24 research outputs found
Recovery of baseline renal function after treatment for prolonged in-stent artery thrombosis, in a COVID-19 positive patient: a case report
Objective: Acute renal in-stent thrombosis is common, especially after complex endovascular treatments, or in case of risk factors such as Covid-19 infection. Irreversible renal damage occurred when the renal artery was occluded for more than 3 hours. In this case, we present a case of renal function recovery after
thromboaspiration of a renal stent thrombosis for more than 72 hours.
Case presentation: A 88-year-old man who tested positive for COVID-19 presented to the emergency room with dyspnea and anuria. He referred a previous complex endovascular intervention with the triple chimney technique (ChEVAR). More than 72 hours passed between the onset of symptoms to the diagnosis of acute renal intra-stent thrombosis. He underwent urgent thromboaspiration with neurovascular devices returning to his baseline renal function.
Conclusion: Despite the prolonged ischemia, renal revascularization with thromboaspiration restored renal function and rescued the remaining renal parenchym
Can New Ultrasound Imaging Techniques Improve Breast Lesion Characterization? Prospective Comparison between Ultrasound BI-RADS and Semi-Automatic Software âSmartBreastâ, Strain Elastography, and Shear Wave Elastography
Background: Ultrasound plays a crucial role in early diagnosis of breast cancer. The aim of this research is to evaluate the diagnostic performance of BI-RADS classification in comparison with new semi-automatic software Resona R9, Mindray, âSmartBreastâ and strain elastography (SE), point shear wave (pSWE), and 2D shear wave (2D SWE) Elastography for breast lesion differentiation. Methods: Ninety-two breast nodules classified according to BI-RADS lexicon by an expert radiologist were evaluated by a second investigator with B-mode ultrasound, color Doppler, âSmartBreastâ, and elastography. Histopathology was considered the gold standard. Results: The agreement between software and investigator was excellent in the identification of the posterior features of breast masses (Cohenâs k = 0.94), good for shape and vascular signal (Cohenâs k, respectively, of 0.6 and 0.65), poor for orientation, margins, and echo pattern (Cohenâs k, respectively, of 0.28, 0.33 and 0.48), moderate for dimensions (Linâs correlation coefficient of 0.90, p = 0.07). SE showed a greater area under curve (AUC) than pSWE and 2D SWE (0.84, 0.64, and 0.61, respectively), with a greater specificity and a comparable sensitivity to pSWE (respectively, of 0.86 and 0.55, 0.81 and 0.84). Conclusions: SE improved the diagnostic performance of BI-RADS classification more than pSWE and 2D SWE; âSmartBreastâ showed good agreement only for shape and vascularization but not for the other ultrasound features of breast lesions
Clinical worsening despite intravenous thrombolysis in acute ischemic stroke secondary to carotid plaque rupture
First-line therapy of acute ischemic stroke is intravenous thrombolysis (IVT) irrespective of etiology. We report on a patient with acute ischemic stroke secondary to carotid plaque rupture who experienced plaque thrombosis and marked clinical worsening despite IVT. While the latter is the gold standard therapy optimal platelets inhibition should be guaranteed to allow a safe as possible carotid intervention. Hereby we discuss all available strategies to be considered in order to better individualized treatment decision-making
Recovery of baseline renal function after treatment for prolonged in-stent artery thrombosis, in a COVID-19 positive patient: a case report
Objective: Acute renal in-stent thrombosis is common, especially after complex endovascular treatments, or in case of risk factors such as Covid-19 infection. Irreversible renal damage occurred when the renal artery was occluded for more than 3 hours. In this case, we present a case of renal function recovery after thromboaspiration of a renal stent thrombosis for more than 72 hours.
Case presentation: A 88-year-old man who tested positive for COVID-19 presented to the emergency room with dyspnea and anuria. He referred a previous complex endovascular intervention with the triple chimney technique (ChEVAR). More than 72 hours passed between the onset of symptoms to the diagnosis of acute renal intra-stent thrombosis. He underwent urgent thromboaspiration with neurovascular devices returning to his baseline renal function.
Conclusion: Despite the prolonged ischemia, renal revascularization with thromboaspiration restored renal function and rescued the remaining renal parenchyma
Clinical worsening despite intravenous thrombolysis in acute ischemic stroke secondary to carotid plaque rupture
Quale ruolo ha lâeco-contrastografia nella valutazione dellâEndoleak nelle endoprotesi aortiche? Confronto tra CEUS e TC su ampia popolazione
The role of ceus in the evaluation of thyroid cancer: from diagnosis to local staging
Ultrasound often represents the first diagnostic step for thyroid nodule evaluation in clinical practice, but baseline US alone is not always effective enough to achieve thyroid nodule characterization. In the last decades new ultrasound techniques, such as CEUS, have been introduced to evaluate thyroid parenchyma as recommended by EFSUMB guidelines, for use in clinical research field, although its role is not yet clear. Several papers show the potential utility of CEUS in the differential diagnosis of benign and malignant thyroid nodules and in the analysis of lymph node involvement in neoplastic pathology. Therefore, we carried out an evaluation of the literature concerning the role of CEUS in three specific areas: the characterization of the thyroid nodule, the evaluation of minimally invasive treatment and locoâregional staging of the lymph node in proven thyroid cancer. According to evidence reported, CEUS can also play an operative role in nodular thyroid pathology as it is able to guide ablation procedures on thyroid nodule and metastatic lymph nodes, to assess the radicality of surgery, to evaluate disease relapse at the level of the margins of ablated regions and to monitor the clinical evolution of necrotic areas in immediate postâtreatment setting