The Official Journal of the Japanese Society of Interventional Radiology
Online ISSN : 2185-6451
Print ISSN : 1340-4520
ISSN-L : 1340-4520
Volume 29, Issue 2
Displaying 1-15 of 15 articles from this issue
State of the Art
Interventional Radiology for Nontraumatic Bleeding
  • Katsumi Hayakawa, Masato Tanikake
    2014 Volume 29 Issue 2 Pages 121-126
    Published: 2014
    Released on J-STAGE: April 22, 2015
    JOURNAL RESTRICTED ACCESS
    Massive hemoptysis is one of the most dreaded of all respiratory emergencies and can have a variety of underlying causes. Bronchial artery embolization (BAE) is a relatively safe treatment for refractory hemoptysis. However, non-bronchial systemic arteries can be a significant source of massive hemoptysis and a cause of recurrence after successful BAE. Moreover, a highly-advanced catheter technique is required because of the smaller arterial size, advanced patient’s age and a dangerous complication such as spinal cord injury. In this review, we discuss the indications and contraindications for IVR with the pathophysiologic features of massive bleeding, the importance of MD-CT and CTA before BAE, the technique with the characteristics of the various embolic agents used in the procedure, short-term and long-term results and possible complications.
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  • Shinsaku Yata
    2014 Volume 29 Issue 2 Pages 127-133
    Published: 2014
    Released on J-STAGE: April 22, 2015
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    Non-traumatic arterial bleeding of gastrointestinal (GI) tract is associated with potential morbidity and mortality. When it fails to achieve hemostasis by an endoscopic measure, transcatheter arterial embolization (TAE) is a good treatment option with a high rate of hemostasis and a low rate of ischemic complication. Various kinds of embolic materials including gelatin sponge particles, metallic coils, and N-butyl-2-cyanoacrylate (NBCA) may be used. Each embolic agent has its own characteristics, benefits and drawbacks that interventionalists need to be familiar with. The choice of embolic agent depends on a combination of the bleeding location, vascular anatomy, achievable catheter position, and the operator’s preference. Evaluation of the angiographic findings is also important. Not only direct signs of GI bleeding like extravasation of contrast medium, but also indirect signs including pseudoaneurysm, vessel spasm or cutoff, and increased vascularity must not to be missed. Provocative angiography or empiric embolization may be useful when the bleeding site cannot be identified angiographically. Compared with TAE, intraarterial vasopressin infusion therapy has disadvantages of a high recurrent bleeding rate and a long-term placement of catheter, but is still probably preferable for diffuse lesions.
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  • Hiroyuki Morishita, Yoshito Takeuchi, Takaaki Itou
    2014 Volume 29 Issue 2 Pages 134-139
    Published: 2014
    Released on J-STAGE: April 22, 2015
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    Vascular embolization is now used as a surgical alternative for non-traumatic and traumatic arterial bleeding.
    In this report, we describe the outline of percutaneous hemostatic procedures for non-traumatic hepatic or pancreatic arterial bleeding.
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  • Keitaro Sofue, Masato Yamaguchi, Naoto Katayama, Akhmadu Muradi, Eisuk ...
    2014 Volume 29 Issue 2 Pages 140-146
    Published: 2014
    Released on J-STAGE: April 22, 2015
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    Spontaneous retroperitoneal hemorrhage (SRH) is defined as a retroperitoneal hemorrhage that occurs without proceeding trauma or any underlying pathology. Survival of patients with SRH depends on rapid and accurate diagnosis followed by imperative management, as the bleeding is often insidious and initially unrecognized. Management had mainly consisted of conservative treatment including cessation or reversal of the anticoagulation, fluid resuscitation, and transfusion previously. Although endovascular intervention of transarterial embolization (TAE) for retroperitoneal hemorrhage caused by trauma or iatrogenic injury is an established procedure, TAE for SRH has been controversial due to its unknown pathophysiology and occult diffuse microvascular bleeding. There is therefore no contemporary consensus to suggest when to attempt transarterial embolization in the treatment of SRH.
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  • Misako Nishio, Shingo Hamaguchi, Yukihisa Ogawa, Yasunori Arai, Kazuki ...
    2014 Volume 29 Issue 2 Pages 147-152
    Published: 2014
    Released on J-STAGE: April 22, 2015
    JOURNAL RESTRICTED ACCESS
    Transcatheter arterial embolization has become a major treatment modality in a variety of obstetric and gynecologic applications.
    We describe three items mainly (1)The pitfall in IR obstetric hemorrhage (2)Selection of embolic material (3)Bleeding by tumor necrosis.
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