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Biomedical subjects

S Heye

Publications and source records attributed to S Heye.

9 recordsLinked to original sources

Value of carbon dioxide wedged venography and transvenous liver biopsy in the definitive diagnosis of Abernethy malformation.

We report a 25-year-old man who presented with congenital absence of the portal vein, or Abernethy malformation, a rare congenital disorder in which the mesenteric and splenic venous drainages bypass the liver and directly drain into the inferior vena cava through an extrahepatic portosystemic shunt. Magnetic resonance imaging, which showed multiple nodular lesions in both liver lobes that were associated with an absence of intrahepatic portal venous branches, strongly suggested the diagnosis of the Abernethy malformation. Carbon dioxide wedged venography and transvenous liver biopsy, which were performed in the same session by a right jugular approach, confirmed these findings. This technique can be considered a valuable alternative diagnostic tool to catheter arteriography and percutaneous transhepatic liver biopsy.

Adult↗

Symptomatic stenosis of the cavernous portion of the internal carotid artery due to an irresectable medial sphenoid wing meningioma: treatment by endovascular stent placement.

A 48-year-old woman, with right-sided proptosis and decreased visual acuity, presented with acute left sensorimotor deficit. Recent ischemia in the right posterior watershed area was found on CT and MR imaging, as well as a right-sided medial sphenoid wing meningioma causing high-grade stenotic encasement of the cavernous portion of the right internal carotid artery. Because the patient was symptomatic and complete resection of the meningioma was impossible, the stenosis was successfully treated with a balloon-expanding stent.

Carotid Artery, Internal↗

Cerebral ischemia after filter-protected carotid artery stenting is common and cannot be predicted by the presence of substantial amount of debris captured by the filter device.

PURPOSE: Protected carotid artery stent placement is currently under clinical evaluation as a potential alternative to carotid endarterectomy. The current study was undertaken to determine the incidence of new ischemic lesions found on diffusion-weighted MR imaging (DWI) in nonselected patients after protected carotid artery stent placement using a filter device and to determine the potential relationship between these new ischemic lesions and the presence or absence of a clear amount of debris captured by the neuroprotection filter device. MATERIALS AND METHODS: A nonrandomized cohort of 52 patients (40 men, 12 women) presenting with carotid occlusive disease underwent protected carotid artery stent placement using a filter device. DWI obtained 1 day before stent placement was compared with that obtained 1 day after stent placement. In addition, the macroscopic and microscopic analysis of debris captured by the filter device during the carotid stent placement procedure was assessed. RESULTS: Neuroprotected carotid stent placement was technically successful in all 53 procedures but was complicated by a transient ischemic attack in 3 patients (5.6%). In 22 patients (41.5%), new ischemic lesions were found on DWI, and in 21 filter devices (39.6%), a substantial amount of atheromatous plaque and/or fibrin was found. No clear relationship between the presence of debris captured by the filter device and new lesions detected by DWI was found (P = .087; odds ratio 3.067). CONCLUSION: Neuroprotected carotid artery stent placement will not avoid silent cerebral ischemia. Systematic microscopic analysis of debris captured by the filter device has no predictive value for potential cerebral ischemia after carotid artery stent placement.

Aged↗

Cat-scratch disease osteomyelitis.

We report on a patient who presented with osteomyelitis of a rib and adjacent abscess as a rare and atypical manifestation of cat-scratch disease. Radiographic findings showed an osteolytic lesion with adjacent mass. Biopsy, serology and polymerase chain reaction technique are essential for the final diagnosis. Prognosis is excellent with full recovery.

Adult↗

Adrenocortical carcinoma with fat inclusion: case report.

Adrenocortical carcinoma is a rare tumor that arises from the adrenal cortex, with an estimated incidence of 0.5% to 2% per 1 million patients yearly. Although some fat content can be expected in hormonally active adrenocortical carcinomas, areas of 100% fat are extremely rare. We present a case of an adrenocortical carcinoma with a small focus of pure fat depicted on magnetic resonance imaging.

Adipose Tissue↗

Preoperative internal iliac artery coil embolization for aneurysms involving the iliac bifurcation.

Endovascular repair of abdominal aortic aneurysms involving the iliac artery, which is seen in about 20% of patients, requires extension of the stent-graft limb into the external iliac artery. Occlusion of the IIA is used to prevent a potential type II endoleak via retrograde flow in the IIA after covering the IIA origin with a stent-graft limb. In this article, the major indications for coil-embolization of the internal iliac artery in aneurysmal disease are reviewed and discussed, as well as the technique and the outcome regarding endoleak incidence and complications.

Angioplasty↗

Therapeutic embolization of a thoracoacromial artery perforated by placement of a deep venous catheter.

An 82-year-old man presented with massive external bleeding from the puncture site after placement of a deep venous catheter in the right subclavian vein. Emergent angiography revealed contrast extravasation along the central venous catheter tract due to perforation of the right thoracoacromial artery. Superselective catheterization of the bleeding artery followed by microparticle embolization definitively stopped the hemorrhage. During follow-up no recurrence of external bleeding was noted. Percutaneous embolization using microparticles is an effective tool to definitively treat iatrogenic arterial hemorrhage as a complication of deep venous catheter placement.

Acromion↗

Left ovarian Brenner tumor.

Ovarian Brenner tumors are uncommon neoplasms of the ovary, representing approximately 2% of all ovarian neoplasms. Nowadays there is general agreement that Brenner tumors are derived from the surface epithelium of the ovary or the pelvic mesothelium through transitional cell metaplasia. Association with other surface-derived neoplasms, either in the ipsilateral or contralateral ovary, is reported in 30% of the cases. We report a case of benign ovarian Brenner tumor and discuss the typical features on magnetic resonance imaging (MRI) and computed tomography (CT) scan as well as the differential diagnosis.

Aged↗