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507 results on '"Srinivasa, Ravi N."'

1. Balloon-occluded middle adrenal artery embolization and percutaneous microwave ablation of a metastatic adrenal tumor from renal cell carcinoma

Author

Kao, Steven D, Division of Vascular and Interventional Radiology, Department of Radiology, Padia, Siddharth A, Moriarty, John M, and Srinivasa, Ravi N

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Oncology and Carcinogenesis, Biomedical Imaging, Rare Diseases, Kidney Disease, Cancer, Adrenal Gland Neoplasms, Arteries, Carcinoma, Renal Cell, Catheter Ablation, Humans, Kidney Neoplasms, Microwaves, Treatment Outcome, Nuclear Medicine & Medical Imaging, Clinical sciences
Abstract

Renal cell carcinomas present with locally advanced or metastatic disease in 25% of patients. Thermal ablation may be considered in selected patients with single-site or oligometastatic disease in selected patients. We describe single-session transarterial particle embolization with the assistance of a balloon-occlusion catheter and microwave ablation of a large hypervascular adrenal metastasis using cone beam CT and fluoroscopic XperGuide needle guidance.

Published
2022

2. Outcome of Children with Transjugular Intrahepatic Portosystemic Shunt: A Meta-Analysis of Individual Patient Data

Author

Deniz, Sinan, Schinner, Regina, Monroe, Eric J., Horslen, Simon, Srinivasa, Ravi N., Lv, Yong, Fan, Daiming, Han, Guohong, Sarma, Moinak Sen, Srivastava, Anshu, Poddar, Ujjal, Yadav, Rajanikant, Hoang, Thi Phuong Thao, Lange, Christian M., Öcal, Osman, Ricke, Jens, Seidensticker, Max, Lurz, Eberhard, Di Giorgio, Angelo, D’Antiga, Lorenzo, and Wildgruber, Moritz

Published
2023
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3. Looking beyond the gunsight: A potential bailout technique for arterial and venous recanalization

Author

Kao, Steven D, Department of Radiology, Radiology, Srinivasa, Ravi N, Callese, Tyler, Jamshidi, Neema, and Plotnik, Adam

Subjects
Biomedical and Clinical Sciences, Cardiovascular Medicine and Haematology, Cardiovascular, Femoral Artery, Humans, Portal Vein, Punctures, Stents, Treatment Outcome, Vena Cava, Inferior, Nuclear Medicine & Medical Imaging, Clinical sciences
Abstract

The "gunsight approach" was initially described as the use of overlapping snares and through- and-through puncture of the portal vein and inferior vena cava for the creation of a transcaval portosystemic shunt. This technique can be adapted for the creation of an extra-anatomic chan- nel between any 2 locations where snares can be deployed. We explain the technique, discuss finer technical points, and describe 2 cases where refractory vascular occlusions are crossed using this technique. The first case involves an extensively calcified femoral arterial chronic total occlusion where subintimal tracking past the occlusion is achieved, but luminal re-entry is ham- pered by dense calcific plaque refractory to multiple re-entry devices. The second case involves a chronic venous occlusion along the femoral vein with loss of in-line flow due to prior stenting. In both cases, the gunsight technique was successfully used as a bailout option after standard recanalization techniques were unsuccessful.

Published
2022

4. Concomitant AngioVac thrombectomy and patent foramen ovale closure in a patient with a large right atrial thrombus and recent paradoxical embolic stroke.

Author

Callese, Tyler E, Yang, Eric H, Levi, Daniel, Srinivasa, Ravi N, and Moriarty, John M

Abstract

A 59-year-old male with a history of gallbladder adenocarcinoma receiving chemotherapy and on therapeutic anticoagulation for portal vein thrombosis presented to the emergency department via ambulance after being found unresponsive and in cardiac arrest. Initial workup upon return of spontaneous circulation revealed a large right atrial mass, patent foramen ovale (PFO), and bilateral acute cortical infarctions. This constellation of findings were concerning for PFO-related paradoxical embolic strokes. Given the risk of recurrent paradoxical embolic events and the absolute contraindication to thrombolysis due to recent cerebral infarction, the decision was made to proceed with percutaneous vacuum-assisted thrombectomy using the AngioVac device. To prevent intraoperative thrombus propagation, PFO-closure was performed immediately prior to thrombectomy. Aspiration thrombectomy and PFO-closure were successful with complete thrombus removal and no intraoperative thrombus propagation. This case presents a minimally invasive and rapid treatment for a complex problem. An efficient and effective interdisciplinary team-based approach allowed the patient to resume cancer treatment relatively unabated.

Published
2021

5. Aortoesophageal fistula involving the central aortic arch salvaged with emergent percutaneous TEVAR, great vessel coverage and in vivo graft fenestration

Author

Lee, Shimwoo, Division of Vascular and Interventional Radiology, Department of Radiology, Srinivasa, Ravi N, Rigberg, David A, Yanagawa, Jane, Benharash, Peyman, Moriarty, John M, Division of Vascular Surgery, Department of Surgery, and Division of Thoracic Surgery, Department of Surgery

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Cardiovascular, Adult, Aorta, Thoracic, Aortic Diseases, Blood Vessel Prosthesis Implantation, Endovascular Procedures, Esophageal Fistula, Female, Gastrointestinal Hemorrhage, Humans, Stents, Treatment Outcome, Vascular Fistula, Nuclear Medicine & Medical Imaging, Clinical sciences
Abstract

Immediate intervention is needed for aortoesophageal fistulas (AEF), a rare but highly lethal cause of massive gastrointestinal hemorrhage. Emergent thoracic endovascular aortic repair (TEVAR) is considered first-line treatment for massive bleeding from AEFs. We describe an unusual and challenging case of TEVAR coverage of an AEF involving the central aortic arch immediately followed by in vivo endograft fenestration to regain arch vessel perfusion. In vivo fenestration, currently a procedure for emergency or investigational purposes only, was shown to be life saving in our case. The main complications associated with the procedure included stroke and infection, requiring esophagectomy and cervical diversion as well as ongoing antibiotic treatment.

Published
2021

6. Minimally Invasive Repair of Ascending Aortic Pseudoaneurysms: An Alternative to Open Surgical Repair in High-Risk Patients.

Author

Zucker, David J S, Smith, Aaron, Srinivasa, Ravi N, Yang, Eric H, Kwon, Murray H, and Moriarty, John M

Abstract

Development of a pseudoaneurysm of the ascending aorta is an uncommon complication of aortic surgery. Several nonsurgical techniques are available for treatment of ascending aortic pseudoaneurysms (AAPs). This report outlines a single-center retrospective experience with 14 nonsurgical procedures for treatment of AAPs in 10 patients. Modified stent grafts, septal defect occlusion devices, coil embolics, and liquid embolics were deployed by transthoracic and endovascular approaches. Complete stasis of the AAP was achieved in 7 of 10 patients (70%). Mean postprocedural recoveries occurred within 3.5 days. Nonsurgical techniques for repair of AAPs offer a comparatively safe and effective alternative to open surgical repair.

Published
2020

7. Percutaneous Biliary Interventions

Author

Bundy, Jacob J., Chick, Jeffrey Forris Beecham, Srinivasa, Ravi N., Chand, Rajat, editor, Eltorai, Adam E. M., editor, Healey, Terrance, editor, and Ahn, Sun, editor

Published
2022
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12. Burnout among Interventional Radiologists

Author

Bundy, Jacob J., Hage, Anthony N., Srinivasa, Ravi N., Gemmete, Joseph J., Lee, Eunjee, Gross, Jonathan S., Healey, Travis L., Solberg, Agnieszka O., Monroe, Eric J., and Chick, Jeffrey Forris Beecham

Published
2020
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30. #InterventionalRadiology

Author

Hage, Anthony N., Chick, Jeffrey Forris Beecham, Jeffers, Brian, Srinivasa, Rajiv N., Gemmete, Joseph J., and Srinivasa, Ravi N.

Published
2018
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