriography of the lower extremities for leg ischemia (397 for limb salvage indications). Standard angioplasty techniques were used in 94 of these patients; 218 patients were unsuitable for standard angioplasty, did not fulfill criteria for “smart” laser treatment, and underwent standard bypass operations. Only 11 patients (plus six others in the second institution) requiring treatment fulfilled the criteria for use of the “smart” laser. In 10 patients the occluding lesion was traversed by the laser wire (diameter 0.021 inch), and luminal patency was effectively restored by balloon angioplasty to ≥ 70% of the most normal-appearing segment of that artery. Satisfactory luminal patency has persisted for 2 to 12 months (mean 6 months) in nine patients; the lesion in the tenth patient restenosed at 3 months. The laser procedure was unsuccessful in all three patients with occlusions greater than 10 cm and in four others. Although there were three microperforations with the laser wire, there were no clinically significant complications. These data suggest that most patients that presently require interventional treatment can be managed by standard angioplasty methods and/or require a bypass operation. The “smart” laser is safe and effective in the short-term in facilitating angioplasty in some patients in whom standard angioplasty techniques are not feasible.
- Published
- 1991
42. Unsuspected inflow disease in candidates for axillofemoral bypass operations: A prospective study
- Author
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Frank J. Veith, Kurt R. Wengerter, Seymour Sprayregen, Sushil K. Gupta, Curtis W. Bakal, Keith D. Calligaro, Charles D. Franco, and Enrico Ascer
- Subjects
medicine.medical_specialty ,business.industry ,Inflow ,medicine.disease ,Surgery ,Stenosis ,Blood pressure ,medicine.anatomical_structure ,Axillary artery ,medicine.artery ,Axillofemoral bypass ,cardiovascular system ,medicine ,cardiovascular diseases ,Derivation ,Radiology ,Prospective cohort study ,business ,Cardiology and Cardiovascular Medicine ,Artery - Abstract
Routine arteriography of the axillary, subclavian, and innominate arteries before axillofemoral bypass surgery has not been advocated because of the presumed rarity of stenosis of these inflow vessels. However, we have noted in this patient population with extensive atherosclerosis that inflow disease can cause axillofemoral graft failure despite normal preoperative clinical and noninvasive parameters. We prospectively determined the incidence of unsuspected inflow stenosis with arteriography in 40 consecutive candidates for primary (28) or secondary (12) axillofemoral bypass surgery. A new arteriographic technique with a single translumbar puncture was developed to safely and clearly visualize the potential inflow and outflow tracts. Ten of the 40 patients (25%) exhibited inflow stenosis greater than 50% of luminal diameter (unilateral in eight patients and bilateral in two patients). Seven were on the left side (five subclavian, two axillary) and five were on the right side (three subclavian, one axillary, one innominate). In eight of the 40 patients (20%) the stenotic inflow lesion was ipsilateral to the ischemic leg and therefore proximal to the preferred inflow site of an axillofemoral bypass. Upper extremity arterial pressure measurements suggested potential inflow artery stenosis in only three of the 12 (25%) instances. These findings show that equal arterial pressures in the upper extremities do not ensure adequate inflow for an axillofemoral graft. Routine arteriographic assessment of inflow intacts is recommended before axillofemoral bypass surgery. (J VASC SURG 1990;11:832-7.)
- Published
- 1990
43. ACC/AHA 2005 Practice Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic)
- Author
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Ziv J. Haskal, Kenneth Rosenfield, Valentin Fuster, David P. Faxon, Alan T. Hirsch, Jonathan L. Halperin, Barbara Riegel, Rodney A. White, Jeffrey W. Olin, Sidney C. Smith, Jeffrey L. Anderson, James C. Stanley, Cynthia D. Adams, Raymond J. Gibbons, Alice K. Jacobs, Joseph P. Ornato, David B. Sacks, Curtis W. Bakal, Christopher J. White, Mark A. Creager, Lloyd M. Taylor, Elliott M. Antman, John White, Sharon A. Hunt, Norman R. Hertzer, Rick A. Nishimura, Richard L. Page, Jules B. Puschett, Loren F. Hiratzka, and William R.C. Murphy
- Subjects
Male ,Arterial disease ,Comorbidity ,Tissue plasminogen activator ,Magnetic resonance angiography ,law.invention ,Renal Artery ,Randomized controlled trial ,Ischemia ,Risk Factors ,law ,Prevalence ,Popliteal Artery ,Aorta, Abdominal ,Randomized Controlled Trials as Topic ,Aged, 80 and over ,Peripheral Vascular Diseases ,Evidence-Based Medicine ,medicine.diagnostic_test ,Flash pulmonary edema ,Middle Aged ,Combined Modality Therapy ,Mesenteric Arteries ,Peripheral ,Femoral Artery ,Intestines ,Treatment Outcome ,Cardiology ,Female ,Cardiology and Cardiovascular Medicine ,Vascular Surgical Procedures ,Algorithms ,medicine.drug ,Adult ,Diagnostic Imaging ,medicine.medical_specialty ,Adolescent ,Aortic Rupture ,Aortoiliac occlusive disease ,Iliac Artery ,Physiology (medical) ,Internal medicine ,medicine ,Humans ,Aged ,Leg ,business.industry ,Cardiovascular Agents ,Digital subtraction angiography ,Atherosclerosis ,medicine.disease ,Aneurysm ,business ,Risk Reduction Behavior ,Aortic Aneurysm, Abdominal - Published
- 2006
44. Quality Improvement for Endovascular Procedures
- Author
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David B. Sacks and Curtis W. Bakal
- Subjects
Quality management ,Process management ,Computer science ,Quality of care ,Set (psychology) - Abstract
Quality improvement (QI) is not usually a popular topic for discussion. It brings images of a bureaucratic ‘‘big brother’’ watching and punishing human errors with no benefit to patients. On the other hand, QI is ideally intended to document the quality of care one provides in clinically relevant ways with opportunities to improve. It is the purpose of this chapter to describe the latter, including specific ways to set up a QI program using useful and relevant criteria.
- Published
- 2005
45. Quality improvement guidelines for transhepatic arterial chemoembolization, embolization, and chemotherapeutic infusion for hepatic malignancy
- Author
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Daniel B, Brown, John F, Cardella, David, Sacks, S Nahum, Goldberg, Debra A, Gervais, Dheeraj K, Rajan, Suresh, Vedantham, Donald L, Miller, Elias N, Brountzos, Clement J, Grassi, Richard B, Towbin, John Fritz, Angle, Stephen, Balter, Timothy W I, Clark, Patricia E, Cole, Peter, Drescher, Neil J, Freeman, Jeffrey D, Georgia, Ziv, Haskal, David M, Hovsepian, Neil M, Kilnani, Sanjoy, Kundu, Patrick C, Malloy, Louis G, Martin, J Kevin, McGraw, Steven G, Meranze, Philip M, Meyers, Steven F, Millward, Kenneth, Murphy, Calvin D, Neithamer, Reed Ali, Omary, Nilesh H, Patel, Anne C, Roberts, Marc S, Schwartzberg, Gary P, Siskin, Harry R, Smouse, Timothy L, Swan, Patricia E, Thorpe, Thomas M, Vesely, Louis K, Wagner, Bret N, Wiechmann, Curtis W, Bakal, Curtis A, Lewis, Albert A, Nemcek, and Kenneth S, Rholl
- Subjects
medicine.medical_specialty ,Carcinoma, Hepatocellular ,Quality management ,Quality Assurance, Health Care ,medicine.medical_treatment ,MEDLINE ,Antineoplastic Agents ,Radiography, Interventional ,Subject matter ,Hepatic Artery ,Health care ,Humans ,Infusions, Intra-Arterial ,Medicine ,Radiology, Nuclear Medicine and imaging ,Medical physics ,Embolization ,Chemoembolization, Therapeutic ,Societies, Medical ,medicine.diagnostic_test ,business.industry ,General surgery ,Liver Neoplasms ,Iodized Oil ,Interventional radiology ,Technical documentation ,Embolization, Therapeutic ,Hepatic malignancy ,Cardiology and Cardiovascular Medicine ,business - Abstract
THE membership of the Society of Interventional Radiology (SIR) Standards of Practice Committee represents experts in a broad spectrum of interventional procedures from the private and academic sectors of medicine. Generally, Standards of Practice Committee members dedicate the vast majority of their professional time to performing interventional procedures; as such, they represent a valid broad expert constituency of the subject matter under consideration for standards production. Technical documents specifying the exact consensus and literature review methodologies as well as the institutional affiliations and professional credentials of the authors of this document are available upon request from SIR, 3975 Fair Ridge Dr, Suite 400 North, Fairfax, VA 22033.
- Published
- 2005
46. Utility of embolization or chemoembolization as second-line treatment in patients with advanced or recurrent colorectal carcinoma
- Author
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Camillo Porta, Mauro Moroni, Giuseppe Nastasi, Enrico Bobbio-Pallavicini, Giancarlo Barazzoni, Scott Wadler, Curtis W. Bakal, Jacob Cynamon, and Peter H. Wiernik
- Subjects
Cancer Research ,Oncology - Published
- 1995
47. Quality Improvement Guidelines for Adult Percutaneous Abscess and Fluid Drainage
- Author
-
Paramjit S. Chopra, James B. Spies, A. Van Moore, Steven L. Dawson, Aubrey M. Palestrant, Dana R. Burke, Anne C. Roberts, Steven G. Meranze, Alain T. Drooz, David Sacks, Richard B. Towbin, John F. Cardella, N J Freeman, Eric J. Stein, and Curtis W. Bakal
- Subjects
medicine.medical_specialty ,Percutaneous ,medicine.diagnostic_test ,business.industry ,General surgery ,medicine ,Radiology, Nuclear Medicine and imaging ,Interventional radiology ,Cardiology and Cardiovascular Medicine ,Intensive care medicine ,Abscess ,medicine.disease ,business - Abstract
Curtis W. Bakal, MD, MPH, Chairman, David Sacks, MD, Dana R. Burke, MD, John F. Cardella, MD, Paramjit S. Chopra, MD, Steven L. Dawson, MD, Alain T. Drooz, MD, Neil Freeman, MD, Steven G. Meranze, MD, A. Van Moore, Jr, MD, Aubrey M. Palestrant, MD, Anne C. Roberts, MD, James B. Spies, MD, Eric J. Stein, MD, Richard Towbin, MD, for the Society of Interventional Radiology Standards of Practice Committee
- Published
- 1995
48. Quality improvement guidelines for central venous access
- Author
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Curtis A, Lewis, Timothy E, Allen, Dana R, Burke, John F, Cardella, Steven J, Citron, Patricia E, Cole, Alain T, Drooz, Elizabeth A, Drucker, Ziv J, Haskal, Louis G, Martin, A, Van Moore, Calvin D, Neithamer, Steven B, Oglevie, Kenneth S, Rholl, Anne C, Roberts, David, Sacks, Orestes, Sanchez, Anthony, Venbrux, and Curtis W, Bakal
- Published
- 2003
49. Quality improvement guidelines for adult diagnostic neuroangiography. Cooperative study between ASITN, ASNR, and SIR
- Author
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Steven J, Citron, Robert C, Wallace, Curtis A, Lewis, Robert C, Dawson, Jacques E, Dion, Allan J, Fox, James V, Manzione, Cynthia S, Payne, Frank J, Rivera, Eric J, Russell, David, Sacks, Wayne F, Yakes, and Curtis W, Bakal
- Published
- 2003
50. Angioplasty standard of practice
- Author
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James B, Spies, Curtis W, Bakal, Dana R, Burke, John F, Cardella, Alain, Drooz, Michael E, Edwards, James W, Husted, Aubrey M, Palestrant, Michael J, Pentecost, Anne C, Roberts, William F, Rogers, Millard C, Spencer, and Phillip J, Weyman
- Published
- 2003
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