The Experts below are selected from a list of 225 Experts worldwide ranked by ideXlab platform
Marc A Huntoon - One of the best experts on this subject based on the ideXlab platform.
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the vertebral artery is unlikely to be the sole source of vascular complications occurring during stellate ganglion block
Pain Practice, 2010Co-Authors: Marc A HuntoonAbstract:Introduction: Stellate ganglion block (SGB) is commonly performed for upper extremity complex regional pain syndrome and other conditions. Known complications of stellate block include Horner's syndrome, hoarseness, hematoma formation, airway compromise, immediate seizure (presumably from vertebral artery injection), and death. A previous arterial anatomy study demonstrated other vessels, eg, the ascending and deep cervical arteries, reinforcing the blood supply of the spinal cord and brain stem. The potential role of these vessels in the pathogenesis of seizures or hematoma during SGB has not been studied. Methods: The anatomical recording log from 10 cadaver dissections and photographic records of same were reviewed to ascertain the presence of the ascending or deep cervical arteries, or other branches emanating from the thyrocervical or Costocervical Trunk and their relationship to the medial anterior surface of the C6 and C7 transverse processes. Results: In 4 cases, as determined by the dissection log, and in 6 cases, determined by photographic images, the ascending cervical artery or a branch from the thyrocervical Trunk passed over the anterior aspect of the transverse processes of C6 or C7. Discussion: Arterial vessels other than the vertebral artery that also supply the anterior spinal cord and brain stem pass directly anterior to the transverse processes at the most common sites of the SGB. It is anatomically possible, therefore, that accidental injection or induced spasm of these vessels and not the vertebral arteries is responsible for some cases of seizure, hematoma, or other vascular complications during SGB.
D Picus - One of the best experts on this subject based on the ideXlab platform.
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Delayed rupture of a pseudoaneurysm of the Costocervical Trunk: treatment with therapeutic embolization.
Radiology, 1991Co-Authors: E V Lang, D PicusAbstract:Fourteen days after removal of an internal jugular catheter inserted prior to renal transplantation, a patient presented with brisk arterial hemorrhage from the insertion site. The hemorrhage, caused by a ruptured pseudoaneurysm of the Costocervical Trunk, was controlled by transcatheter embolization with gelatin particles. One year later the patient reported no problems related to the pseudoaneurysm or its management.
Satoshi Nara - One of the best experts on this subject based on the ideXlab platform.
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Successful management of retropharyngeal hematoma by trans-arterial embolism without intubation.
International journal of emergency medicine, 2021Co-Authors: Gaku Sugiura, Hiroyuki Takahashi, Yoshihisa Kodama, Satoshi NaraAbstract:Retropharyngeal hematoma can cause suffocation if there is delay in securing the airway by intubation. However, there are also concerns about complications that can arise with intubation; it is still unknown which cases do not require intubation. An 88-year-old woman slipped and was found prone and was transported to the emergency room. She was alert without any stridor. Physical examination revealed a subcutaneous hematoma in the anterior cervical region. Computed tomography revealed a retropharyngeal hematoma. Angiography and computed tomography angiography showed extravasation from the right Costocervical Trunk. A radiologist performed trans-arterial embolization, and she had an uneventful course without intubation or developing any complication. She became ambulatory on postoperative day 5. Angiography and computed tomography angiography help in early recognition of extravasation in retropharyngeal hematoma, and trans-arterial embolization can help to avoid intubation and its complications.
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Successful management of retropharyngeal hematoma by trans-arterial embolism without intubation
International Journal of Emergency Medicine, 2021Co-Authors: Gaku Sugiura, Hiroyuki Takahashi, Yoshihisa Kodama, Satoshi NaraAbstract:Background Retropharyngeal hematoma can cause suffocation if there is delay in securing the airway by intubation. However, there are also concerns about complications that can arise with intubation; it is still unknown which cases do not require intubation. Case presentation An 88-year-old woman slipped and was found prone and was transported to the emergency room. She was alert without any stridor. Physical examination revealed a subcutaneous hematoma in the anterior cervical region. Computed tomography revealed a retropharyngeal hematoma. Angiography and computed tomography angiography showed extravasation from the right Costocervical Trunk. A radiologist performed trans-arterial embolization, and she had an uneventful course without intubation or developing any complication. She became ambulatory on postoperative day 5. Conclusion Angiography and computed tomography angiography help in early recognition of extravasation in retropharyngeal hematoma, and trans-arterial embolization can help to avoid intubation and its complications.
Niranjan Khandelwal - One of the best experts on this subject based on the ideXlab platform.
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Non-bronchial causes of haemoptysis: imaging and interventions.
Polish journal of radiology, 2020Co-Authors: Manphool Singhal, Anupam Lal, Nidhi Prabhakar, Mukesh K Yadav, Rajesh Vijayvergiya, Digamber Behra, Niranjan KhandelwalAbstract:To describe non-bronchial causes of haemoptysis on imaging and the role of interventional radiology in their management from cases of haemoptysis archived from our database at a tertiary care, federally funded institution. Retrospective analysis of cases that presented with haemoptysis in our institution from 2008 to 2013 was done, and details of cases in which the bleeding was from a non-bronchial source were archived and details of imaging and treatment were recorded. Retrospective analysis of patients presenting with haemoptysis yielded 24 (n = 24) patients having haemoptysis from non-bronchial sources. Causes of haemoptysis were: Rasmussen aneurysms (n = 12/24), Costocervical Trunk pseudoaneurysm (n = 1/24), left internal mammillary artery pseudoaneurysm (n = 1/24), left ventricular aneurysms (n = 3/24), pulmonary arteriovenous malformations (AVMs) (n = 5/24), and proximal interruption of pulmonary artery (n = 2/24). Imaging and interventional radiology management are described in detail. Haemoptysis can be from non-bronchial sources, which may be either from systemic or pulmonary arteries or cardio-pulmonary fistulas. Bronchial computed tomography angiography (CTBA), if feasible, must always be considered before bronchial artery embolisation because it precisely identifies the source of haemorrhage and vascular anatomy that helps the interventional radiologist in pre-procedural planning. This circumvents chances of re-bleed if standard bronchial artery embolisation is done without CTBA. Copyright © Polish Medical Society of Radiology 2020.
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Non-bronchial causes of haemoptysis: imaging and interventions
Polish Journal of Radiology, 2020Co-Authors: Manphool Singhal, Anupam Lal, Nidhi Prabhakar, Mukesh K Yadav, Rajesh Vijayvergiya, Digamber Behra, Niranjan KhandelwalAbstract:Purpose To describe non-bronchial causes of haemoptysis on imaging and the role of interventional radiology in their management from cases of haemoptysis archived from our database at a tertiary care, federally funded institution. Material and methods Retrospective analysis of cases that presented with haemoptysis in our institution from 2008 to 2013 was done, and details of cases in which the bleeding was from a non-bronchial source were archived and details of imaging and treatment were recorded. Results Retrospective analysis of patients presenting with haemoptysis yielded 24 (n = 24) patients having haemoptysis from non-bronchial sources. Causes of haemoptysis were: Rasmussen aneurysms (n = 12/24), Costocervical Trunk pseudoaneurysm (n = 1/24), left internal mammillary artery pseudoaneurysm (n = 1/24), left ventricular aneurysms (n = 3/24), pulmonary arteriovenous malformations (AVMs) (n = 5/24), and proximal interruption of pulmonary artery (n = 2/24). Imaging and interventional radiology management are described in detail. Conclusions Haemoptysis can be from non-bronchial sources, which may be either from systemic or pulmonary arteries or cardio-pulmonary fistulas. Bronchial computed tomography angiography (CTBA), if feasible, must always be considered before bronchial artery embolisation because it precisely identifies the source of haemorrhage and vascular anatomy that helps the interventional radiologist in pre-procedural planning. This circumvents chances of re-bleed if standard bronchial artery embolisation is done without CTBA.
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An unusual cause of hemoptysis: Costocervical Trunk pseudoaneurysm.
Emergency radiology, 2010Co-Authors: Manphool Singhal, Suresh Giragani, Anupam Lal, Aman Sharma, Niranjan KhandelwalAbstract:A 40-year-old male patient presented with recurrent bouts of hemoptysis over a period of 4 days amounting to a total quantity of 400 ml. On the evening of presentation to the hospital, he had a massive bout of hemoptysis of approximately 500 ml. He had a history of pulmonary tuberculosis (confirmed on sputum examination and imaging) for which he had not taken the complete course of antitubercular chemotherapy. His initial hemoglobin levels were 11 g/dl, and after the bout of hemoptysis dropped to 7 g/dl. His blood pressure was 100/70 mm Hg with postural hypotension. The result of the bronchoscopic examination was normal. The chest X-ray showed the presence of right upper lobe consolidation. The computed tomography (CT) angiography (using bolus tracking technique with the curser on the descending thoracic aorta) for evaluation of the bronchial vessels showed an abnormal enhancing lesion of approximately 1.3 × 1.4 × 1.2 cm seen on the right upper lobe near the posterior parietal pleura at the lung apex. The lesion was isodense to the surrounding contrast-enhanced subclavian artery branches, and the lesion was seen in relation to one of the branches of the second part of the right subclavian artery which was confirmed on coronal reformatted maximum intensity projections and volumerendered images to be the Costocervical Trunk (Figs.1, 2, 3). The right bronchial artery, right intercostal arteries, and right internal mammary artery were normal in diameter and course. A decision was taken to approach the lesion through an endovascular approach. The angiography was done via a right transfemoral route. Using a 5F PICARD catheter (Cook, Bloomington, USA), the selective injections of the right subclavian artery showed the presence of an approximately 1.5-cm diameter oval contrast-filled outpouching seen in relation to the highest intercostal branch of the Costocervical Trunk. Superselective cannulation of this branch was done by using a 2.7F Progreat microcatheter (Terumo, NJ, USA), and the pseudoaneurysm was embolized using n-butyl cyanoacrylate (NBCA) (Endocryl, Samarth Life Sciences Limited, Solan, India) mixed with lipiodol (Lipiodol Ultra-Fluide, Guerbet, Istanbul) (50% mixture, total of about 1 ml). After the embolization, the patient was followed up for 3 months and there was no recurrence of hemoptysis noted. M. Singhal (*) : S. Giragani :A. Lal :N. Khandelwal Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India 160012 e-mail: drmsinghal@yahoo.com
E V Lang - One of the best experts on this subject based on the ideXlab platform.
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Delayed rupture of a pseudoaneurysm of the Costocervical Trunk: treatment with therapeutic embolization.
Radiology, 1991Co-Authors: E V Lang, D PicusAbstract:Fourteen days after removal of an internal jugular catheter inserted prior to renal transplantation, a patient presented with brisk arterial hemorrhage from the insertion site. The hemorrhage, caused by a ruptured pseudoaneurysm of the Costocervical Trunk, was controlled by transcatheter embolization with gelatin particles. One year later the patient reported no problems related to the pseudoaneurysm or its management.
