The Experts below are selected from a list of 294 Experts worldwide ranked by ideXlab platform

P. Chan - One of the best experts on this subject based on the ideXlab platform.

  • Large-volume iodinated Contrast Medium Extravasation: low frequency and good outcome after conservative management in a single-centre cohort of more than 67,000 patients.
    European radiology, 2018
    Co-Authors: Shee Yen Tay, Hsiu-chin Chang, P. Chan
    Abstract:

    Our aim was to retrospectively investigate the frequency and outcome of large-volume iodinated Contrast Medium (CM) Extravasation in our institution and to compare our management protocol to current practice. Institutional review board approval was obtained, and informed consent was waived because the study was retrospective. From January 2008 to September 2016, radiological examinations with intravenous non-ionic iodinated CM administration were performed in 67,129 patients. Contrast Medium Extravasation events on CT scans and intravenous pyelograms but not on angiograms were included. All data were collected prospectively and stratified according to age, injection method (manual vs auto-injection), prevention of Extravasation by various means (including intercom alarm), management of Extravasation (routine application of silver sulfadiazine ointment, clobetasol propionate cream, and damp gauze at room temperature), etc. The incidence of large-volume CM Extravasation was very low (0.04% [27/67,129] overall; 0.03% related to manual injection [age range, 59-92 years; mean, 75.4 years], and 0.045% related to auto-injection [age range, 36-86 years; mean, 65.8 years]). The CM Extravasation volume in majority of patients was 20–40 ml in 5 of 9 patients (55.6%) in the manual injection group and 14 of 18 (77.8%) in the auto-injection group. Swelling and pain were the most common symptoms. No patient developed severe signs or needed surgical intervention. Results show a very low incidence of large-volume CM Extravasation without severe complications or sequelae. The casual effect between our protocols and good outcome cannot be scrutinised thoroughly because the study lacks a control group and is retrospective. • The incidence of large-volume Contrast Medium Extravasation (≥20 ml) was 0.04%. • No patient needed surgical intervention, and most recovered within 7 days. • Each element of our management protocol contributed to good outcome.

  • Patient safety during radiological examinations: a nationwide survey of residency training hospitals in Taiwan
    BMJ open, 2016
    Co-Authors: Yuan Hao Lee, Clayton Chi Chang Chen, San Kan Lee, Cheng Yu Chen, Yung-liang Wan, Wan Yuo Guo, Amy Cheng, P. Chan
    Abstract:

    Variations in radiological examination procedures and patient load lead to variations in standards of care related to patient safety and healthcare quality. To understand the status of safety measures to protect patients undergoing radiological examinations at residency training hospitals in Taiwan, a follow-up survey evaluating the full spectrum of diagnostic radiology procedures was conducted. Questionnaires covering 12 patient safety-related themes throughout the examination procedures were mailed to the departments of diagnostic radiology with residency training programmes in 19 medical centres (with >500 beds) and 17 smaller local institutions in Taiwan. After receiving the responses, all themes in 2014 were compared between medical centres and local institutions by using χ(2) or 2-sample t-tests. Radiology Directors or Technology Chiefs of medical centres and local institutions in Taiwan participated in this survey by completing and returning the questionnaires. The response rates of medical centres and local institutions were 95% and 100%, respectively. As indicated, large medical centres carried out more frequent clinically ordered, radiologist-guided patient education to prepare patients for specific examinations (CT, 28% vs 6%; special procedures, 78% vs 44%) and incident review and analysis (89% vs 47%); however, they required significantly longer access time for MRI examinations (7.00±29.50 vs 3.50±3.50 days), had more yearly incidents of large-volume Contrast-Medium Extravasation (2.75±1.00 vs 1.00±0.75 cases) and blank radiographs (41% vs 8%), lower monthly rates of suboptimal (but interpretable) radiographs (0.00±0.01% vs 0.64±1.84%) and high-risk reminder reporting (0.01±0.16% vs 1.00±1.75%) than local institutions. Our study elucidates the status of patient safety in diagnostic radiology in Taiwan, thereby providing helpful information to improve patient safety guidelines needed for medical imaging in the future. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Shee Yen Tay - One of the best experts on this subject based on the ideXlab platform.

  • Large-volume iodinated Contrast Medium Extravasation: low frequency and good outcome after conservative management in a single-centre cohort of more than 67,000 patients
    European Radiology, 2018
    Co-Authors: Chih-hsiang Ko, Shee Yen Tay, Hsiu-chin Chang, Wing P Chan
    Abstract:

    ObjectivesOur aim was to retrospectively investigate the frequency and outcome of large-volume iodinated Contrast Medium (CM) Extravasation in our institution and to compare our management protocol to current practice.MethodsInstitutional review board approval was obtained, and informed consent was waived because the study was retrospective. From January 2008 to September 2016, radiological examinations with intravenous non-ionic iodinated CM administration were performed in 67,129 patients. Contrast Medium Extravasation events on CT scans and intravenous pyelograms but not on angiograms were included. All data were collected prospectively and stratified according to age, injection method (manual vs auto-injection), prevention of Extravasation by various means (including intercom alarm), management of Extravasation (routine application of silver sulfadiazine ointment, clobetasol propionate cream, and damp gauze at room temperature), etc.ResultsThe incidence of large-volume CM Extravasation was very low (0.04% [27/67,129] overall; 0.03% related to manual injection [age range, 59-92 years; mean, 75.4 years], and 0.045% related to auto-injection [age range, 36-86 years; mean, 65.8 years]). The CM Extravasation volume in majority of patients was 20–40 ml in 5 of 9 patients (55.6%) in the manual injection group and 14 of 18 (77.8%) in the auto-injection group. Swelling and pain were the most common symptoms. No patient developed severe signs or needed surgical intervention.ConclusionsResults show a very low incidence of large-volume CM Extravasation without severe complications or sequelae. The casual effect between our protocols and good outcome cannot be scrutinised thoroughly because the study lacks a control group and is retrospective.Key Points• The incidence of large-volume Contrast Medium Extravasation (≥20 ml) was 0.04%. • No patient needed surgical intervention, and most recovered within 7 days. • Each element of our management protocol contributed to good outcome.

  • Large-volume iodinated Contrast Medium Extravasation: low frequency and good outcome after conservative management in a single-centre cohort of more than 67,000 patients.
    European radiology, 2018
    Co-Authors: Shee Yen Tay, Hsiu-chin Chang, P. Chan
    Abstract:

    Our aim was to retrospectively investigate the frequency and outcome of large-volume iodinated Contrast Medium (CM) Extravasation in our institution and to compare our management protocol to current practice. Institutional review board approval was obtained, and informed consent was waived because the study was retrospective. From January 2008 to September 2016, radiological examinations with intravenous non-ionic iodinated CM administration were performed in 67,129 patients. Contrast Medium Extravasation events on CT scans and intravenous pyelograms but not on angiograms were included. All data were collected prospectively and stratified according to age, injection method (manual vs auto-injection), prevention of Extravasation by various means (including intercom alarm), management of Extravasation (routine application of silver sulfadiazine ointment, clobetasol propionate cream, and damp gauze at room temperature), etc. The incidence of large-volume CM Extravasation was very low (0.04% [27/67,129] overall; 0.03% related to manual injection [age range, 59-92 years; mean, 75.4 years], and 0.045% related to auto-injection [age range, 36-86 years; mean, 65.8 years]). The CM Extravasation volume in majority of patients was 20–40 ml in 5 of 9 patients (55.6%) in the manual injection group and 14 of 18 (77.8%) in the auto-injection group. Swelling and pain were the most common symptoms. No patient developed severe signs or needed surgical intervention. Results show a very low incidence of large-volume CM Extravasation without severe complications or sequelae. The casual effect between our protocols and good outcome cannot be scrutinised thoroughly because the study lacks a control group and is retrospective. • The incidence of large-volume Contrast Medium Extravasation (≥20 ml) was 0.04%. • No patient needed surgical intervention, and most recovered within 7 days. • Each element of our management protocol contributed to good outcome.

Wing P Chan - One of the best experts on this subject based on the ideXlab platform.

  • Large-volume iodinated Contrast Medium Extravasation: low frequency and good outcome after conservative management in a single-centre cohort of more than 67,000 patients
    European Radiology, 2018
    Co-Authors: Chih-hsiang Ko, Shee Yen Tay, Hsiu-chin Chang, Wing P Chan
    Abstract:

    ObjectivesOur aim was to retrospectively investigate the frequency and outcome of large-volume iodinated Contrast Medium (CM) Extravasation in our institution and to compare our management protocol to current practice.MethodsInstitutional review board approval was obtained, and informed consent was waived because the study was retrospective. From January 2008 to September 2016, radiological examinations with intravenous non-ionic iodinated CM administration were performed in 67,129 patients. Contrast Medium Extravasation events on CT scans and intravenous pyelograms but not on angiograms were included. All data were collected prospectively and stratified according to age, injection method (manual vs auto-injection), prevention of Extravasation by various means (including intercom alarm), management of Extravasation (routine application of silver sulfadiazine ointment, clobetasol propionate cream, and damp gauze at room temperature), etc.ResultsThe incidence of large-volume CM Extravasation was very low (0.04% [27/67,129] overall; 0.03% related to manual injection [age range, 59-92 years; mean, 75.4 years], and 0.045% related to auto-injection [age range, 36-86 years; mean, 65.8 years]). The CM Extravasation volume in majority of patients was 20–40 ml in 5 of 9 patients (55.6%) in the manual injection group and 14 of 18 (77.8%) in the auto-injection group. Swelling and pain were the most common symptoms. No patient developed severe signs or needed surgical intervention.ConclusionsResults show a very low incidence of large-volume CM Extravasation without severe complications or sequelae. The casual effect between our protocols and good outcome cannot be scrutinised thoroughly because the study lacks a control group and is retrospective.Key Points• The incidence of large-volume Contrast Medium Extravasation (≥20 ml) was 0.04%. • No patient needed surgical intervention, and most recovered within 7 days. • Each element of our management protocol contributed to good outcome.

Hsiu-chin Chang - One of the best experts on this subject based on the ideXlab platform.

  • Large-volume iodinated Contrast Medium Extravasation: low frequency and good outcome after conservative management in a single-centre cohort of more than 67,000 patients
    European Radiology, 2018
    Co-Authors: Chih-hsiang Ko, Shee Yen Tay, Hsiu-chin Chang, Wing P Chan
    Abstract:

    ObjectivesOur aim was to retrospectively investigate the frequency and outcome of large-volume iodinated Contrast Medium (CM) Extravasation in our institution and to compare our management protocol to current practice.MethodsInstitutional review board approval was obtained, and informed consent was waived because the study was retrospective. From January 2008 to September 2016, radiological examinations with intravenous non-ionic iodinated CM administration were performed in 67,129 patients. Contrast Medium Extravasation events on CT scans and intravenous pyelograms but not on angiograms were included. All data were collected prospectively and stratified according to age, injection method (manual vs auto-injection), prevention of Extravasation by various means (including intercom alarm), management of Extravasation (routine application of silver sulfadiazine ointment, clobetasol propionate cream, and damp gauze at room temperature), etc.ResultsThe incidence of large-volume CM Extravasation was very low (0.04% [27/67,129] overall; 0.03% related to manual injection [age range, 59-92 years; mean, 75.4 years], and 0.045% related to auto-injection [age range, 36-86 years; mean, 65.8 years]). The CM Extravasation volume in majority of patients was 20–40 ml in 5 of 9 patients (55.6%) in the manual injection group and 14 of 18 (77.8%) in the auto-injection group. Swelling and pain were the most common symptoms. No patient developed severe signs or needed surgical intervention.ConclusionsResults show a very low incidence of large-volume CM Extravasation without severe complications or sequelae. The casual effect between our protocols and good outcome cannot be scrutinised thoroughly because the study lacks a control group and is retrospective.Key Points• The incidence of large-volume Contrast Medium Extravasation (≥20 ml) was 0.04%. • No patient needed surgical intervention, and most recovered within 7 days. • Each element of our management protocol contributed to good outcome.

  • Large-volume iodinated Contrast Medium Extravasation: low frequency and good outcome after conservative management in a single-centre cohort of more than 67,000 patients.
    European radiology, 2018
    Co-Authors: Shee Yen Tay, Hsiu-chin Chang, P. Chan
    Abstract:

    Our aim was to retrospectively investigate the frequency and outcome of large-volume iodinated Contrast Medium (CM) Extravasation in our institution and to compare our management protocol to current practice. Institutional review board approval was obtained, and informed consent was waived because the study was retrospective. From January 2008 to September 2016, radiological examinations with intravenous non-ionic iodinated CM administration were performed in 67,129 patients. Contrast Medium Extravasation events on CT scans and intravenous pyelograms but not on angiograms were included. All data were collected prospectively and stratified according to age, injection method (manual vs auto-injection), prevention of Extravasation by various means (including intercom alarm), management of Extravasation (routine application of silver sulfadiazine ointment, clobetasol propionate cream, and damp gauze at room temperature), etc. The incidence of large-volume CM Extravasation was very low (0.04% [27/67,129] overall; 0.03% related to manual injection [age range, 59-92 years; mean, 75.4 years], and 0.045% related to auto-injection [age range, 36-86 years; mean, 65.8 years]). The CM Extravasation volume in majority of patients was 20–40 ml in 5 of 9 patients (55.6%) in the manual injection group and 14 of 18 (77.8%) in the auto-injection group. Swelling and pain were the most common symptoms. No patient developed severe signs or needed surgical intervention. Results show a very low incidence of large-volume CM Extravasation without severe complications or sequelae. The casual effect between our protocols and good outcome cannot be scrutinised thoroughly because the study lacks a control group and is retrospective. • The incidence of large-volume Contrast Medium Extravasation (≥20 ml) was 0.04%. • No patient needed surgical intervention, and most recovered within 7 days. • Each element of our management protocol contributed to good outcome.

Mark J. Sands - One of the best experts on this subject based on the ideXlab platform.

  • Effectiveness of coil embolization in angiographically detectable versus non-detectable sources of upper gastrointestinal hemorrhage.
    Journal of vascular and interventional radiology : JVIR, 2009
    Co-Authors: Siddharth A. Padia, Michael A. Geisinger, James S. Newman, Gregory Pierce, Nancy A. Obuchowski, Mark J. Sands
    Abstract:

    To determine whether the effectiveness of arterial embolization in patients with acute upper gastrointestinal hemorrhage is related to the visualization of Contrast Medium Extravasation at angiography. Transcatheter embolization was performed in 108 patients who experienced acute upper gastrointestinal hemorrhage during a 5-year period. Patient charts were retrospectively reviewed. Thirty-six patients who underwent embolization after angiography demonstrated active Contrast Medium Extravasation from an involved artery. Seventy-two patients underwent embolization in the absence of Contrast Medium Extravasation into a bowel lumen. Embolization technique, requirement for further blood products, need for further surgery, and 30-day mortality were recorded. The gastroduodenal artery (GDA) was embolized in 26 of the 36 patients (72%) with Extravasation, and the left gastric artery was embolized in 10 (28%). The GDA was embolized in 64 of the 72 patients (89%) without Extravasation, and the left gastric artery was embolized in 13 (18%). After embolization, 23 of the 36 patients (64%) with Extravasation and 44 of the 72 (61%) without Extravasation required additional blood product transfusions. Seven of the 36 patients (19%) with Extravasation and 16 of the 72 (22%) without Extravasation required subsequent surgery secondary to bleeding. Thirty-day hemorrhage-related mortality was 17% (six of 36 patients) in the positive Extravasation group and 22% (16 of 72 patients) in the negative Extravasation group. The treatment success rate was 44% (16 of 36 patients) in the positive Extravasation group and 44% (32 of 72 patients) in the negative Extravasation group. In patients with acute upper gastrointestinal hemorrhage, arterial embolization is equally effective in patients who demonstrate active Contrast Medium Extravasation at angiography as in those who do not show Contrast Extravasation.